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Table of Contents
CLINICAL IMAGE
Year : 2019  |  Volume : 8  |  Issue : 4  |  Page : 199

Interstitial pregnancy


1 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkuo Branch; School of Medicine, Chang Gung University, Taoyuan, Taiwan
2 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkuo Branch, Taoyuan, Taiwan
3 School of Nursing, Taipei Medical University, Taipei, Taiwan

Date of Submission12-Sep-2019
Date of Decision07-Oct-2019
Date of Acceptance07-Oct-2019
Date of Web Publication24-Oct-2019

Correspondence Address:
Dr. Chih-Feng Yen
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch; No. 5, Fu-Hsin Street, Kwei-Shan, Tao-Yuan, 33305
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_100_19

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How to cite this article:
Yen CF, Lin YS, Lin SL. Interstitial pregnancy. Gynecol Minim Invasive Ther 2019;8:199

How to cite this URL:
Yen CF, Lin YS, Lin SL. Interstitial pregnancy. Gynecol Minim Invasive Ther [serial online] 2019 [cited 2019 Nov 19];8:199. Available from: http://www.e-gmit.com/text.asp?2019/8/4/199/269824



A 30-year-old woman, gravida 4, para 1, visited the outpatient department with prolonged vaginal bleeding and mild right lower abdomen pain at 9 weeks of gestation. Human chorionic gonadotropin level was 15,037 mIU/mL, and transvaginal ultrasonography showed an eccentrically located gestational sac with abundant blood supply [Figure 1]a. Laparoscopy revealed a bulging mass measuring 4 cm × 3 cm with a thin surrounding wall at the root of tubal insertion into the uterus [Figure 1]b. Right cornuotomy was performed to remove the embedded gestational tissues [Figure 1]c. The  Fallopian tube More Details was preserved by repairing with 1-0 monocryl [Figure 1]d. The patient recovered and conceived uneventfully 5 months later with healthy intrauterine pregnancy.
Figure 1: (a) Transvaginal ultrasonography revealed a gestation sac located outside the cavity with abundant blood supply, (b) laparoscopy found the ectopic site as a bulge at the uterotubal junction; the surrounding wall was thin with dilated vessels, (c) after cornuotomy, the gestational sac was removed with an endo-bag, (d) the tube was successfully preserved after suture repair

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Interstitial pregnancy is an ectopic pregnancy implanted in the tubal interstitial portion where it traverses through the uterine muscular wall for approximately 1–2 cm to enter the cavity.[1],[2],[3] Surgical management could be carried out with either cornual resection or cornuotomy.[4] Our case demonstrated typical pictures and a conservative process of the laparoscopic surgical treatment.

Ethical statement

This study was approved by the institutional review board of Chang Gung Medical Foundation (IRB No. 201901161B0 obtained on July 26th, 2019). IRB agrees to waive the informed consent.

Financial support and sponsorship

Nil.

Conflicts of interest.

There are no conflicts of interest.



 
  References Top

1.
Moawad NS, Mahajan ST, Moniz MH, Taylor SE, Hurd WW. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol 2010;202:15-29.  Back to cited text no. 1
    
2.
Cordeiro DE, Alves JA, Feitosa FE. Interstitial and angular pregnancies: Case reports and differential diagnosis. J Obstet Gynaecol Res 2018;44:1999-2002.  Back to cited text no. 2
    
3.
Kalidindi M, Shahid A, Odejinmi F. Expect the unexpected: The dilemmas in the diagnosis and management of interstitial ectopic pregnancy—Case report and literature review. Gynecol Minim Invasive Ther 2016;5:35-7.  Back to cited text no. 3
    
4.
Lee MH, Im SY, Kim MK, Shin SY, Park WI. Comparison of laparoscopic cornual resection and cornuotomy for interstitial pregnancy. J Minim Invasive Gynecol 2017;24:397-401.  Back to cited text no. 4
    


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