A medical management of interstitial ectopic pregnancy: A 5‐year clinical study

Tang, Amy; Baartz, David; Khoo, S. K.

doi:10.1111/j.1479-828x.2006.00537.x

Cited by 72 publications

(67 citation statements)

References 14 publications

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“…The mean duration of undetectable HCG in serum is 43 +/-64 days (Jourdain et al, 2003). An interstitial mass or heterogeneous area with persistent vascularization on ultrasound has been reported (Tang et al, 2006). Subject to negativity complete of HCG, they do not constitute a therapeutic failure (Tang et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

Ragmoun¹,

Daadoucha²,

Benhlima³

et al. 2017

ijccr

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Interstitial pregnancy is a rare entity that accounts for nearly 2% of ectopic pregnancies. His diagnosis is almost always based on laparoscopy. The risk of rupture with significant hemorrhage remains high. The treatment is classically surgical by corneal resection, medical treatment is increasingly used. Through an observation of an interstitial pregnancy diagnosed in our department and treated initially medically and then by radical surgery and by means of a review of the literature, we will try to explain the different diagnostic and therapeutic methods used in interstitial pregnancies, we will also learn the importance of patient selection in order to avoid risky changes, especially in the absence of consensus.

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Section: Discussionmentioning

confidence: 99%

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

Ragmoun¹,

Daadoucha²,

Benhlima³

et al. 2017

ijccr

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“…Interstitial ectopic pregnancies, also called cornual pregnancies occur in 1-4% of ectopic gestations [1]. Risk factors include ipsilateral ectopic pregnancy, salpingectomy and in vitro fertilization [2].…”

Section: Introductionmentioning

confidence: 99%

Anesthetic Considerations for Termination of Interstitial Pregnancy

Rutherford¹,

Suresh²,

Munnur³

2017

OGIJ

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Background: Interstitial pregnancy, also called cornual pregnancy occurs in 1-4% of ectopic gestations and predisposes to maternal hemorrhage. Diagnosis can be radiologically difficult.Case Report: A 30 year old G6P3 female presented with fetal movement after dilation and curettage. MRI was concerning for abdominal pregnancy, fetal age 18 weeks by abdominal girth. Patient was scheduled for exploratory laparotomy under GETA. Pregnancy was found to be cornual and self-contained; patient underwent resection of the ectopic without incident. Conclusion:This case report provides instructive significance for anesthesia management in this rare condition, and development of an anesthetic plan in the face of significant surgical uncertainty.Keywords: Cornual Pregnancy; Interstitial pregnancy; Anesthesia

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“…Serially repeated transvaginal ultrasonographic examinations are not necessary, since the differences that can be detected in such examinations are not indicative of, or able to predict, treatment failure. 18,19 Nevertheless, the evidence of embryonic cardiac activity one week after the initial treatment, despite a significant decrease in serum β-hCG levels, showed that one follow-up transvaginal ultrasonographic examination was indispensable in our case.…”

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confidence: 99%

“…This treatment has the advantages of generally being highly effective, not causing any side effects and avoiding possible complications associated with a surgical procedure. 18 One week after the initial dose, the patient's serum β-hCG concentration had decreased by over 15%, which is considered to be sufficient decline on the seventh day after treatment. 7 Nevertheless, transvaginal ultrasonography examination detected an embryo with cardiac activity.…”

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confidence: 99%

“…In a review on 20 cases, a second dose was required in 30% of them, with a success rate of 94%. 18 After conservative treatment with methotrexate, it is necessary to continue making regular examinations on the patient, because of the risk of rupture, and to measure serum β-hCG levels to assess whether the treatment was successful. Serially repeated transvaginal ultrasonographic examinations are not necessary, since the differences that can be detected in such examinations are not indicative of, or able to predict, treatment failure.…”

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Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment

et al. 2012

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CONTEXT: Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determining the most appropriate course of action in these situations. CASE REPORT: In a patient with an ultrasound diagnosis of interstitial pregnancy, clinical treatment using methotrexate was chosen. However, after one week, there was a marked decline in the serum level of the β subunit of chorionic gonadotropin hormone, although an ultrasound examination revealed embryonic cardiac activity. A second dose of the chemotherapy was administered. Embryonic cardiac activity persisted 48 hours later. Video laparoscopy was performed to achieve right-side cornual resection, which resulted in satisfactory resolution of the case.resUMo CONTEXTO: A gestação intersticial é uma forma rara de gestação ectópica. A melhor opção terapêu-tica ainda não está definida, havendo risco de hemorragia com o tratamento cirúrgico, em decorrên-cia da grande vascularização na região cornual uterina. A descrição de casos facilitam a análise dos resultados e ajuda os clínicos a determinarem a melhor conduta nessas situações. RELATO DE CASO: Em paciente com diagnóstico ultrassonográfico de gestação intersticial, optou-se por tratamento clínico com administração de metotrexate. Após uma semana, houve declínio acentuado do nível sérico da sub-unidade β do hormônio gonadotrófico coriônico, porém, na ultrassonografia, foi detectada a presença de atividade cardíaca embrionária. Foi administrada uma segunda dose do quimioterápico. Após 48 horas, a atividade cardíaca persistia. Realizou-se vídeo-laparoscopia para ressecção cornual direita, com resolução satisfatória do caso.I MD, MSc. Volunteer at Birth Control Outpatient

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A medical management of interstitial ectopic pregnancy: A 5‐year clinical study

Abstract: The methotrexate/folinic acid regimen used as a one-dose treatment is safe and effective for unruptured interstitial pregnancy, with no side-effects and the advantage of avoiding invasive surgery. Subsequent tubal patency and reproductive function are yet to be ascertained.

Cited by 72 publications

References 14 publications

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

About a Case of Failure of Medical Treatment of an Interstitial Pregnancy

Anesthetic Considerations for Termination of Interstitial Pregnancy

Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment

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