Conservative management of interstitial pregnancies: experience of a single centre

Uludağ, Semih; Kütük, Mehmet Serdar; Dolanbay, Mehmet; Özgün, Mahmut Tuncay; Eliyeva, Gunel; Altun, Ozguc

doi:10.1080/01443615.2017.1417979

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…Uludag et al reported successful local methortrixacate (MTX) treatment in 7 cases and successful laparascopic cornuostomy in the remaining 3 cases. The success rate was not different between the local MTX and laparascopy groups (100% vs. 66.6%, p > .05) (14). In her case series published in 2018, Dagar et al presented successful treatment of cornual pregnancy with methotrexate injection (15).…”

Section: Discussionmentioning

confidence: 91%

Cornual Ectopic Pregnancy: a Case series and Literature review

Fessehaye,

Gashawbeza

2024

Preprint

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Background: Cornual (interstitial) ectopic pregnancy is an uncommon type of ectopic pregnancy which accounts for 2%-4% of all ectopic pregnancies. It often poses a diagnostic and therapeutic challenge with a high mortality risk as a result of massive intraperitoneal bleeding. We report review of three cases of cornual ectopic pregnancy. Objective: To describe clinical presentation and management of cornual ectopic pregnancy cases Methods: Three cases of cornual ectopic pregnancy were retrospectively analyzed Results: Successful cornual wedge resection and removal of products of conception was performed in two cases (one ruptured and the other unruptured), while the 3rd case (ruptured with massive hemorrhage) was managed with hysterectomy. Conclusion: Early diagnosis of cornual ectopic pregnancy gives patients a wider opportunity to have conservative management either with MTX or laparascopic surgery. However; whenever there is hemodynamic instability, laparotomy with either cornual resection or hysterectomy is advisable.

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Section: Discussionmentioning

confidence: 91%

Cornual Ectopic Pregnancy: a Case series and Literature review

Fessehaye,

Gashawbeza

2024

Preprint

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“…MTX therapy has been shown to be effective. 18,19 However, for cases with large mass in diameter > 20 mm 18 and high serum β-hCG levels, 19 MTX therapy is likely to fail. Some researchers have reported their practices of hysteroscopic procedure with/or without laparoscopic assistant.…”

Section: Discussionmentioning

confidence: 99%

“…MTX therapy has been shown to be effective 18,19 . However, for cases with large mass in diameter > 20 mm 18 and high serum β‐hCG levels, 19 MTX therapy is likely to fail.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of image diagnostic modalities, it is now possible to detect and identify interstitial pregnancy at an earlier gestational age and allow gynecologists to consider conservative strategies enabling uterine reservation. MTX therapy has been shown to be effective 18,19 . However, for cases with large mass in diameter > 20 mm 18 and high serum β‐hCG levels, 19 MTX therapy is likely to fail.…”

Section: Discussionmentioning

confidence: 99%

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The feasibility of laparoscopically assisted, hysteroscopic removal of interstitial pregnancies: A case series

Niu

Tang

et al. 2021

J of Obstet and Gynaecol

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Objective: The study objective was to assess the feasibility of the management of interstitial pregnancy by laparoscopically assisted hysteroscopic removal. Methods: This retrospective study included a case series of 17 patients who were diagnosed interstitial pregnancy with dilated proximal tubal ostium by transvaginal ultrasonography at the Women's hospital, School of Medicine, Zhejiang University between August 2017 and October 2020. Laparoscopically assisted hysteroscopic removals of the products of conception were performed. Various data were collected including age, surgical and obstetric history, gestational age, preoperative symptoms, human chorionic gonadotropin level and ultrasonography results. The outcomes measured were intraoperative bleeding, pathologic findings, conversions. Results: Eleven cases were successfully resected the interstitial gestational products with laparoscopically assisted hysteroscopy. There were four cases failed of hysteroscopic removal, for the proximal tubal ostia were too small for the surgical instruments to enter. Then cornual wedge resections were performed. Two cases were identified as intramural pregnancy by hysteroscopic and laparoscopic view. Most of the intramural pregnancy tissue of one patient was removed by hysteroscopy. The other one converted to laparoscopy. Conclusion: Laparoscopically assisted hysteroscopic management could be a feasible surgical option to interstitial pregnancies. Further clinical studies are needed to establish detailed criteria to select the appropriate cases for hysteroscopic management.

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“…Cornuostomy is an attractive alternative to cornual resection because it preserves the normal uterine myometrium [14].…”

Section: Introductionmentioning

confidence: 99%

Use of Laparoscopic Slip Knot with Purse-String Suture in Surgical Management of Unruptured Heterotopic Interstitial Pregnancies

et al. 2020

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The aim of this study was to investigate the advantages and disadvantages of using laparoscopic slip knot with purse-string suture technique in the surgical management of unruptured heterotopic interstitial pregnancies compared with other surgical strategies. Material/Methods:We retrospectively analyzed data on 13 patients with unruptured heterotopic interstitial pregnancies who underwent laparoscopy in our hospital between May 2012 and August 2018. The control group consisted of 10 patients who underwent cornual resection or cornuostomy with conventional sutures and knots. The study group consisted of 3 patients whose surgical plans involved use of the slip knot with purse-string suture technique followed by cornuostomy. We evaluated the surgical records and video to comparatively analyze their operation duration, intraoperative blood loss, and pregnancy outcomes. Results:The average volume of intraoperative blood loss was 76.67±25 ml in the study group and 215.00±110 ml in the control group. On average, the intraoperative blood loss volume in the study group was 138 ml less than in the control group and the difference was statistically significant (P<0.05). There was no statistically significant difference in the live birth rate and operation time between the 2 groups (P>0.05). The duration of hemostasis in the study group was 11 min shorter than in the control group, while the duration of cornual electrocoagulation in the study group was 18.5 s shorter. Both groups achieved thorough hemostasis without the help of vasopressin and avoided use of embryo-killing drugs such as methotrexate. Neither group required second surgery or developed postoperative complications such as uterus rupture or persistent ectopic pregnancy. Conclusions:This strategy is safe and reliable for gestational sac clearance while simultaneously preventing any potential harm to the intrauterine embryo. It is particularly suitable for unruptured HIP patients who have a strong desire to preserve their intrauterine embryos.

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Conservative management of interstitial pregnancies: experience of a single centre

Cited by 5 publications

References 27 publications

Cornual Ectopic Pregnancy: a Case series and Literature review

Cornual Ectopic Pregnancy: a Case series and Literature review

The feasibility of laparoscopically assisted, hysteroscopic removal of interstitial pregnancies: A case series

Use of Laparoscopic Slip Knot with Purse-String Suture in Surgical Management of Unruptured Heterotopic Interstitial Pregnancies

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