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Management and obstetric outcomes of 17 heterotopic interstitial pregnancies

BACKGROUND: Heterotopic interstitial pregnancy is a rare variant of heterotopic pregnancies, and it poses challenges in treating the heterotopic pregnancy and preserving the intrauterine pregnancy. However, there is no clear consensus regarding the optimal management. The aim of this study was to in...

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Autores principales: Jiang, Yuan, Chen, Jie, Zhou, Huaijun, Zheng, Mingming, Han, Ke, Ling, Jingxian, Zhu, Xianghong, Tang, Xiaoqiu, Li, Rong, Hong, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870515/
https://www.ncbi.nlm.nih.gov/pubmed/29587664
http://dx.doi.org/10.1186/s12884-018-1700-x
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author Jiang, Yuan
Chen, Jie
Zhou, Huaijun
Zheng, Mingming
Han, Ke
Ling, Jingxian
Zhu, Xianghong
Tang, Xiaoqiu
Li, Rong
Hong, Ying
author_facet Jiang, Yuan
Chen, Jie
Zhou, Huaijun
Zheng, Mingming
Han, Ke
Ling, Jingxian
Zhu, Xianghong
Tang, Xiaoqiu
Li, Rong
Hong, Ying
author_sort Jiang, Yuan
collection PubMed
description BACKGROUND: Heterotopic interstitial pregnancy is a rare variant of heterotopic pregnancies, and it poses challenges in treating the heterotopic pregnancy and preserving the intrauterine pregnancy. However, there is no clear consensus regarding the optimal management. The aim of this study was to investigate the pregnancy outcomes of women diagnosed with heterotopic interstitial pregnancy. METHODS: A total of 17 women diagnosed with heterotopic interstitial pregnancy between July 2010 and December 2015 were included. General characteristics of each patient, including age, gravidity and parity, history of pelvic inflammatory disease or surgery, and especially the corresponding therapeutic interventions, were retrospectively analyzed. Moreover, pregnancy outcomes were further followed by face-to-face interview. RESULTS: Of the 17 patients, 10 (58.5%) underwent surgical treatment (7 laparoscopic cornual resection, and 3 laparotomy); and 3 cases simultaneously terminated the intrauterine pregnancy by suction evacuation. Compared with laparotomy, laparoscopic cornual section showed shorter operative time (median 40 vs. 70 min), less blood loss (150 vs. 400 ml) and shorter hospital stay (2 vs. 4 days). In addition, 4 (23.5%) patients underwent selective embryo reduction under transvaginal ultrasound guidance. Expectant management was chosen in the remaining 3 patients. In the follow-up study, other than a case of missed miscarriage, the other 13 women who remained committed to their pregnancies all delivered healthy babies either by caesarean section or vaginal birth. No congenital anomalies were reported, and all the infants were in good growth and development. CONCLUSIONS: Laparoscopic cornual resection is a feasible approach with favorable surgical and long-term pregnancy outcomes. Additionally, medical or expectant management may be a viable treatment option for selected symptom-free patient. Although the survival of the intrauterine pregnancy could not always be assured, the prognosis for a woman with heterotopic interstitial pregnancy is generally good.
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spelling pubmed-58705152018-03-29 Management and obstetric outcomes of 17 heterotopic interstitial pregnancies Jiang, Yuan Chen, Jie Zhou, Huaijun Zheng, Mingming Han, Ke Ling, Jingxian Zhu, Xianghong Tang, Xiaoqiu Li, Rong Hong, Ying BMC Pregnancy Childbirth Research Article BACKGROUND: Heterotopic interstitial pregnancy is a rare variant of heterotopic pregnancies, and it poses challenges in treating the heterotopic pregnancy and preserving the intrauterine pregnancy. However, there is no clear consensus regarding the optimal management. The aim of this study was to investigate the pregnancy outcomes of women diagnosed with heterotopic interstitial pregnancy. METHODS: A total of 17 women diagnosed with heterotopic interstitial pregnancy between July 2010 and December 2015 were included. General characteristics of each patient, including age, gravidity and parity, history of pelvic inflammatory disease or surgery, and especially the corresponding therapeutic interventions, were retrospectively analyzed. Moreover, pregnancy outcomes were further followed by face-to-face interview. RESULTS: Of the 17 patients, 10 (58.5%) underwent surgical treatment (7 laparoscopic cornual resection, and 3 laparotomy); and 3 cases simultaneously terminated the intrauterine pregnancy by suction evacuation. Compared with laparotomy, laparoscopic cornual section showed shorter operative time (median 40 vs. 70 min), less blood loss (150 vs. 400 ml) and shorter hospital stay (2 vs. 4 days). In addition, 4 (23.5%) patients underwent selective embryo reduction under transvaginal ultrasound guidance. Expectant management was chosen in the remaining 3 patients. In the follow-up study, other than a case of missed miscarriage, the other 13 women who remained committed to their pregnancies all delivered healthy babies either by caesarean section or vaginal birth. No congenital anomalies were reported, and all the infants were in good growth and development. CONCLUSIONS: Laparoscopic cornual resection is a feasible approach with favorable surgical and long-term pregnancy outcomes. Additionally, medical or expectant management may be a viable treatment option for selected symptom-free patient. Although the survival of the intrauterine pregnancy could not always be assured, the prognosis for a woman with heterotopic interstitial pregnancy is generally good. BioMed Central 2018-03-27 /pmc/articles/PMC5870515/ /pubmed/29587664 http://dx.doi.org/10.1186/s12884-018-1700-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Jiang, Yuan
Chen, Jie
Zhou, Huaijun
Zheng, Mingming
Han, Ke
Ling, Jingxian
Zhu, Xianghong
Tang, Xiaoqiu
Li, Rong
Hong, Ying
Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title_full Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title_fullStr Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title_full_unstemmed Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title_short Management and obstetric outcomes of 17 heterotopic interstitial pregnancies
title_sort management and obstetric outcomes of 17 heterotopic interstitial pregnancies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870515/
https://www.ncbi.nlm.nih.gov/pubmed/29587664
http://dx.doi.org/10.1186/s12884-018-1700-x
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