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Interstitial Ectopic Pregnancy—Case Reports and Medical Management

The term intramural (interstitial) ectopic pregnancy refers to a pregnancy developing outside the uterine cavity, with a gestational sac implanted into the interstitial part of the Fallopian tube, surrounded by a layer of the myometrium. The prevalence rate of interstitial pregnancy (IP) is 2–4% of...

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Autores principales: Kampioni, Małgorzata, Chmaj-Wierzchowska, Karolina, Wszołek, Katarzyna, Wilczak, Maciej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967369/
https://www.ncbi.nlm.nih.gov/pubmed/36837435
http://dx.doi.org/10.3390/medicina59020233
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author Kampioni, Małgorzata
Chmaj-Wierzchowska, Karolina
Wszołek, Katarzyna
Wilczak, Maciej
author_facet Kampioni, Małgorzata
Chmaj-Wierzchowska, Karolina
Wszołek, Katarzyna
Wilczak, Maciej
author_sort Kampioni, Małgorzata
collection PubMed
description The term intramural (interstitial) ectopic pregnancy refers to a pregnancy developing outside the uterine cavity, with a gestational sac implanted into the interstitial part of the Fallopian tube, surrounded by a layer of the myometrium. The prevalence rate of interstitial pregnancy (IP) is 2–4% of all ectopic pregnancies. Surgery is the primary treatment for interstitial ectopic pregnancy; the pharmacological management of ectopic pregnancy, including IP, in asymptomatic patients includes systemic administration of methotrexate. In this report, we present two cases of this rare pregnancy type, reviewing our management technique and treatment ways presented in the literature. In our patients, the management was initially conservative and included methotrexate, administered as intravenous bolus injection, regular beta-human chorionic gonadotropins (β-HCG) level measurements in peripheral blood, and monitoring of the patient’s general condition. Due to signs of intra-abdominal bleeding in patient A and inadequate β-HCG level reduction in patient B, both patients eventually underwent laparoscopic cornual resection. Pregnancy, implanted into the interstitial part of the Fallopian tube and surrounded by myometrial tissue with myometrial invasion of the trophoblast, poses a serious diagnostic challenge to modern gynecology due to particularly low sensitivity and specificity of symptoms, and may require both pharmacological and surgical treatment.
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spelling pubmed-99673692023-02-26 Interstitial Ectopic Pregnancy—Case Reports and Medical Management Kampioni, Małgorzata Chmaj-Wierzchowska, Karolina Wszołek, Katarzyna Wilczak, Maciej Medicina (Kaunas) Case Report The term intramural (interstitial) ectopic pregnancy refers to a pregnancy developing outside the uterine cavity, with a gestational sac implanted into the interstitial part of the Fallopian tube, surrounded by a layer of the myometrium. The prevalence rate of interstitial pregnancy (IP) is 2–4% of all ectopic pregnancies. Surgery is the primary treatment for interstitial ectopic pregnancy; the pharmacological management of ectopic pregnancy, including IP, in asymptomatic patients includes systemic administration of methotrexate. In this report, we present two cases of this rare pregnancy type, reviewing our management technique and treatment ways presented in the literature. In our patients, the management was initially conservative and included methotrexate, administered as intravenous bolus injection, regular beta-human chorionic gonadotropins (β-HCG) level measurements in peripheral blood, and monitoring of the patient’s general condition. Due to signs of intra-abdominal bleeding in patient A and inadequate β-HCG level reduction in patient B, both patients eventually underwent laparoscopic cornual resection. Pregnancy, implanted into the interstitial part of the Fallopian tube and surrounded by myometrial tissue with myometrial invasion of the trophoblast, poses a serious diagnostic challenge to modern gynecology due to particularly low sensitivity and specificity of symptoms, and may require both pharmacological and surgical treatment. MDPI 2023-01-26 /pmc/articles/PMC9967369/ /pubmed/36837435 http://dx.doi.org/10.3390/medicina59020233 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Kampioni, Małgorzata
Chmaj-Wierzchowska, Karolina
Wszołek, Katarzyna
Wilczak, Maciej
Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title_full Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title_fullStr Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title_full_unstemmed Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title_short Interstitial Ectopic Pregnancy—Case Reports and Medical Management
title_sort interstitial ectopic pregnancy—case reports and medical management
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967369/
https://www.ncbi.nlm.nih.gov/pubmed/36837435
http://dx.doi.org/10.3390/medicina59020233
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