Management of interstitial pregnancy using selective uterine artery embolization.
BACKGROUND
Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy which is treated by surgery, medical treatment, or both. Management options are not standardized. Currently, conservative nonsurgical treatment seems to be an alternative method in case of interstitial pregnancy.


METHODS
A right interstitial pregnancy was diagnosed in a 28-year-old woman. She was successfully treated by 2 courses of systemic methotrexate (1 mg/kg) 24 hours apart followed by selective uterine artery embolization. The postembolization course was uneventful, and no rupture occurred. Ten weeks after embolization, human chorionic gonadotropin level was negative.


CONCLUSIONS
Uterine embolization associated with methotrexate can be used successfully in treating selected cases of early interstitial pregnancy. We hypothesize that this procedure combined with methotrexate could reduce hemorrhagic risk.
Deruelle
Philippe
P
Service de Gynécologie, Hôpital Jeanne de Flandre, Universitaire de Lille, France. p-deruelle@chru-lille.fr
Lucot
Jean-Philippe
JP
Lions
Christophe
C
Robert
Yann
Y
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D006063:Chorionic Gonadotropin / Q000032:analysis; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy* / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D014599:Uterus / Q000098:blood supply* / Q000473:pathology
D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D008727:Methotrexate