Successful management of interstitial pregnancy with fetal cardiac activity by laparoscopic-assisted cornual resection with preoperative transcatheter uterine artery embolization.
BACKGROUND
Interstitial pregnancy is a rare but dangerous form of ectopic pregnancy. Although various forms of minimally invasive management for this disorder have been previously reported, optimal treatment regimen has not been yet unknown due to its rarity.


METHODS
A 29-year-old married woman with no previous disease history was referred under suspicion of ectopic pregnancy. Serum hCG value was 95,365 mIU/mL. On ultrasonographic examination, gestational sac with a viable embryo was identified in the left cornual region. Three-dimensional computed tomographic angiography showed prominent vascular mass in the left cornual region. Preoperative transcatheter uterine artery embolization followed by laparoscopic-assisted cornual resection with local methotrexate injection was successfully performed.


CONCLUSIONS
Laparoscopic-assisted cornual resection with preoperative transcatheter uterine artery embolization for interstitial pregnancy with prominent vascular flow is a safe and reliable minimally invasive procedure for woman wishing fertility preservation.
Takeda
Akihiro
A
Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan. gyendoscopy@gmail.com
Koyama
Kazuyuki
K
Imoto
Sanae
S
Mori
Masahiko
M
Sakai
Kotaro
K
Nakamura
Hiromi
H
D000328:Adult; D000792:Angiography; D005260:Female; D005318:Fetal Heart; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care; D055357:Uterine Artery Embolization