Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment.
BACKGROUND
Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determining the most appropriate course of action in these situations.


METHODS
In a patient with an ultrasound diagnosis of interstitial pregnancy, clinical treatment using methotrexate was chosen. However, after one week, there was a marked decline in the serum level of the β subunit of chorionic gonadotropin hormone, although an ultrasound examination revealed embryonic cardiac activity. A second dose of the chemotherapy was administered. Embryonic cardiac activity persisted 48 hours later. Video laparoscopy was performed to achieve right-side cornual resection, which resulted in satisfactory resolution of the case.
Birth Control Outpatient Clinic, Instituto Israelita de Responsabilidade Social Albert Einstein, São Paulo, Brazil. szylit@apm.org.br
Nilson Abrão
NA
Szylit
Sérgio
S
Podgaec
Evelyn
E
Traina
Rita de Cassia Sanches
Rde C
Oliveira
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D017211:Treatment Failure; D020535:Video-Assisted Surgery / Q000379:methods*
D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate