title: [Interstitial pregnancy: experience at Rouen's hospital].
abstract: OBJECTIVE
  Presenting our experience concerning interstitial pregnancies (IP) surgical management and to evaluate our patients' subsequent long-term fertility.
  
  
  METHODS
  Twenty patients underwent surgical treatment of IP in our department over 15 years. In this retrospective study, we present symptoms that led to diagnosis, treatments, fertility and obstetrical outcome.
  
  
  RESULTS
  Mean gestational age at diagnosis was 8SA, with a median BHCG rate of 7411 IU/L, and a patient mean age of 30 years. Ninety percent of patients had at least one risk factor for ectopic pregnancy. Pain or bleeding were the most common symptoms at admission, 4 patients were admitted in an hypovolemic shock status. Location of the interstitial ectopic pregnancy was discovered during surgery in 45 % of cases. Six patients had a large hemoperitoneum bigger than 1L, 5 patients had an IP of uterine stump after salpingectomy for a previous ectopic pregnancy. The most used surgical technique was in 60 % of cases the excision by Endo GIA stapling(®) with salpingectomy. Regarding fertility, 12 patients wished pregnancy in the aftermath of the intervention, 10 had at least one pregnancy, among them there is an ectopic contralateral ampullary pregnancy, and a contralateral recurrence of interstitial pregnancy. Four patients were delivered by cesarean section and 4 patients were delivered vaginally, some several times. No uterine rupture occured.
  
  
  CONCLUSIONS
  Interstitial pregnancy is a rare ectopic pregnancy. Its diagnosis is difficult and may involve maternal life-threatening and fertility. In subsequent pregnancies, the clinician has to be careful concerning the risks of interstitial pregnancy recurrence and uterine rupture.
authors.affiliation: Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France; Clinique universitaire de gynécologie-obstétrique, université Joseph-Fourrier et CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France. Electronic address: xdouysset@gmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Douysset
authors.affiliation: Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors.forename: E
authors.initials: E
authors.lastname: Verspyck
authors.affiliation: Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Diguet
authors.affiliation: Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors.forename: L
authors.initials: L
authors.lastname: Marpeau
authors.affiliation: Maternité du Belvédère, 72, rue Louis-Pasteur, 76130 Mont Saint-Aignan, France.
authors.forename: I
authors.initials: I
authors.lastname: Chanavaz-Lacheray
authors.affiliation: Clinique pédiatrique, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors.forename: S
authors.initials: S
authors.lastname: Rondeau
authors.affiliation: Pôle gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
authors.forename: B
authors.initials: B
authors.lastname: Resch
authors.affiliation: Clinique universitaire de gynécologie-obstétrique, université Joseph-Fourrier et CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France.
authors.forename: F
authors.initials: F
authors.lastname: Sergent
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D011247:Pregnancy; D065167:Pregnancy, Interstitial / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D058994:Salpingectomy; D014597:Uterine Rupture; D055815:Young Adult
keywords: Cornual ectopic pregnancy; Ectopic pregnancy; Grossesse cornuale; Grossesse ectopique; Grossesse interstitielle; Interstitial ectopic pregnancy; Laparoscopie; Laparoscopy