title: Interstitial pregnancy management and subsequent pregnancy outcome.
abstract: We report on management and subsequent fertility outcome of interstitial pregnancy in a retrospective cohort study (Canadian Task Force classification II-3) at a university affiliated teaching hospital. Of 706 women with extrauterine pregnancy, 14 consecutive women with interstitial pregnancy were treated by methotrexate, laparotomy or laparoscopy between 1997 and 2007. The first four women, with significant hemoperitoneum, were treated by laparotomy. Of the next 10 women, four were selected for medical treatment with methotrexate. Only one case was treated successfully. The other six women had laparoscopic treatment. Of nine laparoscopies, one was converted to laparotomy due to excessive blood loss during the procedure. Of nine women desiring a child, three were infertile, whereas six conceived with an intrauterine pregnancy. A change from diagnosis later in pregnancy and laparotomy to more conservative treatment, mainly by laparoscopy, suggests a possibly better subsequent pregnancy rate.
authors: Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Ron
authors: R
authors: Sagiv
authors: Abraham
authors: A
authors: Debby
authors: Ran
authors: R
authors: Keidar
authors: Ram
authors: R
authors: Kerner
authors: Abraham
authors: A
authors: Golan
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005298:Fertility; D006465:Hemoperitoneum / Q000601:surgery; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate
keywords: Ectopic pregnancy; interstitial pregnancy; laparoscopic surgery; medical treatment; methotrexate