title: Pivotal points in interstitial pregnancy: new insights in conservative medical treatment of non-ruptured interstitial pregnancy.
abstract: We report the efficacy of a minimally invasive approach of the multidose protocol with methotrexate (MTX) in the management of three cases of interstitial pregnancy (IP), with elevated serum β-hCG in two cases. New considerations and management strategies are discussed. Successful termination of IP and in one case, a subsequent successful pregnancy, was achieved. The process led to the development of an enhanced understanding of diagnostic modalities and their limitations, with regard to the particular entities under discussion. We also focused attention on pivotal points and anatomical features in the management of this dangerous occurrence. Long-term results with careful follow-up were analysed by instrumental procedure. This hazardous type of ectopic pregnancy can be managed with systemic administration of MTX, also in patients with elevated β-hCG values. The present report underlines that an integrated approach in early diagnosis, multidose treatment and close follow-up, are essential forms of medical management.
authors.affiliation: Department of Obstetrics and Gynecology, Malzoni Hospital , Lecco.
authors.forename: A
authors.initials: A
authors.lastname: Pellegrino
authors.forename: G R
authors.initials: GR
authors.lastname: Damiani
authors.forename: S
authors.initials: S
authors.lastname: Landi
authors.forename: M
authors.initials: M
authors.lastname: Tartagni
authors.forename: S
authors.initials: S
authors.lastname: Tafuri
authors.forename: A
authors.initials: A
authors.lastname: Caringella
authors.forename: C
authors.initials: C
authors.lastname: Sportelli
authors.forename: M
authors.initials: M
authors.lastname: Gaetani
authors.forename: G
authors.initials: G
authors.lastname: Loverro
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000188:drug therapy*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate