Laparoscopically-assisted, hysteroscopic removal of an interstitial pregnancy with a fertility-preserving technique.
Described is a novel surgical management of an unruptured interstitial pregnancy with preservation of the ipsilateral fallopian tube and uterine cornua. The patient was a 34-year-old woman, gravida 3, para 1, with an unruptured left interstitial pregnancy at 9 weeks' gestation, who desired preservation of fertility. The ectopic pregnancy was entirely removed via laparoscopically assisted hysteroscopy with a fertility-preserving surgical technique, with minimal blood loss, preservation of reproductive organs, restoration of anatomy, a patent ipsilateral fallopian tube, and expedient return to normal reproductive function. After the procedure, serial human chorionic gonadotropin levels were obtained until they were <5 mIU/mL. A hysterosalpingogram obtained 2 months after the procedure showed normal uterine and fallopian tube contour and bilateral tubal patency. We conclude that this laparoscopically assisted hysteroscopic technique is a safe and efficient fertility-preserving approach to management of an unruptured interstitial pregnancy.
Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Atlanta, Georgia. Electronic address: ceana@nezhat.com.
Ceana H
CH
Nezhat
Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Atlanta, Georgia.
Erica C
EC
Dun
D000328:Adult; D000818:Animals; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D059351:Organ Sparing Treatments / Q000379:methods; D011247:Pregnancy; D065167:Pregnancy, Interstitial / Q000601:surgery*
Cornual pregnancy; Ectopic pregnancy; Hysteroscopic removal; Interstitial pregnancy; Laparoscopy