Current diagnosis and treatment of interstitial pregnancy

Am J Obstet Gynecol. 2010 Jan;202(1):15-29. doi: 10.1016/j.ajog.2009.07.054.

Abstract

The incidence of interstitial pregnancy is rising. Traditional treatment with laparotomy, hysterectomy, or cornual wedge resection is associated with high morbidity and detrimental effects on future fertility. A diverse array of alternate treatments has been introduced over the last 3 decades, with the common goal of achieving a minimally invasive, standardized management strategy. This has been facilitated by impressive strides towards prompt diagnosis, both radiologically and chemically. In this review, we explore the current state of the art diagnostic criteria and the clinically significant diverse therapeutic options with supporting literature. Finally, we propose a structured, best-practice management plan for the once-lethal interstitial pregnancy, based on the current literature.

Publication types

  • Review

MeSH terms

  • Abortifacient Agents, Nonsteroidal / therapeutic use
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Female
  • Humans
  • Laparoscopy
  • Methotrexate / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Tubal / diagnosis*
  • Pregnancy, Tubal / diagnostic imaging
  • Pregnancy, Tubal / epidemiology
  • Pregnancy, Tubal / surgery*
  • Risk Factors
  • Rupture, Spontaneous
  • Ultrasonography
  • Vagina / diagnostic imaging

Substances

  • Abortifacient Agents, Nonsteroidal
  • Chorionic Gonadotropin, beta Subunit, Human
  • Methotrexate