Current diagnosis and treatment of interstitial pregnancy

American Journal of Obstetrics and Gynecology

Volumn 202, Issue 1, 2010, Pages 15-29

  Moawad, Nash S ^a   Mahajan, Sangeeta T ^b   Moniz, Michelle H ^a   Taylor, Sarah E ^a   Hurd, William W ^b  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY HOSPITALS OF CLEVELAND   (United States)

Author keywords

cornual; ectopic; interstitial pregnancy; laparoscopic treatment

Indexed keywords

CHORIONIC GONADOTROPIN BETA SUBUNIT; DACTINOMYCIN; ETOPOSIDE; FOLINIC ACID; METHOTREXATE; POTASSIUM CHLORIDE;

ABDOMINAL PAIN; ECTOPIC PREGNANCY; HUMAN; HYSTERECTOMY; INTERSTITIAL PREGNANCY; INTERSTITIAL PREGNANY; LAPAROSCOPY; LAPAROTOMY; NUCLEAR MAGNETIC RESONANCE IMAGING; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SINGLE DRUG DOSE; SPONTANEOUS ABORTION; TRANSVAGINAL ECHOGRAPHY; UTERINE ARTERY EMBOLIZATION; VAGINA BLEEDING;

ABORTIFACIENT AGENTS, NONSTEROIDAL; CHORIONIC GONADOTROPIN, BETA SUBUNIT, HUMAN; FEMALE; HUMANS; LAPAROSCOPY; METHOTREXATE; PREGNANCY; PREGNANCY OUTCOME; PREGNANCY, TUBAL; RISK FACTORS; RUPTURE, SPONTANEOUS; VAGINA;

EID: 72149114586     PISSN: 00029378     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ajog.2009.07.054     Document Type: Review

References (109)

1. Tulandi T., and Al-Jaroudi D. Interstitial pregnancy: results generated from the Society of Reproductive Surgeons Registry. Obstet Gynecol 103 (2004) 47-50
2. Lau S., and Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril 72 (1999) 207-215
3. Damario M.A., and Rock J.A. Ectopic pregnancy. In: Rock J.A., and Jones III H.W. (Eds). Te Linde's operative gynecology (2003), Lippincott, Williams & Wilkins, Philadelphia 507-536
4. Walker J.J. Ectopic pregnancy. Clin Obstet Gynecol 50 (2007) 89-99
5. Jansen R.P., and Elliott P.M. Angular intrauterine pregnancy. Obstet Gynecol 58 (1981) 167-175
6. Filhastre M., Dechaud H., Lesnik A., and Taourel P. Interstitial pregnancy: role of MRI. Eur Radiol 15 (2005) 93-95
7. Soriano D., Vicus D., Mashiach R., Schiff E., Seidman D., and Goldenberg M. Laparoscopic treatment of cornual pregnancy: a series of 20 consecutive cases. Fertil Steril 90 (2008) 839-843
8. Felmus L.B., and Pedowitz P. Interstitial pregnancy; a survey of 45 cases. Am J Obstet Gynecol 66 (1953) 1271-1279
9. Ankum W.M., Mol B.W., Van der Veen F., and Bossuyt P.M. Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril 65 (1996) 1093-1099
10. MaCrae R., Olowu O., Rizzuto M.I., and Odejinmi F. Diagnosis and laparoscopic management of 11 consecutive cases of cornual ectopic pregnancy. Arch Gynecol Obstet 280 (2009) 59-64
11. Elito Jr. J., and Camano L. Unruptured tubal pregnancy: different treatments for early and late diagnosis. Sao Paulo Med J 124 (2006) 321-324
12. Sindos M., Togia A., Sergentanis T.N., et al. Ruptured ectopic pregnancy: risk factors for a life-threatening condition. Arch Gynecol Obstet 279 (2009) 621-623
13. Bickell N.A., Bodian C., Anderson R.M., and Kase N. Time and the risk of ruptured tubal pregnancy. Obstet Gynecol 104 (2004) 789-794
14. Araujo Jr. E., Zanforlin Filho S.M., Pires C.R., et al. Three-dimensional transvaginal sonographic diagnosis of early and asymptomatic interstitial pregnancy. Arch Gynecol Obstet 275 (2007) 207-210
15. Bourdel N., Roman H., Gallot D., et al. Interstitial Pregnancy. Ultrasonographic diagnosis and contribution of MRI: a case report. Gynecol Obstet Fertil 35 (2007) 121-124
16. Auslender R., Arodi J., Pascal B., and Abramovici H. Interstitial pregnancy: early diagnosis by ultrasonography. Am J Obstet Gynecol 146 (1983) 717-718
17. Doubilet P., and Benson C.B. Atlas of ultrasound in obstetrics and gynecology: a multimedia reference (2003), Lippincott, Williams & Wilkins, Philadelphia
18. Jafri S.Z., Loginsky S.J., Bouffard J.A., and Selis J.E. Sonographic detection of interstitial pregnancy. J Clin Ultrasound 15 (1987) 253-257
19. Timor-Tritsch I.E., Monteagudo A., Matera C., and Veit C.R. Sonographic evolution of cornual pregnancies treated without surgery. Obstet Gynecol 79 (1992) 1044-1049
20. Ackerman T.E., Levi C.S., Dashefsky S.M., Holt S.C., and Lindsay D.J. Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy. Radiology 189 (1993) 83-87
21. Takeuchi K., Yamada T., Oomori S., Ideta K., Moriyama T., and Maruo T. Comparison of magnetic resonance imaging and ultrasonography in the early diagnosis of interstitial pregnancy. J Reprod Med 44 (1999) 265-268
22. Maymon R., and Shulman A. Controversies and problems in the current management of tubal pregnancy. Hum Reprod Update 2 (1996) 541-551
23. Jermy K., Thomas J., Doo A., and Bourne T. The conservative management of interstitial pregnancy. BJOG 111 (2004) 1283-1288
24. Zalel Y., Caspi B., and Insler V. Expectant management of interstitial pregnancy. Ultrasound Obstet Gynecol 4 (1994) 238-240
25. Bremner T., Cela V., and Luciano A.A. Surgical management of interstitial pregnancy. J Am Assoc Gynecol Laparosc 7 (2000) 387-389
26. Sagiv R., Golan A., Arbel-Alon S., and Glezerman M. Three conservative approaches to treatment of interstitial pregnancy. J Am Assoc Gynecol Laparosc 8 (2001) 154-158
27. Grobman W.A., and Milad M.P. Conservative laparoscopic management of a large cornual ectopic pregnancy. Hum Reprod 13 (1998) 2002-2004
28. Downey G.P., and Tuck S.M. Spontaneous uterine rupture during subsequent pregnancy following non-excision of an interstitial ectopic gestation. BJOG 101 (1994) 162-163
29. Stovall T.G., and Ling F.W. Single-dose methotrexate: an expanded clinical trial. Am J Obstet Gynecol 168 (1993) 1759-1765
30. Menon S., Colins J., and Barnhart K.T. Establishing a human chorionic gonadotropin cutoff to guide methotrexate treatment of ectopic pregnancy: a systematic review. Fertil Steril 87 (2007) 481-484
31. Tanaka T., Hayashi H., Kutsuzawa T., Fujimoto S., and Ichinoe K. Treatment of interstitial ectopic pregnancy with methotrexate: report of a successful case. Fertil Steril 37 (1982) 851-852
32. Tang A., Baartz D., and Khoo S.K. A medical management of interstitial ectopic pregnancy: a 5-year clinical study. Aust N Z J Obstet Gynaecol 46 (2006) 107-111
33. Barnhart K., Spandorfer S., and Coutifaris C. Medical treatment of interstitial pregnancy: a report of three unsuccessful cases. J Reprod Med 42 (1997) 521-524
34. Dilbaz S., Katas B., Demir B., and Dilbaz B. Treating cornual pregnancy with a single methotrexate injection: a report of 3 cases. J Reprod Med 50 (2005) 141-144
35. Shalev E., Romano S., Bustan M., Megory E., Weiner E., and Zuckerman H. Interstitial pregnancy: successful treatment with methotrexate. Isr J Med Sci 25 (1989) 239-240
36. Brown D.L., Felker R.E., Stovall T.G., Emerson D.S., and Ling F.W. Serial endovaginal sonography of ectopic pregnancies treated with methotrexate. Obstet Gynecol 77 (1991) 406-409
37. Fernandez H., De Ziegler D., Bourget P., Feltain P., and Frydman R. The place of methotrexate in the management of interstitial pregnancy. Hum Reprod 6 (1991) 302-306
38. Karsdorp V.H., Van der Veen F., Schats R., Boer-Meisel M.E., and Kenemans P. Successful treatment with methotrexate of five vital interstitial pregnancies. Hum Reprod 7 (1992) 1164-1169
39. Voigt R.R., van der Veen F., Karsdorp V.H., Hogerzeil H.V., and Ketting B.W. Treatment of interstitial pregnancy with methotrexate: report of an unsuccessful case. Hum Reprod 9 (1994) 1576-1579
40. Hajenius P.J., Voigt R.R., Engelsbel S., Mol B.W., Hemrika D.J., and Van der Veen F. Serum human chorionic gonadotropin clearance curves in patients with interstitial pregnancy treated with systemic methotrexate. Fertil Steril 66 (1996) 723-728
41. Barnhart K.T., Gosman G., Ashby R., and Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing "single dose" and "multidose" regimens. Obstet Gynecol 101 (2003) 778-784
42. Lin Y.S., Chen C.L., Yuan C.C., and Wang P.H. Successful rescue of an early interstitial pregnancy after failed systemic methotrexate treatment: a case report. J Reprod Med 52 (2007) 332-334
43. Benifla J.L., Fernandez H., Sebban E., Darai E., Frydman R., and Madelenat P. Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment. Eur J Obstet Gynecol Reprod Biol 70 (1996) 151-156
44. Goldenberg M., Bider D., Oelsner G., Admon D., and Mashiach S. Treatment of interstitial pregnancy with methotrexate via hysteroscopy. Fertil Steril 58 (1992) 1234-1236
45. Lim J.E., Kim T., Lee N.W., et al. Ultrasonographic endometrial features in tubal pregnancy: are they predictive factors of successful medical treatment?. Ultrasound Med Biol 33 (2007) 714-719
46. Chen C.L., Wang P.H., Chiu L.M., Yang M.L., and Hung J.H. Successful conservative treatment for advanced interstitial pregnancy: a case report. J Reprod Med 47 (2002) 424-426
47. Altaras M., Cohen I., Cordoba M., Ben-Nun I., and Ben-Aderet N. Treatment of an interstitial pregnancy with actinomycin D: case report. BJOG 95 (1988) 1321-1323
48. Hafner T., Aslam N., Ross J.A., Zosmer N., and Jurkovic D. The effectiveness of non-surgical management of early interstitial pregnancy: a report of ten cases and review of the literature. Ultrasound Obstet Gynecol 13 (1999) 131-136
49. Deruelle P., and Closset E. Management of interstitial pregnancy using selective uterine artery embolization. Obstet Gynecol 107 (2006) 427-428
50. Valsky D.V., Hamani Y., Verstandig A., and Yagel S. The use of 3D rendering, VCI-C, 3D power Doppler and B-flow in the evaluation of interstitial pregnancy with arteriovenous malformation treated by selective uterine artery embolization. Ultrasound Obstet Gynecol 29 (2007) 352-355
51. Ophir E., Singer-Jordan J., Oettinger M., et al. Uterine artery embolization for management of interstitial twin ectopic pregnancy: case report. Hum Reprod 19 (2004) 1774-1777
52. Yang S.B., Lee S.J., Joe H.S., Goo D.E., Chang Y.W., and Kim D.H. Selective uterine artery embolization for management of interstitial ectopic pregnancy. Korean J Radiol 8 (2007) 176-179
53. Loret de Mola J.R., Austin C.M., Judge N.E., Assel B.G., Peskin B., and Goldfarb J.M. Cornual heterotopic pregnancy and cornual resection after in vitro fertilization/embryo transfer: a report of two cases. J Reprod Med 40 (1995) 606-610
54. Sills E.S., Perloe M., Kaplan C.R., Sweitzer C.L., Morton P.C., and Tucker M.J. Uncomplicated pregnancy and normal singleton delivery after surgical excision of heterotopic (cornual) pregnancy following in vitro fertilization/embryo transfer. Arch Gynecol Obstet 266 (2002) 181-184
55. Thakur Y., Coker A., Morris J., and Oliver R. Laparoscopic and ultrasound-guided transcervical evacuation of cornual ectopic pregnancy: an alternative approach. J Obstet Gynaecol 24 (2004) 809-810
56. Zhang X., Liu X., and Fan H. Interstitial pregnancy and transcervical curettage. Obstet Gynecol 104 (2004) 1193-1195
57. Baumann R., Magos A.L., and Turnbull A. Prospective comparison of video pelviscopy with laparotomy for ectopic pregnancy. BJOG 98 (1991) 765-771
58. Chan L.Y., and Yuen P.M. Successful treatment of ruptured interstitial pregnancy with laparoscopic surgery: a report of 2 cases. J Reprod Med 48 (2003) 569-571
59. Rahimi M.A. A new laparoscopic approach for the treatment of interstitial ectopic pregnancy. J Am Assoc Gynecol Laparosc 6 (1999) 205-207
60. Moon H.S., Choi Y.J., Park Y.H., and Kim S.G. New simple endoscopic operations for interstitial pregnancies. Am J Obstet Gynecol 182 (2000) 114-121
61. Tulandi T., Vilos G., and Gomel V. Laparoscopic treatment of interstitial pregnancy. Obstet Gynecol 85 (1995) 465-467
62. Woh L., Koh P.R., Wong C.N., Sun Y.L., Lin E.T., and Huang M.H. Laparoscopic management of a large viable cornual pregnancy. JSLS 11 (2007) 506-508
63. Woodland M.B., DePasquale S.E., Molinari J.A., and Sagullo C.C. Laparoscopic approach to interstitial pregnancy. J Am Assoc Gynecol Laparosc 3 (1996) 439-441
64. Morita Y., Tsutsumi O., Momoeda M., and Taketani Y. Cornual pregnancy successfully treated laparoscopically with fibrin glue hemostasis. Obstet Gynecol 90 (1997) 685-687
65. Katz Z., and Lurie S. Laparoscopic cornuostomy in the treatment of interstitial pregnancy with subsequent hysterosalpingography. BJOG 104 (1997) 955-956
66. Laury D. Laparoscopic treatment of an interstitial pregnancy. J Am Assoc Gynecol Laparosc 2 (1995) 219-221
67. Pasic R.P., Hammons G., Gardner J.S., and Hainer M. Laparoscopic treatment of cornual heterotopic pregnancy. J Am Assoc Gynecol Laparosc 9 (2002) 372-375
68. Gezer A., and Mutlu H. Laparoscopic management of cornual pregnancy without sutures. Arch Gynecol Obstet 270 (2004) 194-196
69. Pasic R., and Wolfe W.M. Laparoscopic diagnosis and treatment of interstitial ectopic pregnancy: a case report. Am J Obstet Gynecol 163 (1990) 587-588
70. Pansky M., Bukovsky I., Golan A., Raziel A., and Caspi E. Conservative management of interstitial pregnancy using operative laparoscopy. Surg Endosc 9 (1995) 515-516
71. Gleicher N., Karande V., Rabin D., and Pratt D. Laparoscopic removal of twin cornual pregnancy after in vitro fertilization. Fertil Steril 61 (1994) 1161-1162
72. Hill G., Segars J., and Herbert C. Laparoscopic management of interstitial pregnancy. J Gynecol Surg 5 (1989) 209-212
73. Mol F., Mol B.W., Ankum W.M., van der Veen F., and Hajenius P.J. Current evidence on surgery, systemic methotrexate and expectant management in the treatment of tubal ectopic pregnancy: a systematic review and meta-analysis. Hum Reprod Update 14 (2008) 309-319
74. Vicino M., Loverro G., Resta L., Bettocchi S., Vimercati A., and Selvaggi L. Laparoscopic cornual excision in a viable large interstitial pregnancy without blood flow detected by color Doppler ultrasonography. Fertil Steril 74 (2000) 407-409
75. Coric M., Barisic D., and Strelec M. Laparoscopic approach to interstitial pregnancy. Arch Gynecol Obstet 270 (2004) 287-289
76. Reich H., McGlynn F., Budin R., Tsoutsoplides G., and DeCaprio J. Laparoscopic treatment of ruptured interstitial pregnancy. J Gynecol Surg 6 (1990) 135-138
77. Sergent F., Le Cornec J.B., Meilhaud M.F., and Marpeau L. [Laparoscopic cornual excision with an automatic stapler for ruptured interstitial pregnancies]. J Gynecol Obstet Biol Reprod (Paris) 32 (2003) 426-430
78. Vilos G.A. Laparoscopic resection of a heterotopic cornual pregnancy followed by term vaginal delivery. J Am Assoc Gynecol Laparosc 2 (1995) 471-473
79. Moawad N.S., Dayaratna S., and Mahajan S.T. Mini-cornual excision: a simple stepwise laparoscopic technique for the treatment of cornual pregnancy. JSLS 13 (2009) 87-91
80. Hasbargen U., Summerer-Moustaki M., Hillemanns P., Scheidler J., Kimmig R., and Hepp H. Uterine dehiscence in a nullipara, diagnosed by MRI, following use of unipolar electrocautery during laparoscopic myomectomy: case report. Hum Reprod 17 (2002) 2180-2182
81. Weissman A., and Fishman A. Uterine rupture following conservative surgery for interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol 44 (1992) 237-239
82. Su C.F., Tsai H.J., Chen G.D., Shih Y.T., and Lee M.S. Uterine rupture at scar of prior laparoscopic cornuostomy after vaginal delivery of a full-term healthy infant. J Obstet Gynaecol Res 34 (2008) 688-691
83. Ng S., Hamontri S., Chua I., Chern B., and Siow A. Laparoscopic management of 53 cases of cornual ectopic pregnancy. Fertil Steril 92 (2009) 448-452
84. Andersen B.B. Successful intrauterine term pregnancy after resection of corneal pregnancy. Eur J Obstet Gynecol Reprod Biol 84 (1999) 99-100
85. Leach R.E., Ney J.A., and Ory S.J. Selective embryo reduction of an interstitial heterotopic gestation. Fetal Diagn Ther 7 (1992) 41-45
86. Perez J.A., Sadek M.M., Savale M., Boyer P., and Zorn J.R. Local medical treatment of interstitial pregnancy after in-vitro fertilization and embryo transfer (IVF-ET): two case reports. Hum Reprod 8 (1993) 631-634
87. Giurgis R. Simultaneous intrauterine and ectopic pregnancies following in vitro fertilization and gamete intrafallopian transfer: a review of nine cases. Hum Reprod 5 (1990) 484-486
88. Wood C., and Hurley V. Ultrasound diagnosis and laparoscopic excision of an interstitial ectopic pregnancy. Aust N Z J Obstet Gynaecol 32 (1992) 371-372
89. Sherer D.M., Scibetta J.J., and Sanko S.R. Heterotopic quadruplet gestation with laparoscopic resection of ruptured interstitial pregnancy and subsequent successful outcome of triplets. Am J Obstet Gynecol 172 (1995) 216-217
90. Sasso R.A. Laparoscopic diagnosis and treatment of cornual pregnancy: a case report. J Reprod Med 40 (1995) 68-70
91. Ostrzenski A. A new laparoscopic technique for interstitial pregnancy resection: a case report. J Reprod Med 42 (1997) 363-366
92. Dalkalitsis N., Stefanidis K., Paschopoulos M., Navrozoglou I., Mouzakioti E., and Lolis D. Laparoscopic treatment of interstitial pregnancy using the harmonic scalpel. Clin Exp Obstet Gynecol 25 (1998) 49-50
93. Matsuzaki S., Fukaya T., Murakami T., and Yajima A. Laparoscopic cornuostomy for interstitial pregnancy: a case report. J Reprod Med 44 (1999) 981-982
94. Osuga Y., Tsutsumi O., Fujiwara T., Kugu K., Fujimoto A., and Taketani Y. Usefulness of long-jaw forceps in laparoscopic cornual resection of interstitial pregnancies. J Am Assoc Gynecol Laparosc 8 (2001) 429-432
95. Vilos G.A. Laparoscopic ligation and resection of two ipsilateral interstitial pregnancies in the same patient. J Am Assoc Gynecol Laparosc 8 (2001) 299-302
96. Yoo E.H., Chun S.H., and Kim J.I. Endoscopic treatment of interstitial pregnancy. Acta Obstet Gynecol Scand 82 (2003) 189-191
97. Grimbizis G.F., Tsalikis T., Mikos T., et al. Case report: laparoscopic treatment of a ruptured interstitial pregnancy. Reprod Biomed Online 9 (2004) 447-451
98. Huang M.C., Su T.H., and Lee M.Y. Laparoscopic management of interstitial pregnancy. Int J Gynaecol Obstet 88 (2005) 51-52
99. Takeda A., Manabe S., Mitsui T., and Nakamura H. Management of patients with ectopic pregnancy with massive hemoperitoneum by laparoscopic surgery with intraoperative autologous blood transfusion. J Minim Invasive Gynecol 13 (2006) 43-48
100. Oliver R., Malik M., Coker A., and Morris J. Management of extra-tubal and rare ectopic pregnancies: case series and review of current literature. Arch Gynecol Obstet 276 (2007) 125-131
101. Qin L., Li S., and Tan S. Laparoscopic loop ligature for selective therapy in heterotopic interstitial and intrauterine pregnancy following in-vitro fertilization and embryo transfer. Int J Gynaecol Obstet 101 (2008) 80-81
102. Choi Y.S., Eun D.S., Choi J., Shin K.S., Choi J.H., and Park H.D. Laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy. Fertil Steril 91 (2009) 1933-1937
103. Cheng Z., Xu L., Zhu Y., Dai H., Qu X., and Gong J. Laparoscopic uterine vessels occlusion for the treatment of interstitial pregnancy. J Laparoendosc Adv Surg Tech A (2009) Epub ahead of print
104. Casadio P., Formelli G., Spagnolo E., et al. Laparoscopic treatment of interstitial twin pregnancy. Fertil Steril 92 (2009) 390.e13-390.e17
105. Ko M.L., Jeng C.J., Chou C.S., She B.C., Chen S.C., and Tzeng C.R. Laparoscopic electrodessication of an interstitial pregnancy. Fertil Steril 88 (2007) 705.e19-705.e20
106. Reich H., Johns D.A., DeCaprio J., McGlynn F., and Reich E. Laparoscopic treatment of 109 consecutive ectopic pregnancies. J Reprod Med 33 (1988) 885-890
107. Broome J.D., Vancaillie T.G., and Torode H. Conservative treatment of interstitial pregnancy. Gynecological Endoscopy 8 (1999) 1-4
108. Mehra S., Hotchandani M., Khatri I.B., and Negi H. Endoscopic management of corneal pregnancy. JK Science 4 (2002) 92-94
109. Gunenc Z., Bingol B., and Yesildaglar N. Laparoscopic management of a corneal ectopic pregnancy associated with persistent gestational trophoblastic disease: a case report. Gynecol Surg 4 (2007) 201-202