Abstract
Background:
Interstitial ectopic pregnancy comprises 1%–2% of all ectopic gestations but carries 7 times more mortality than other ectopic pregnancies. An interstitial pregnancy has the potential to cause massive hemorrhaging at any time during early pregnancy, making early recognition and treatment crucial.
Case:
A 41-year-old parous woman had a pan mural calcified fibroid in close proximity to an ectopic pregnancy; she desired to have future fertility after treatment. Laparoscopic linear cornuostomy, followed by a right salpingectomy and a myomectomy, was performed.
Results:
Various etiologies have been described in the literature, including previous, ectopic in-vitro fertilization; pelvic inflammatory disease; and previous ipsilateral salpingectomy, but in the current case, the presence of the pan mural fibroid in close proximity to the tubal ostium was considered to be the plausible cause for this interstitial ectopic pregnancy, per histopathologic examination of the specimens. This patient's ß–human chorionic gonadotropin level became negative at 3 weeks post surgery.
Conclusions:
Compared to a cornuectomy, a laparoscopic cornuostomy, with a salpingectomy and a concurrent myomectomy, is a safe and feasible option, considering a patient's desire for future fertility and her lower risk of uterine rupture.
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