Digital Presentation AGES XXVIII Annual Scientific Meeting 2018

Interstitial Ectopic Pregnancy: A Laparoscopic Approach (5417)

Rosie McBain 1 , Ricardo Palma-Dias 1 , Alex Ades 1
  1. Royal Women's Hospital, Parkville, Victoria, Australia

Interstitial ectopic pregnancies are rare, representing 1-3% of all ectopic pregnancies1,2. Traditionally these have been managed with either local or systemic methotrexate alone or in combination with intrasac potassium chloride3.

We describe the case of a 31yo g2p0 who presented with a spontaneous pregnancy at 4+3 gestation to the emergency department with right iliac fossae and suprapubic pain and 4 weeks of vaginal bleeding. bHCG was 23381 IU/L, serial transvaginal ultrasounds demonstrated a right interstitial ectopic pregnancy, with 32 x 30 x 26mm inhomogeneous conglomerate in the right cornua, covered by myometrium anteriorly and cranially with serosal bulging seen posteriorly and caudally.

We present the video demonstrating laparoscopic resection of interstitial ectopic pregnancy using laparoscopic injection of vasopressin into the uterus and the pregnancy itself, followed by resection of the ectopic pregnancy with a harmonic blade scalpel.

Subsequent imaging and bHCG have shown resolution of the pregnancy.

  1. 1. Dilbas S, Katas B, Demir B, Dilbaz B. Treating corneal pregnancy with a single methotrexate injection: a report of 3 cases. J Reprod Med 2005; 50(2):141.
  2. 2. Lau S, Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril. 1999;72(2):207.
  3. 3. Ramkrishna J, Kan GR, Reidy KL, Ang WC, Palma-Dias R. Comparison of management regimens following ultrasound diagnosis of nontubal ectopic pregnancies: a retrospective cohort study. BJOG 2017;https://doi.org/10.1111.1471-0528.14752.
  • Have you presented oral, video or DCS at an AGES meeting before?: No
  • Are you a trainee and if so at what level?: 2
  • Are you a subspecialists or AGES member?: No