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Published in: Gynecological Surgery 1/2019

Open Access 01-12-2019 | Fertility | Review Article

The diagnosis and management of interstitial ectopic pregnancies: a review

Authors: Maximilian Brincat, Alison Bryant-Smith, T. K. Holland

Published in: Gynecological Surgery | Issue 1/2019

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Abstract

The objective of this article is to review the published literature on the diagnosis and management of interstitial pregnancies (IPs). IPs account for 2–6% of all ectopic pregnancies and have the potential to cause life-threatening haemorrhage resulting in a 2–5% mortality rate. There is little consensus on the best practice for diagnosing and managing interstitial pregnancies. By reviewing the published data, we set out to determine what the best evidence-based practice for the management of interstitial ectopic pregnancies is, what protocols can be used and whether this improves post-operative outcomes and future fertility rates.
Literature
8.
go back to reference Buster JE, Heard MJ (2000) Current issues in medical management of ectopic pregnancy. Current Opinion in Obstetrics and Gynecology. 12(6):525–527CrossRef Buster JE, Heard MJ (2000) Current issues in medical management of ectopic pregnancy. Current Opinion in Obstetrics and Gynecology. 12(6):525–527CrossRef
19.
go back to reference Al Memar M, Touqmatchi D, Kothari A (2013) Is laparoscopy always the gold standard for diagnosis of ectopic pregnancies? BJOG Int J Obstet Gynaecol 120:546–547 Al Memar M, Touqmatchi D, Kothari A (2013) Is laparoscopy always the gold standard for diagnosis of ectopic pregnancies? BJOG Int J Obstet Gynaecol 120:546–547
20.
go back to reference Athansias P, Psychoulis M, Hayes K (2011) Management of interstitil pregnancies. Conservative treatment as a reliable alternative to surgery. Gynecol Surg 8 Athansias P, Psychoulis M, Hayes K (2011) Management of interstitil pregnancies. Conservative treatment as a reliable alternative to surgery. Gynecol Surg 8
22.
go back to reference Stovall TG, Ling FW, Gray LA (1991) Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol 77(5):754–757PubMed Stovall TG, Ling FW, Gray LA (1991) Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol 77(5):754–757PubMed
23.
go back to reference Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ, on behalf of the Royal College of Obstetricians and Gynaecologists (2016) Diagnosis and management of ectopic pregnancy. BJOG 123:e15–e55CrossRef Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ, on behalf of the Royal College of Obstetricians and Gynaecologists (2016) Diagnosis and management of ectopic pregnancy. BJOG 123:e15–e55CrossRef
24.
go back to reference Saraj AJ, Wilcox JG, Najmabadi S, Stein SM, Johnson MB, Paulson RJ (1998) Resolution of hormonal markers of ectopic gestation. a randomized trial comparing single-dose intramuscular methotrexate and salpingostomy. Obstet Gynecol 92:989–994PubMed Saraj AJ, Wilcox JG, Najmabadi S, Stein SM, Johnson MB, Paulson RJ (1998) Resolution of hormonal markers of ectopic gestation. a randomized trial comparing single-dose intramuscular methotrexate and salpingostomy. Obstet Gynecol 92:989–994PubMed
25.
go back to reference Mol F, Van Mello NM, Strandell A, Strandell K, Jurkovic D, Ross J, Barnhart KT, Yalcinkaya TM, Verhoeve HR, Graziosi GCM, Koks CAM, Klinte I, Hogstrom L, Janssen ICAH, Kragt H, Hoek A, Timbos-Kemper CM, Broakmans FJM, Hajenius PJ (2014) Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label multicenter, randomised controlled trial. Lancet 383(9927):1483–1489CrossRef Mol F, Van Mello NM, Strandell A, Strandell K, Jurkovic D, Ross J, Barnhart KT, Yalcinkaya TM, Verhoeve HR, Graziosi GCM, Koks CAM, Klinte I, Hogstrom L, Janssen ICAH, Kragt H, Hoek A, Timbos-Kemper CM, Broakmans FJM, Hajenius PJ (2014) Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label multicenter, randomised controlled trial. Lancet 383(9927):1483–1489CrossRef
26.
go back to reference Sowter MC, Farquhar CM, Petries KJ, Gudex G (2001) A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy. BJOG 108:192–203PubMed Sowter MC, Farquhar CM, Petries KJ, Gudex G (2001) A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy. BJOG 108:192–203PubMed
27.
go back to reference Jurkovic D, Memtsa M, Sawyer E, Donaldson A, Jamil A, Schram K, et al (2016) Single-dose systemix methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomised trial. Obstet Gynecol 49(2) Jurkovic D, Memtsa M, Sawyer E, Donaldson A, Jamil A, Schram K, et al (2016) Single-dose systemix methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomised trial. Obstet Gynecol 49(2)
28.
go back to reference Van Mello NM, Mol F, Verhoeve HR, Van Wely M, Adriaanse AH, Boss EA, et al (2012) Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomised comparison. Hum Reprod 28(2):60–67 Van Mello NM, Mol F, Verhoeve HR, Van Wely M, Adriaanse AH, Boss EA, et al (2012) Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomised comparison. Hum Reprod 28(2):60–67
34.
go back to reference Cucinella G et al (2014) Interstitial pregnancy: a ‘road map’ of surgical treatment based on a systematic review of the literature. Gynecol Obstet Investig 78:141–149CrossRef Cucinella G et al (2014) Interstitial pregnancy: a ‘road map’ of surgical treatment based on a systematic review of the literature. Gynecol Obstet Investig 78:141–149CrossRef
35.
go back to reference Flystra D (1998) Tubal pregnancy: a review of current diagnosis and treatment. Obstet Gynecol Surv 1:122–126 Flystra D (1998) Tubal pregnancy: a review of current diagnosis and treatment. Obstet Gynecol Surv 1:122–126
Metadata
Title
The diagnosis and management of interstitial ectopic pregnancies: a review
Authors
Maximilian Brincat
Alison Bryant-Smith
T. K. Holland
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Gynecological Surgery / Issue 1/2019
Print ISSN: 1613-2076
Electronic ISSN: 1613-2084
DOI
https://doi.org/10.1186/s10397-018-1054-4

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