Interstitial Pregnancy: Case Report of Atypical Ectopic Pregnancy.

A report describes a case of a 36-year-old female, G2P0A1, who presented with transvaginal bleeding with clots and abdominal pain, located in the hypogastric region. The pain was of intermittent frequency, which was described as colic pain, with an intensity of 6 out of 10 on the numerical pain scale. She reported the pain to improve with rest and aggravate by movement, which was initiated 20 days ago and showing progressive clinical improvement on the previous days. She also reported amenorrhea 7weeks ago and showed a positive qualitative serum beta-human chorionic gonadotropin (HCG) test. 

Examination revealed her to be clinically and hemodynamically stable and without signs of peritonism. also, an absence of active bleeding through the external orifice of the cervix was noted. 

she also had a history of abortion (with uterine curettage) during the first trimester of pregnancy, 6 months before admission. No history of ectopic or molar pregnancy, pelvic inflammatory disease, genital infections, vulvovaginitis, tubal reconstruction or in vitro fertilization (IVF) was present. 

After admission to the hospital, the transvaginal ultrasound revealed a uterus in anteversion and anteflexion with an endometrium of 10 mm. Additionally, a 3.47 cm mass was observed in the myometrial region located at the left cornual region, with degenerated gestational sac inside and without a fetal heartbeat, suggesting the diagnosis of interstitial EP.

The patient was explained the case and an exploratory laparotomy was planned. the surgical procedure confirmed the presence of an intact interstitial EP. a left salpingectomy was performed along with resection of the interstitial portion of the left uterine tube. The postop period was uneventful and she was discharged following standard laparotomy protocol. 

SOURCE- Santos LTR, Oliveira SCS, Rocha LGA, Sousa NDS, Figueiredo RS. Interstitial Pregnancy: Case Report of Atypical Ectopic Pregnancy. Cureus. 2020;12(5):e8081. Published 2020 May 13. doi:10.7759/cureus.8081