Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of early detection of interstitial ectopic pregnancy resulted in a maternal near-miss and calls for the need for increased awareness and high index of suspicion among sonographers and clinicians. A case of a 24-year-old gravida two para zero, one previous ectopic pregnancy (G2P01EP) was brought into our facility with generalized abdominal pain and hemorrhagic shock. She had a previous history of left salpingectomy for a ruptured tubal ectopic pregnancy four years earlier at a secondary health care facility. Emergency laparotomy after aggressive resuscitation revealed ruptured interstitial ectopic pregnancy with massive hemoperitoneum and a dead fetus. Wedge resection of the right cornua along with the Fallopian tube was done. Diagnosis of interstitial ectopic pregnancy is challenging due to its rarity and location in the intrauterine portion of the Fallopian tube. Ultrasonographic diagnosis in early pregnancy is key. Awareness creation and a high index of suspicion is required among sonographers and clinicians to prevent needless morbidity and mortality.
| Published in | Journal of Gynecology and Obstetrics (Volume 9, Issue 4) |
| DOI | 10.11648/j.jgo.20210904.16 |
| Page(s) | 125-127 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Ectopic, Hemorrhagic Shock, Interstitial, Life-threatening, Near-miss
| [1] | Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Ectopic Pregnancy. In: Williams Obstetrics. 24th ed. New York, NY: McGraw-Hill Education; 2014. P. 387-8. |
| [2] | Finlinson AR, Bollig KJ, Schust DJ. Differentiating pregnancies near the uterotubal junction (angular, cornual, and interstitial): a review and recommendations. Fertil Res Pract. 2020 May 4; 6 (1): 8. |
| [3] | Brincat M, Bryant-Smith A, Holland TK. The diagnosis and management of interstitial ectopic pregnancies: a review. Gynecol Surg. 2019 Feb 4; 16 (1): 2. |
| [4] | Lau S, Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril. 1999 Aug; 72 (2): 207–15. |
| [5] | Obed S. Diagnosis of Unruptured Ectopic Pregnancy is Still Uncommon in Ghana. Ghana Med J. 2006 Mar; 40 (1): 3–7. |
| [6] | Dagar M, Srivastava M, Ganguli I, Bhardwaj P, Sharma N, Chawla D. Interstitial and Cornual Ectopic Pregnancy: Conservative Surgical and Medical Management. J Obstet Gynecol India. 2018 Dec; 68 (6): 471–6. |
| [7] | Rock JA, Jones HW. Ectopic pregnancy. In: Te Linde’s Operative Gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2008, p. 816. |
| [8] | Kun WM, Tung WK. On the look-out for a rarity--interstitial/cornual pregnancy. Eur J Emerg Med Off J Eur Soc Emerg Med. 2001 Jun; 8 (2): 147–50. |
| [9] | Tulandi T, Al-Jaroudi D. Interstitial pregnancy: results generated from the Society of Reproductive Surgeons Registry. Obstet Gynecol. 2004 Jan; 103 (1): 47–50. |
| [10] | Ng PH, NorAzlin MI, Nasri NI. Term interstitial pregnancy with uterine conservation. Int J Gynaecol Obstet off Organ Int Fed Gynaecol Obstet. 2007 Dec; 99 (3): 251. |
| [11] | Hamouda ES, Littooij AS, Thia EW, Ong CL. Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report. J Radiol Case Rep. 2013 Oct 1; 7 (10): 34–42. |
| [12] | Timor-Tritsch IE, Monteagudo A, Matera C, Veit CR. Sonographic evolution of cornual pregnancies treated without surgery. Obstet Gynecol. 1992 Jun; 79 (6): 1044–9. |
| [13] | Ackerman TE, Levi CS, Dashefsky SM, Holt SC, Lindsay DJ. Interstitial line: sonographic finding in interstitial [cornual] ectopic pregnancy. Radiology. 1993 Oct; 189 (1): 83–7. |
| [14] | Rastogi R, GL M, Rastogi N, Rastogi V. Interstitial ectopic pregnancy: A rare and difficult clinicosonographic diagnosis. J Hum Reprod Sci. 2008; 1 (2): 81–2. |
APA Style
David Putiero Suoseg, Anwar Sadat Seidu, Ubeida Koray, Safia Iddrisu, Munkaila Mohammed, et al. (2021). Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss. Journal of Gynecology and Obstetrics, 9(4), 125-127. https://doi.org/10.11648/j.jgo.20210904.16
ACS Style
David Putiero Suoseg; Anwar Sadat Seidu; Ubeida Koray; Safia Iddrisu; Munkaila Mohammed, et al. Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss. J. Gynecol. Obstet. 2021, 9(4), 125-127. doi: 10.11648/j.jgo.20210904.16
AMA Style
David Putiero Suoseg, Anwar Sadat Seidu, Ubeida Koray, Safia Iddrisu, Munkaila Mohammed, et al. Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss. J Gynecol Obstet. 2021;9(4):125-127. doi: 10.11648/j.jgo.20210904.16
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.jgo.20210904.16,
author = {David Putiero Suoseg and Anwar Sadat Seidu and Ubeida Koray and Safia Iddrisu and Munkaila Mohammed and Shafawu Mustapha Baba and Abraham Babatuiamu Titigah and Ana Maria Simono Charadan},
title = {Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss},
journal = {Journal of Gynecology and Obstetrics},
volume = {9},
number = {4},
pages = {125-127},
doi = {10.11648/j.jgo.20210904.16},
url = {https://doi.org/10.11648/j.jgo.20210904.16},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210904.16},
abstract = {Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of early detection of interstitial ectopic pregnancy resulted in a maternal near-miss and calls for the need for increased awareness and high index of suspicion among sonographers and clinicians. A case of a 24-year-old gravida two para zero, one previous ectopic pregnancy (G2P01EP) was brought into our facility with generalized abdominal pain and hemorrhagic shock. She had a previous history of left salpingectomy for a ruptured tubal ectopic pregnancy four years earlier at a secondary health care facility. Emergency laparotomy after aggressive resuscitation revealed ruptured interstitial ectopic pregnancy with massive hemoperitoneum and a dead fetus. Wedge resection of the right cornua along with the Fallopian tube was done. Diagnosis of interstitial ectopic pregnancy is challenging due to its rarity and location in the intrauterine portion of the Fallopian tube. Ultrasonographic diagnosis in early pregnancy is key. Awareness creation and a high index of suspicion is required among sonographers and clinicians to prevent needless morbidity and mortality.},
year = {2021}
}
TY - JOUR T1 - Ruptured Interstitial Ectopic Pregnancy at 18 Weeks: How Failure of Early Detection Resulted in a Maternal Near-miss AU - David Putiero Suoseg AU - Anwar Sadat Seidu AU - Ubeida Koray AU - Safia Iddrisu AU - Munkaila Mohammed AU - Shafawu Mustapha Baba AU - Abraham Babatuiamu Titigah AU - Ana Maria Simono Charadan Y1 - 2021/08/27 PY - 2021 N1 - https://doi.org/10.11648/j.jgo.20210904.16 DO - 10.11648/j.jgo.20210904.16 T2 - Journal of Gynecology and Obstetrics JF - Journal of Gynecology and Obstetrics JO - Journal of Gynecology and Obstetrics SP - 125 EP - 127 PB - Science Publishing Group SN - 2376-7820 UR - https://doi.org/10.11648/j.jgo.20210904.16 AB - Interstitial ectopic pregnancy occurs when a gestational sac implants within the interstitial portion of the Fallopian tube. It is an uncommon and dangerous type of ectopic pregnancy with high morbidity and mortality. Rupture of interstitial ectopic pregnancy usually leads to life-threatening hemorrhage. This case report illustrates how failure of early detection of interstitial ectopic pregnancy resulted in a maternal near-miss and calls for the need for increased awareness and high index of suspicion among sonographers and clinicians. A case of a 24-year-old gravida two para zero, one previous ectopic pregnancy (G2P01EP) was brought into our facility with generalized abdominal pain and hemorrhagic shock. She had a previous history of left salpingectomy for a ruptured tubal ectopic pregnancy four years earlier at a secondary health care facility. Emergency laparotomy after aggressive resuscitation revealed ruptured interstitial ectopic pregnancy with massive hemoperitoneum and a dead fetus. Wedge resection of the right cornua along with the Fallopian tube was done. Diagnosis of interstitial ectopic pregnancy is challenging due to its rarity and location in the intrauterine portion of the Fallopian tube. Ultrasonographic diagnosis in early pregnancy is key. Awareness creation and a high index of suspicion is required among sonographers and clinicians to prevent needless morbidity and mortality. VL - 9 IS - 4 ER -
Information
Email: