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. 2018 Mar 27;18(1):78.
doi: 10.1186/s12884-018-1700-x.

Management and obstetric outcomes of 17 heterotopic interstitial pregnancies

Yuan Jiang  1   2 , Jie Chen  1   2 , Huaijun Zhou  1   2 , Mingming Zheng  2 , Ke Han  2 , Jingxian Ling  2 , Xianghong Zhu  2 , Xiaoqiu Tang  2 , Rong Li  2 , Ying Hong  3   4
Affiliations

Management and obstetric outcomes of 17 heterotopic interstitial pregnancies

Yuan Jiang et al. BMC Pregnancy Childbirth. .

Abstract

Background: Heterotopic interstitial pregnancy is a rare variant of heterotopic pregnancies, and it poses challenges in treating the heterotopic pregnancy and preserving the intrauterine pregnancy. However, there is no clear consensus regarding the optimal management. The aim of this study was to investigate the pregnancy outcomes of women diagnosed with heterotopic interstitial pregnancy.

Methods: A total of 17 women diagnosed with heterotopic interstitial pregnancy between July 2010 and December 2015 were included. General characteristics of each patient, including age, gravidity and parity, history of pelvic inflammatory disease or surgery, and especially the corresponding therapeutic interventions, were retrospectively analyzed. Moreover, pregnancy outcomes were further followed by face-to-face interview.

Results: Of the 17 patients, 10 (58.5%) underwent surgical treatment (7 laparoscopic cornual resection, and 3 laparotomy); and 3 cases simultaneously terminated the intrauterine pregnancy by suction evacuation. Compared with laparotomy, laparoscopic cornual section showed shorter operative time (median 40 vs. 70 min), less blood loss (150 vs. 400 ml) and shorter hospital stay (2 vs. 4 days). In addition, 4 (23.5%) patients underwent selective embryo reduction under transvaginal ultrasound guidance. Expectant management was chosen in the remaining 3 patients. In the follow-up study, other than a case of missed miscarriage, the other 13 women who remained committed to their pregnancies all delivered healthy babies either by caesarean section or vaginal birth. No congenital anomalies were reported, and all the infants were in good growth and development.

Conclusions: Laparoscopic cornual resection is a feasible approach with favorable surgical and long-term pregnancy outcomes. Additionally, medical or expectant management may be a viable treatment option for selected symptom-free patient. Although the survival of the intrauterine pregnancy could not always be assured, the prognosis for a woman with heterotopic interstitial pregnancy is generally good.

Keywords: Expectant management; Heterotopic interstitial pregnancy; Laparoscopic cornual resection; Selective embryo reduction.

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Conflict of interest statement

Ethics approval and consent to participate

This study was performed according to the Declaration of Helsinki and approved by the institutional review boards of Nanjing Drum Tower Hospital (NJDTH20160810). All patients consented to participate in the research, and oral/written informed consent was obtained from each patient.

Consent for publication

We have obtained consent to publish from each patient.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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