Interstitial ectopic pregnancy rupture at 17 weeks of gestation: A case report and literature review

Abstract

Interstitial pregnancy is a rare type of ectopic pregnancy that commonly results in uterine rupture and life-threatening haemorrhage. Interstitial ectopic pregnancies are associated with a 2-5% mortality rate and a high risk of uterine rupture before 12 weeks of gestation when compared to tubal pregnancy. Due to the thickness and distensibility of the interstitial segment of the Fallopian tube, ectopic pregnancy in this location attains a considerable size before complications arise. Unfortunately, this clinical entity may prove to be a diagnostic challenge, leading to delays in treatment and significant morbidity and mortality in women of reproductive age. Herein, we report a case of a ruptured interstitial ectopic pregnancy occurring at 17 weeks of gestation that was successfully managed with surgical intervention, after proving to be a diagnostic challenge.

Keywords: B-hCG, Beta-human chorionic gonadotropin; CBC, Complete blood count; CT, Computed tomography; Cornual wedge resection; Cornuostomy; Ectopic pregnancy; Interstitial pregnancy; Uterine rupture.

Fig. 1

(1A) Intra-uterine gestation (yellow circle) containing fetal components eccentrically located towards the left cornua. (1B) Dense fluid (yellow arrow) within the left sub-diaphragmatic region indicative of acute haemorrhage in keeping with rupture.

Fig. 2

(2A) Ruptured left interstitial ectopic pregnancy of 17 weeks' gestation en-sac discovered during emergency laparotomy. (2B) Partial wedge resection and repair of the left uterine cornua were performed.