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  • Print publication year: 2009
  • Online publication date: February 2014

16 - Non-tubal ectopic pregnancies

Summary

This chapter provides a summary of each type of non-tubal ectopic pregnancy, with particular emphasis on the ultrasound diagnosis and management options. Interstitial pregnancy is characterised by the implantation of the conceptus in the interstitial portion of the fallopian tube, which is surrounded by the muscular wall of the uterus. The advances in high-resolution transvaginal ultrasonography and the establishment of early pregnancy units have facilitated the early non-invasive diagnosis of interstitial pregnancy before complications occur. This has opened the door for more conservative management options such as medical treatment with methotrexate. The management of interstitial pregnancy was surgical, in the form of cornual resection or hysterectomy. The reason for this was the late detection of this condition, which used to be diagnosed at laparotomy following tubal rupture. Medical management using methotrexate, a folate antagonist, has been increasingly used in the treatment of women identified as having an unruptured interstitial pregnancy.

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