Surgical Management of Interstitial Ectopic Pregnancy Using Intramyometrial Vasopressin and Cornuostomy

Interstitial pregnancy is a rare entity with a high risk of maternal mortality. It is difficult to diagnose in early pregnancy and can result in uterine rupture at the cornual end leading to catastrophic heamorrhage. The key to its management lies in early diagnosis by detailed history history, early radiological diagnosis, and management by medical or surgical means as indicated. Surgical management forms the mainstay of management in case of ruptured interstitial pregnancy or if the gestational age is advanced and the HCG levels are high. There is an inclination towards laproscopic management rather than laparotomy, and more conservative techniques involving cornuostomy rather than cornuectomy. Caution should be exercised in the next pregnancy as there is a risk of repeat intestitial pregnancy in the next conception. An elective cesarean section should be done in the next pregnancy to avoid the risk of uterine rupture at the cornuostomy site.