Interstitial ectopic pregnancy: laparoscopic surgical management and subsequent outcome-a case report

Interstitial ectopic pregnancy (IEP) is a rare form of ectopic pregnancy (EP). IEPs account for 1-3% of all EPs but with significant associated morbidity and mortality. The main presentation is usually abdominal pain with vaginal bleeding. Ultrasonography usually forms the cornerstone of diagnosis of IEP with distinct features described in literature. Management can be medical or surgical with the choice based on certain patient factors. We present a case of an IEP that was surgically managed in our unit and conduct a literature review of this condition.

A 37-year-old Kenyan woman presented with 5 weeks of amenorrhea and pelvic pain. Her investigations revealed a beta-human chorionic gonadotropin (β-HCG) level of 27,399 milli-international units per milliliter (miu/ml). Ultrasonography revealed an IEP with fetal cardiac activity in the left tube that was unruptured. She underwent a laparoscopic cornuostomy and had an uneventful post-operative stay.

IEPs are rare pregnancies with seldom specific risk factors. They present with the classical EP symptoms of vaginal bleeding and abdominal pain with symptoms of rupture if it has occurred. Ultrasonography is the gold standard in diagnosis with several pathognomonic features identified in literature. Its surgical management involves cornuostomy which can be performed laparoscopically as in the described case. The prognosis is usually good with few untoward pregnancy complications.