Interstitial Ectopic Pregnancies: Laparoscopy Vs. Laparotomy

Document Type : Original Article

Author

FACOG, FRCSC, FACS, HCLD, Professor and Head of the Division of Reproductive Endocrinology and Infertility of the Department of Obstetrics & Gynecology at the University of South Alabama

Abstract

As used in the literature, an interstitial ectopic pregnancy can refer to three different situations.
A true interstitial ectopic pregnancy occurs in the Fallopian tube’s interstitial or intramural
segment. When a woman has a single uterine horn, a bicornuate uterus, or a septate uterus, her
ectopic pregnancy is a cornual pregnancy. When an ectopic pregnancy occurs in one of the
uterine angles, but outside the Fallopian tube, a rare angular pregnancy has occurred.
In the past, an interstitial pregnancy was managed conservatively until over 12 weeks on
the premise that the uterine muscle protected against early rupture. Recently, however,
evidence contradicts this belief as early rupture is more common than initially thought.
With the advances in laparoscopic surgery, laparoscopy is accomplished with great success. That said, if the physician deems it safer to do laparotomy, patient safety is key to
management of an interstitial ectopic pregnancy.

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