Objective:The incidence of interstitial pregnancy(IP)has increased by using assisted reproductive technology,especially after ipsilateral salpingectomy.This review aimed to examine the current state of prevention,risk...Objective:The incidence of interstitial pregnancy(IP)has increased by using assisted reproductive technology,especially after ipsilateral salpingectomy.This review aimed to examine the current state of prevention,risk factors,diagnosis,and management of IP,based on the current literature.Data sources:We searched PubMed for English language articles published up to June 2018.The search terms included interstitial pregnancy,ectopic pregnancy or cornual pregnancy,angular pregnancy,and combinations of these terms.Study selection:Articles were obtained and reviewed to analyze risk factors,diagnosis,prevention,and management of IP.Results:Ipsilateral salpingectomy is the main high-risk factor of IP,especially after in vitro fertilization.Cornual suture at the time of salpingectomy helps to reduce the IP rate.Laparoscopic cornuostomy appears to be an effective treatment in intact cases,although it sometimes needs to be combined with methotrexate therapy in ruptured cases complicated by persistent disease.展开更多
Background Heterotopic pregnancy （HP） is defined as a pregnancy in which one or more embryos is viably implanted in the uterus while the other is implanted elsewhere as an ectopic pregnancy. The occurrence of HP ris...Background Heterotopic pregnancy （HP） is defined as a pregnancy in which one or more embryos is viably implanted in the uterus while the other is implanted elsewhere as an ectopic pregnancy. The occurrence of HP rises dramatically with the increased use of assisted reproductive technology. HP of interstitial pregnancy is one special situation which needs more concern. Here we evaluate the efficacy of local aspiration and instillation of hyperosmolar glucose in the treatment of live interstitial pregnancy complicated with live intrauterine pregnancy after in vitro fertilization and embryo transfer. Methods Five female patients were diagnosed with live interstitial pregnancies complicated with intrauterine pregnancies. They were treated with transvaginal ultrasound-guided aspiration of interstitial pregnancy and instillation of hyperosmolar glucose at the Center for Reproductive Medicine of Peking University Third Hospital from January 1st, 2008 to May 30th, 2011. Results Gemmule embryos in all 5 cases were aspirated successfully and there was no abdominal hemorrhage, threatened abortion or infection in any of the cases. The sac of interstitial pregnancy continued to progress after aspiration and stopped growing between 11 to 20 weeks. By the 30th week of pregnancy, 80% of the interstitial masses had disappeared. Four cases have delivered and one is still in on-going pregnancy. All of the four cases underwent cesarean section and there were nothing special detected in the corner of the uterus. Conclusion Local aspiration and instillation of hyperosmolar glucose may be an effective way to treat live interstitial pregnancy when coexisting with a live intrauterine pregnancy.展开更多
基金This study was supported by the programs of Medical Science and Technology of Zhejiang Province,China(2018244125)Department of Education of Zhejiang Province,China(Y201534677).
文摘Objective:The incidence of interstitial pregnancy(IP)has increased by using assisted reproductive technology,especially after ipsilateral salpingectomy.This review aimed to examine the current state of prevention,risk factors,diagnosis,and management of IP,based on the current literature.Data sources:We searched PubMed for English language articles published up to June 2018.The search terms included interstitial pregnancy,ectopic pregnancy or cornual pregnancy,angular pregnancy,and combinations of these terms.Study selection:Articles were obtained and reviewed to analyze risk factors,diagnosis,prevention,and management of IP.Results:Ipsilateral salpingectomy is the main high-risk factor of IP,especially after in vitro fertilization.Cornual suture at the time of salpingectomy helps to reduce the IP rate.Laparoscopic cornuostomy appears to be an effective treatment in intact cases,although it sometimes needs to be combined with methotrexate therapy in ruptured cases complicated by persistent disease.
文摘Background Heterotopic pregnancy （HP） is defined as a pregnancy in which one or more embryos is viably implanted in the uterus while the other is implanted elsewhere as an ectopic pregnancy. The occurrence of HP rises dramatically with the increased use of assisted reproductive technology. HP of interstitial pregnancy is one special situation which needs more concern. Here we evaluate the efficacy of local aspiration and instillation of hyperosmolar glucose in the treatment of live interstitial pregnancy complicated with live intrauterine pregnancy after in vitro fertilization and embryo transfer. Methods Five female patients were diagnosed with live interstitial pregnancies complicated with intrauterine pregnancies. They were treated with transvaginal ultrasound-guided aspiration of interstitial pregnancy and instillation of hyperosmolar glucose at the Center for Reproductive Medicine of Peking University Third Hospital from January 1st, 2008 to May 30th, 2011. Results Gemmule embryos in all 5 cases were aspirated successfully and there was no abdominal hemorrhage, threatened abortion or infection in any of the cases. The sac of interstitial pregnancy continued to progress after aspiration and stopped growing between 11 to 20 weeks. By the 30th week of pregnancy, 80% of the interstitial masses had disappeared. Four cases have delivered and one is still in on-going pregnancy. All of the four cases underwent cesarean section and there were nothing special detected in the corner of the uterus. Conclusion Local aspiration and instillation of hyperosmolar glucose may be an effective way to treat live interstitial pregnancy when coexisting with a live intrauterine pregnancy.
