Conservative treatment for interstitial monochorionic twin pregnancy: case report and review of the published work

J Obstet Gynaecol Res. 2014 Mar;40(3):829-32. doi: 10.1111/jog.12250. Epub 2013 Dec 10.

Abstract

Interstitial pregnancy is considered one of the most hazardous types of ectopic pregnancies, with a mortality rate of 2-2.5%. We describe a case of a viable monochorionic twin pregnancy in a 35-year-old woman successfully treated with systemic methotrexate associated with bilateral uterine arteries' embolization. β-hCG was undetectable 67 days after the first administration of methotrexate and the ultrasonography performed on day 67 showed the remnant of the gestational sac in the right uterine horn, a thin endometrium and a normal myometrial vascularization. Conservative treatment allowed us to avoid surgical treatment and to preserve the patient's fertility.

Keywords: interstitial pregnancy; monochorionic twin pregnancy; uterine artery embolization.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abortifacient Agents, Nonsteroidal / adverse effects
  • Abortion, Induced / adverse effects*
  • Adult
  • Combined Modality Therapy / adverse effects
  • Female
  • Humans
  • Methotrexate / adverse effects
  • Pregnancy
  • Pregnancy, Interstitial / surgery
  • Pregnancy, Interstitial / therapy*
  • Pregnancy, Twin*
  • Treatment Outcome
  • Uterine Artery Embolization / adverse effects

Substances

  • Abortifacient Agents, Nonsteroidal
  • Methotrexate