Surgical Techniques of Managing Interstitial Pregnancy Miss Christina
- Slides: 8
Surgical Techniques of Managing Interstitial Pregnancy Miss Christina Aung Trainee in Obstetrics and Gynaecology East Kent Hospitals University Foundation Trust UK
Objectives: ● Background on interstitial pregnancies ● Cases series and surgical techniques used ● References
Background ● Interstitial pregnancy is pregnancy developing in portion of proximal fallopian tube that lies within the muscular wall of the uterus. ● Incidence: 2 -4% ● Mortality: 2 -2. 5% ● Management: - Conservative - Medical - Surgical
Cornuotomy with harmonic scalpel & Cornuotomy with Ligasure and bipolar forceps
Wedge resection with Ligasure and closure of myometrium
Cornuectomy with Ligasure using vasopressin and endo-loops
Conclusion ●Different energy sources and techniques can be used to achieve the wanted results ●Preserving cornual integrity following laparoscopic cornuotomy & cronual resection is important ●The incidences of subsequent uterine rupture and dehiscence associated with corneal resection have been reported as 30%. ●Laparoscopic treatment of interstitial pregnancies is effective
References ● Moawad N, Mahajan S, Moniz M, Taylor S, Hurd WW (2010) Current Diagnosis and treatment of interstitial pregnancy. American Journal of Obstetrics & Gynaecology 202(1): 15 -29 ● Soriano D, Vicus D, Mashiach R, Schiff E, Seidman D, Goldenberg M (2008). Laparoscopic treatment of cornual pregnancy: a series of 20 consecutive cases, Fertility and Sterility 90(3): 839 -843 ● Jermy K, Thomas J, Doo A, Bourne T (2004) The conservative management of interstitial pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology 111: 1283– 1288 ● Weissman A, Fishman A (1992) Uterine rupture following conservative surgery for interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol 44: 237 -9. ● Choi YS, Eun DS, Choi J, Shin KS, Choi JG, Park HD (2009) Laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy. Fertil Steril 91(5): 1933 -7.
