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Case Reports in Obstetrics and Gynecology
Volume 2018, Article ID 2815871, 5 pages
https://doi.org/10.1155/2018/2815871
Case Report

Interstitial Pregnancy: From Medical to Surgical Approach—Report of Three Cases

1Department of Obstetrics and Gynecology, SS Annunziata Hospital, Chieti, Italy
2Department of Medicine and Aging Sciences University “G. d’Annunzio” of Chieti-Pescara, Italy
3Department of Obstetrics and Gynecology, Casa di Cura Salus srl, Brindisi, Italy
4Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
5Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
6“G. d’Annunzio” University, Chieti, Italy

Correspondence should be addressed to M. R. Spina; moc.liamg@anipsatreborairam

Received 20 June 2018; Accepted 24 September 2018; Published 15 October 2018

Academic Editor: Maria Grazia Porpora

Copyright © 2018 L. Di Tizio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Interstitial pregnancy is a rare form of ectopic pregnancy that usually leads to uterine rupture resulting in sudden life-threatening haemorrhage, need for blood transfusion, and admission to intensive care unit. Mortality rate is 6–7 times higher than that in classical ectopic pregnancy. Uterine rupture has been typically reported to occur at more advanced gestational ages compared to tubal pregnancy although several recent reports have shown a high risk of rupture before 12 weeks of gestation. Cases Presentation. We report three cases of women affected by interstitial pregnancy, with different clinical symptoms, and managed to be treated with surgery or medical therapy. An emergency laparotomy was performed in the first case by the general surgeon, while in the second case laparoscopy was made by a gynecologist; last case shows the success of systemic administration of methotrexate. Conclusion. Interstitial pregnancy is still a challenging condition to diagnose and treat; early diagnosis may help to choose the proper management.