Successful management of an advanced interstitial ectopic pregnancy in a resource-limited setting: a case report

J Med Case Rep. 2024 Mar 20;18(1):168. doi: 10.1186/s13256-024-04437-y.

Abstract

Background: Interstitial ectopic pregnancy is an ectopic gestation developing in the uterine part of the fallopian tube. The condition is rare and presents challenges for clinical as well as radiological diagnosis. This case report presents a rare case of interstitial ectopic pregnancy diagnosed intraoperatively.

Case presentation: A 36-year-old Black woman, referred from a peripheral health facility, presented at the emergency department with severe abdominal pains, vaginal spotting, nausea, and vomiting, with a 2-month history of irregular menstrual flow. Clinical and laboratory findings were suggestive of an acute abdomen likely due to a ruptured ectopic pregnancy (ultrasound was not available). An emergency exploratory laparotomy was done, which revealed a right adnexal ruptured interstitial pregnancy of a lifeless female fetus weighing 500 g (estimated mean gestational age of 22-23 weeks). The left fallopian tube looked normal. The site of rupture was repaired, followed by cleaning and closure of the abdomen. The post-operative period was uneventful, and the patient was discharged on postoperative day 7.

Conclusion: Interstitial pregnancies are uncommon and rarely attain advanced gestational ages, as in this case, compared with other tubal ectopic pregnancies. However, women presenting with signs of hypovolemic shock and acute abdomen, with a positive pregnancy test, warrant a high index of suspicion.

Keywords: Advanced interstitial ectopic pregnancy; Cameroon; Case presentation; Laparotomy.

Publication types

  • Case Reports

MeSH terms

  • Abdomen
  • Abdomen, Acute*
  • Adult
  • Fallopian Tubes
  • Female
  • Humans
  • Infant
  • Pregnancy
  • Pregnancy, Interstitial*
  • Pregnancy, Tubal* / diagnostic imaging
  • Pregnancy, Tubal* / surgery
  • Rupture