Lamuwalla Murtaza, Panjwani Sajida, Ismail Allyzain, Samji Sunil, Kaguta Munawar, Jaiswal Shweta
Family Medicine Resident, The Aga Khan University, East Africa Medical College, Tanzania.
Department of Surgery, The Aga Khan Hospital, Dar-es-Salaam, Tanzania.
Int J Surg Case Rep. 2025 Jan;126:110688. doi: 10.1016/j.ijscr.2024.110688. Epub 2024 Nov 28.
Interstitial ectopic pregnancy is a rare but life-threatening condition, accounting for 2.4 % of all ectopic pregnancies. Diagnosing it can be challenging, as the interstitial portion of the fallopian tube allows for delayed rupture due to its capacity to expand, often leading to significant haemorrhage. Early detection is critical to preventing severe complications.
We report the case of a 30-year-old primigravida who presented for routine antenatal care at 12 weeks of gestation, asymptomatic with no identifiable risk factors. Routine ultrasound revealed a suspicious gestation near the left uterine horn, leading to a diagnosis of interstitial ectopic pregnancy via MRI. The patient underwent a laparotomy with successful wedge resection and salpingectomy. She recovered well without complications.
This case highlights the diagnostic challenges of interstitial ectopic pregnancy, which can remain asymptomatic longer than other types due to the anatomical features of the interstitial segment. Diagnostic imaging is vital for accurate diagnosis, especially in stable patients. Early intervention is key to avoiding catastrophic outcomes like uterine rupture and severe haemorrhage. Advances in imaging and surgical techniques have improved patient outcomes, but careful prenatal follow-up remains crucial for future pregnancies due to the increased risk of uterine rupture.
Routine antenatal care and imaging play a pivotal role in the early detection of interstitial ectopic pregnancies. Prompt diagnosis and management can significantly reduce the risk of severe complications, emphasizing the importance of vigilant prenatal monitoring in reducing maternal morbidity and mortality.
间质部异位妊娠是一种罕见但危及生命的情况，占所有异位妊娠的2.4%。由于输卵管间质部能够扩张，导致破裂延迟，常常引发大量出血，因此诊断这种疾病具有挑战性。早期检测对于预防严重并发症至关重要。
我们报告一例30岁初孕妇的病例，该孕妇在妊娠12周时前来进行常规产前检查，无症状且无明显危险因素。常规超声检查发现子宫左角附近有可疑妊娠，通过磁共振成像（MRI）诊断为间质部异位妊娠。患者接受了剖腹手术，成功进行了楔形切除术和输卵管切除术。她恢复良好，无并发症。
该病例突出了间质部异位妊娠的诊断挑战，由于间质段的解剖特征，其无症状持续时间可能比其他类型更长。诊断性影像学检查对于准确诊断至关重要，尤其是对于病情稳定的患者。早期干预是避免子宫破裂和严重出血等灾难性后果的关键。影像学和手术技术的进步改善了患者的预后，但由于子宫破裂风险增加，对于未来妊娠进行仔细的产前随访仍然至关重要。
常规产前检查和影像学检查在间质部异位妊娠的早期检测中起着关键作用。及时诊断和处理可显著降低严重并发症的风险，强调了警惕的产前监测对于降低孕产妇发病率和死亡率的重要性。
