BARI – A rare case of ectopic pregnancy (of the interstitial type) has been resolved with a minimally invasive operation capable of saving the uterus of a young woman who, in the future, may still have children. Thus the difficult case involving the Obstetrics and Gynecology team of the San Paolo Hospital in Bari, directed by Giovanni Di Vagno, was resolved. The protagonist is a 30-year-old non-EU citizen, mother of a child and in the 14th week of pregnancy, who presented herself in the emergency room complaining of pain in the lower part of the abdomen. Ultrasound made it possible to diagnose a pregnancy that ended at 7 weeks, implanted right in the portion of the tube that crosses the uterus (interstitial pregnancy). The gynecologists then intervened urgently.
“The woman – explains Francesco Meo, who performed the surgery – was treated laparoscopically and vaginally. We proceeded to remove the gestational sac through the vagina and the uterine cavity, avoiding bleeding with the application of haemostatic stitches by laparoscopy. The peculiarity consists in the fact that in the literature different methods are described for the treatment, often demolishing, with the removal of the portion of the uterus crossed by the tube. In this case, however, the removal was avoided and we proceeded in conservatively, preserving the uterus itself and its functionality with a double approach, transvaginal and laparoscopic, used with excellent results in very rare cases”.
“The interstitial pregnancy – underlines the director of the operating unit Giovanni Di Vagno – is established in the section of the fallopian tube that crosses the uterine wall.
Implantation of the pregnancy in this section of the tube is very rare, accounting for only 2% of ectopic pregnancies. It is difficult to diagnose and treatment is related to several factors including haemodynamic stability, desire for future pregnancies, gestational age. The conservative intervention adopted has the advantage of having a lower risk of uterine rupture in the event of a subsequent pregnancy, essentially guaranteeing the possibility for this young woman to still be able to have children”.
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