Hysteroscopic treatment for interstitial pregnancy: A case report

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Interstitial pregnancy is a rare form of ectopic pregnancy in which the gestational sac implants in a unique location within the uterus. Rupture of an interstitial pregnancy can lead to severe, potentially life-threatening uterine hemorrhage. Common treatment options include laparoscopic surgery to incise the myometrium and remove the embryo, laparoscopic wedge resection of the lesion, or medical therapy. However, these surgical interventions can compromise the integrity of the uterine muscle layer and may lead to fallopian tube obstruction. This report concerns the case of a 29-year-old patient who underwent frozen-thawed blastocyst transfer and presented at 6 weeks of gestation. A 3D ultrasound suggested a possible interstitial tubal pregnancy. Hysteroscopy was performed, during which no gestational sac was identified within the uterine cavity. Under ultrasound guidance, microforceps were introduced via hysteroscopy into the interstitial portion of the right fallopian tube, and fresh chorionic villi were successfully retrieved. Follow-up 3D ultrasound showed no abnormalities. In this case, the interstitial tubal pregnancy was removed via hysteroscopy using non-electrosurgical instrumentation, effectively preserving the integrity of the myometrium and avoiding thermal damage to the endometrium. This approach enabled rapid recovery and reduced the risk of uterine rupture in future pregnancies. • Interstitial pregnancy, a rare type of ectopic pregnancy, is often confused with cornual pregnancy. • The interstitial line sign is a specific ultrasound feature of interstitial pregnancy. • The standard treatment for interstitial pregnancy includes medical management or surgical options such as cornuotomy or cornual wedge resection. • This article proposes hysteroscopic treatment for interstitial pregnancy, as it preserves the integrity of the myometrium and allows for a faster postoperative recovery.

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