R Oliver1, M Malik, A Coker, J Morris. 1. Harold Wood Hospital, Gubbins Lane, Romford, Essex RM3 0BE, UK. oliverreebs@aol.com
Abstract
OBJECTIVE: Management of extra-tubal ectopic gestations remains an inadequately explored clinical field due to the rarity of the presentations. We present a synopsis of the management highlighted by our personal case series. METHOD: A literature search was conducted through Pubmed and Medline databases. We reviewed all cases presenting with extra-tubal nidations in our institute, including seven interstitial, two cervical, three ovarian and two abdominal pregnancies. RESULT: The advances in minimal access techniques and imaging modalities have resulted in novel fertility preserving endoscopic procedures. All except one of the patients were treated by endoscopic procedures, including a novel procedure for evacuation of cornual ectopics. CONCLUSION: A high index of suspicion is essential, combined with meticulous review of clinical findings and imaging modalities to make an accurate diagnosis. Treatment with the least invasive method, either by minimal access techniques, non-invasive radiological procedures or medical treatment should be encouraged.
OBJECTIVE: Management of extra-tubal ectopic gestations remains an inadequately explored clinical field due to the rarity of the presentations. We present a synopsis of the management highlighted by our personal case series. METHOD: A literature search was conducted through Pubmed and Medline databases. We reviewed all cases presenting with extra-tubal nidations in our institute, including seven interstitial, two cervical, three ovarian and two abdominal pregnancies. RESULT: The advances in minimal access techniques and imaging modalities have resulted in novel fertility preserving endoscopic procedures. All except one of the patients were treated by endoscopic procedures, including a novel procedure for evacuation of cornual ectopics. CONCLUSION: A high index of suspicion is essential, combined with meticulous review of clinical findings and imaging modalities to make an accurate diagnosis. Treatment with the least invasive method, either by minimal access techniques, non-invasive radiological procedures or medical treatment should be encouraged.