Thomas Aust1, Aoife O'Neill, Gregory Cario. 1. Sydney Women's Endosurgery Centre, St. George Private Hospital, Sydney, New South Wales, Australia. tomaust@doctors.org.uk
Abstract
OBJECTIVE: To describe the laparoscopic management of an interstitial gestation of a heterotopic pregnancy. DESIGN: Case report and technique description. SETTING: Tertiary-level private practice. PATIENT(S): Woman with a 6-week gestation spontaneous heterotopic twin pregnancy: one twin intrauterine, one interstitial. INTERVENTION(S): A purse-string suture was applied to the proximal portion of the interstitial heterotopic pregnancy. MAIN OUTCOME MEASURE(S): To enable a cornual resection to be performed with minimal bleeding and without recourse to laparotomy. RESULT(S): At 8 weeks gestation an ultrasound scan confirmed a viable singleton intrauterine pregnancy, but a scan at 12 weeks showed a missed miscarriage. CONCLUSION(S): The embedding of the suture into the uterine serosa prevents slipping of the ligature that could occur with a pretied loop.
OBJECTIVE: To describe the laparoscopic management of an interstitial gestation of a heterotopic pregnancy. DESIGN: Case report and technique description. SETTING: Tertiary-level private practice. PATIENT(S): Woman with a 6-week gestation spontaneous heterotopic twin pregnancy: one twin intrauterine, one interstitial. INTERVENTION(S): A purse-string suture was applied to the proximal portion of the interstitial heterotopic pregnancy. MAIN OUTCOME MEASURE(S): To enable a cornual resection to be performed with minimal bleeding and without recourse to laparotomy. RESULT(S): At 8 weeks gestation an ultrasound scan confirmed a viable singleton intrauterine pregnancy, but a scan at 12 weeks showed a missed miscarriage. CONCLUSION(S): The embedding of the suture into the uterine serosa prevents slipping of the ligature that could occur with a pretied loop.