Clinical case of interstitial tubal pregnancy treatment with mifepristone and misoprostol

Abstract

The article presents the experience of drug treatment of inertial tubal pregnancy. Currently, ectopic pregnancy is one of the most serious pathologies of pregnancy, leading to a decrease in the woman's reproductive health and directly threatening her life. In this clinical case, the possibility of treatment of ectopic pregnancy with mifepristone and misoprostol in a hospital of the 3rd level, with a patient's refusal of surgical treatment, has been demonstrated. At the moment, according to clinical recommendations adopted in the Russian Federation, interstitial tubal pregnancy is an indication for surgical treatment. Instructions for the use of mifepristone and misoprostol do not provide indications and treatment regimens for ectopic pregnancy. Medicamentous treatment of ectopic pregnancy is possible only with early diagnosis, in hospital settings and with the patient's voluntary consent. We have demonstrated the possibility to consider drug treatment not only as a therapy for despair, but also as an alternative to surgery leading to operative trauma of the reproductive organs, which is more extensive with the rare localization of interstitial tubal pregnancy, namely not only removal of the fallopian tube, but excision of the uterine tube trunk angle. Operative treatment of ectopic pregnancy leads to various complications that reduce the reproductive function of patients. Conservative treatment, perhaps, will help in the subsequent to avoid complications associated with surgical treatment and preserve the ability to procreate, in women with a burdened obstetric-gynecological anamnesis.