Interstitial pregnancy: A survey of 45 cases

Abstract

1.1. An analysis of 45 cases of interstitial pregnancy has been presented. These were obtained from a total group of 944 ectopic pregnancies of all varieties, an incidence of 4.7 per cent.2.2. There was one death, a mortality rate for interstitial pregnancy of 2.2 per cent.3.3. Perforation occurred most frequently between the fifth and twelfth weeks of gestation, contrary to the general impression of late rupture.4.4. Transmigration of the ovum was noted in 26.7 per cent of the cases.5.5. The most frequent complaint was abdominal pain. Amenorrhea, anomalous vaginal bleeding, and shock were other important signs and symptoms.6.6. Profound shock appeared in 71.2 per cent of the patients with cornual perforation. This was the result of massive intraperitoneal hemorrhage.7.7. The diagnosis of interstitial pregnancy is seldom made prior to rupture. Tender cystic enlargement at one horn of the uterus is suggestive of this type of ectopic gestation.8.8. During laparotomy an interstitial pregnancy may be recognized by asymmetric enlargement of the uterus superior to the insertion of the round ligament, without a corresponding enlargement of the rest of the organ.9.9. Treatment is immediate surgery and blood transfusion. Because of the greater speed with which it usually can be accomplished, and because control of hemorrhage is almost immediate, hysterectomy is preferable to cornual resection of an extensive laceration.