Interstitial ectopic

[Linh]

Hi Steve,

I saw a live intrauterine preg on this lady with a bit of spotting last week. No pain. Comes in for a scan for TOP. I measure the distance from the outer layer of the decidual reaction to the myometrial outer layer to be 5mm in TRV and SAG. The sac is obviously very eccentrically located.

Do you think this is interstitial ectopic preg?

What is your criteria to call one?

[Linh]

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[Stephen Bird]

Nice images,

We use the 5mm rule as well,

However we would be guided by the clinical scenario.

I see these eccentric pregnancies from time to time and most just grow normally and look fine when they are a bit bigger.

If it is a true interstitial ectopic it will declare itself with symptoms.

If you can see the pregnancy seperate from the endometrium I am more concerned but this is NOT the case in your images so the sac may have just washed up on the top right hand corner of the endometrial cavity and is setting up a home there quite nicely.

If I can see the right corneal endometrium finish and then the sac looks disconnected from the cavity and embedded in the myometrium where the tube is entering I would be a lot more concerned.

Nearly always when they look like this one they are fine.

I presume from the history she was asymptomatic as well which is very reassuring.

Steve

[Linh]

Thanks Steve for your input and reassurance. Patient opted for MTOP anyway.

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