Conservative therapy of interstitial pregnancy in deep infiltrative endometriosis

In: Journal of obstetrics and women's diseases · 2020 · vol. 69(5) , pp. 77–86 · doi:10.17816/jowd69577-86 · W3117099396
article OA: hybrid CC0
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-29 ⓘ

This paper reviews risk factors for ectopic pregnancy in deep infiltrative endometriosis and presents a case of successful methotrexate treatment for interstitial tubal pregnancy with persistent trophoblast.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-30 · read from full text ⓘ

This article reviews the prevalence and risk factors of ectopic pregnancy, with specific attention to the role of external genital endometriosis in its development. The authors discuss existing algorithms for conservative therapy of rare ectopic localizations and present a clinical case involving methotrexate treatment for trophoblast persistence after laparoscopic removal of an interstitial tubal pregnancy in a patient with deep infiltrative endometriosis. The paper highlights the complexity of managing such cases where anatomical distortion from endometriosis intersects with reproductive pathology. Relevance to endometriosis: This paper is centrally about endometriosis, specifically focusing on deep infiltrative endometriosis as a comorbid condition complicating the diagnosis and conservative management of interstitial ectopic pregnancy.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

This article summarizes data on the prevalence, risk factors and the role of external genital endometriosis in the development of ectopic pregnancy. The existing algorithms for the use of conservative therapy of ectopic pregnancy of rare localizations are discussed. The authors presented a clinical case of using methotrexate in the treatment of a patient with infiltrative endometriosis and trophoblast persistence after laparoscopic removal of interstitial tubal pregnancy.
Full text 9,298 characters · extracted from oa-html · click to expand
Conservative therapy of interstitial pregnancy in deep infiltrative endometriosis - Authors: Khachaturyan A.R.1,2, Yarmolinskaya M.I.1,3, Tsypurdeyeva A.A.1,2, Popov E.N.4, Rudikova A.I.1 - Affiliations: - The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott - Saint Petersburg State University - North-Western State Medical University named after I.I. Mechnikov - AVA-PETER Ltd. - Issue: Vol 69, No 5 (2020) - Pages: 77-86 - Section: Original study articles - Submitted: 23.12.2020 - Accepted: 23.12.2020 - Published: 23.12.2020 - URL: https://journals.eco-vector.com/jowd/article/view/56608 - DOI: https://doi.org/10.17816/JOWD69577-86 - ID: 56608 Cite item Abstract This article summarizes data on the prevalence, risk factors and the role of external genital endometriosis in the development of ectopic pregnancy. The existing algorithms for the use of conservative therapy of ectopic pregnancy of rare localizations are discussed. The authors presented a clinical case of using methotrexate in the treatment of a patient with infiltrative endometriosis and trophoblast persistence after laparoscopic removal of interstitial tubal pregnancy. Full Text About the authors Armine R. Khachaturyan The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State University Author for correspondence. Email: [email protected] ORCID iD: 0000-0003-2141-6307 SPIN-code: 2691-3910 MD, PhD, Senior Researcher. The Department of Gynecology and Endocrinology; Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, the Faculty of Medicine Russian Federation, Saint PetersburgMaria I. Yarmolinskaya The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov Email: [email protected] ORCID iD: 0000-0002-6551-4147 SPIN-code: 3686-3605 Scopus Author ID: 7801562649 ResearcherId: P-2183-2014 MD, PhD, DSci (Medicine), Professor, Professor of the Russian Academy of Sciences, Head of the Department of Gynecology and Endocrinology, Head of the Diagnostics and Treatment of Endometriosis Center; Professor. The Department of Obstetrics and Gynecology Russian Federation, Saint PetersburgAnna A. Tsypurdeyeva The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State University Email: [email protected] ORCID iD: 0000-0001-7774-2094 SPIN-code: 5208-9707 MD, PhD, Head of the Department of Gynecology with the Operating Unit; Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, the Faculty of Medicine Russian Federation, Saint PetersburgEduard N. Popov AVA-PETER Ltd. Email: [email protected] ORCID iD: 0000-0001-8671-3551 ResearcherId: K-2802-2018 MD, Head of the Department of Operative Gynecology Russian Federation, Saint PetersburgAlexandra I. Rudikova The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott Email: [email protected] ORCID iD: 0000-0002-3505-8240 Resident Russian Federation, Saint PetersburgReferences - Основные показатели деятельности акушерско-гинекологической службы в Российской Федерации в 2018 году. Справочник Министерства здравоохранения Российской Федерации. – М., 2019. [Osnovnye pokazateli deyatel’nosti akushersko-ginekologicheskoy sluzhby v Rossiyskoy Federatsii v 2018 godu. Spravochnik Ministerstva zdravookhraneniya Rossiyskoy Federatsii. Moscow; 2019. (In Russ.)] - Клинические рекомендации (протокол лечения). Внематочная (эктопическая) беременность. – М., 2017. – 35 с. [Klinicheskie rekomendatsii (protokol lecheniya). Vnematochnaya (ektopicheskaya) beremennost’. Moscow; 2017. 35 р. (In Russ.)] - Saraswat L, Ayansina DT, Cooper KG, et al. Pregnancy outcomes in women with endometriosis: A national record linkage study. BJOG. 2017;124(3):444-452. https://doi.org/10.1111/1471-0528.13920. - Ankum WM, Mol BW, van der Veen F, Bossuyt PM. Risk factors for ectopic pregnancy: A meta-analysis. Fertil Steril. 1996;65(6):1093-1099. https://doi.org/10.1016/s0015-0282(16)58320-4. - Hjordt Hansen MV, Dalsgaard T, Hartwell D, et al. Reproductive prognosis in endometriosis. A national cohort study. Acta Obstet Gynecol Scand. 2014;93(5):483-489. https://doi.org/10.1111/aogs.12373. - Hwang A, Chou L, Islam MM, et al. Risk factors for ectopic pregnancy in the Taiwanese population: Aretrospective observational study. Arch Gynecol Obstet. 2016;294(4):779-783. https://doi.org/10.1007/s00404-016-4117-7. - Beobachtungen der k. k. medizinisch-chirurgischen Josephs-Aсademie zu Wien: Band. Camesina; 1801. 189 р. - Reid P, Buddha LL. Hysteroscopic diagnosis of interstitial ectopic pregnancy. BJOG. 2004;111(1):89-90. https://doi.org/10.1111/j.1471-0528.2004.00013.x. - Meyer WR, Mitchell DE. Hysteroscopic removal of an interstitial ectopic gestation. A case report. J Reprod Med. 1989;34(11):928-929. - Tanaka T, Hayashi H, Kutsuzawa T, et al. Treatment of interstitial ectopic pregnancy with methotrexate: Report of a successful case. Fertil Steril. 1982;37(6):851-852. https://doi.org/10.1016/s0015-0282(16)46349-1. - Tang A, Baartz D, Khoo SK. A medical management of interstitial ectopic pregnancy: A 5-year clinical study. Aust N Z J Obstet Gynaecol. 2006;46(2):107-111. https://doi.org/10.1111/j.1479-828X.2006.00537.x. - Lozeau AM, Potter B. Diagnosis and management of ectopic pregnancy. Am Fam Physician. 2005;72(9):1707−1714. [Erratum in am fam physician. 2007;75(3):312]. - Seror V, Gelfucci F, Gerbaud L, et al. Care pathways for ectopic pregnancy: A population-based cost-effectiveness analysis. Fertil Steril. 2007;87(4):737-748. https://doi.org/ 10.1016/j.fertnstert.2006.11.005. - National Collaborating Centre for Women’s and Children’s Health (UK). Ectopic pregnancy and miscarriage: Diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. London: RCOG; 2012. - Lipscomb GH. Medical management of ectopic pregnancy. Clin Obstet Gynecol. 2012;55(2):424-432. https://doi.org/ 10.1097/GRF.0b013e3182510a48. - Diagnosis and management of ectopic pregnancy: Green-top guideline No. 21. BJOG. 2016;123(13):e15-e55. https://doi.org/10.1111/1471-0528.14189. - Yao M, Tulandi T. Current status of surgical and nonsurgical management of ectopic pregnancy. Fertil Steril. 1997;67(3):421-433. https://doi.org/10.1016/s0015-0282(97)80064-7. - Sowter MC, Frappell J. The role of laparoscopy in the management of ectopic pregnancy. Rev Gyn Practice. 2002;2(1-2):73-82. https://doi.org/10.1016/S1471-7697(02) 00007-2. - Hajenius PJ, Mol BW, Ankum WM, et al. Clearance curves of serum human chorionic gonadotrophin for the diagnosis of persistent trophoblast. Hum Reprod. 1995;10(3):683-687. https://doi.org/10.1093/oxfordjournals.humrep.a136012. - Lund CO, Nilas L, Bangsgaard N, Ottesen B. Persistent ectopic pregnancy after linear salpingotomy: A non-predictable complication to conservative surgery for tubal gestation. Acta Obstet Gynecol Scand. 2002;81(11):1053-1059. https://doi.org/10.1034/j.1600-0412.2002.811110.x. - National Guideline Alliance (UK). Ectopic pregnancy and miscarriage: Diagnosis and initial management. London: National Institute for Health and Care Excellence (UK); 2019. - Kirk E, van Calster B, Condous G, et al. Ectopic pregnancy: using the hCG ratio to select women for expectant or medical management. Acta Obstet Gynecol Scand. 2011;90(3):264-272. https://doi.org/10.1111/j.1600-0412. 2010.01053.x. - Da Costa Soares R, Elito J Jr, Camano L. Increment in beta-hCG in the 48-h period prior to treatment: A new variable predictive of therapeutic success in the treatment of ectopic pregnancy with methotrexate. Arch Gynecol Obstet. 2008;278(4):319-324. https://doi.org/10.1007/s00404-008-0589-4. - Nguyen Q, Kapitz M, Downes K, Silva C. Are early human chorionic gonadotropin levels after methotrexate therapy a predictor of response in ectopic pregnancy? Am J Obstet Gynecol. 2010;202(6):630.e1-5. https://doi.org/10.1016/ j.ajog.2010.03.022. - Skubisz MM, Li J, Wallace EM, Tong S. Decline in βhCG levels between days 0 and 4 after a single dose of methotrexate for ectopic pregnancy predicts treatment success: A retrospective cohort study. BJOG. 2011;118(13):1665-1668. https://doi.org/10.1111/j.1471-0528.2011.03133.x. - Stovall TG, Ling FW, Gray LA. Single-dose methotrexate for treatment of ectopic pregnancy. Obstet Gynecol. 1991;77(5):754-757. - Fernandez H, Bourget P, Ville Y, et al. Treatment of unruptured tubal pregnancy with methotrexate: Pharmacokinetic analysis of local versus intramuscular administration. Fertil Steril. 1994;62(5):943-947. https://doi.org/10.1016/s0015-0282(16)57055-1. - Marret H, Fauconnier A, Dubernard G, et al. [Evidence-based evaluation and expertise of methotrexate off label use in gynaecology and obstetrics: Work of the CNGOF. (In French)]. J Gynecol Obstet Biol Reprod. 2015;44(3):230-236. https://doi.org/10.1016/j.jgyn.2014.12.008. - Ярмолинская М.И., Айламазян Э.К. Генитальный эндометриоз. Различные грани проблемы. – СПб.: Эко-Вектор, 2017. – 615 c. [Yarmolinskaya MI, Aylamazyan EK. Genital’ny endometrioz. Razlichnye grani problemy. Saint Petersburg: Eko-Vektor; 2017. 615 p. (In Russ.)]

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-html ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (2)

References (22)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK