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Re: Interstitial pregnancyFrom: Wolfgang Moroder, M.D. (wolfgang.moroder@tin.it)Mon Oct 6 11:36:23 2003
Dear Terry. The videoclip is 1.6 MB. At this time it should be arrived (one never knows, once an e-mail took 4 full days to go to my next town...). Dscription of the clip: in a transvaginal coronal plane,you can see on the lefthand side of the fundus a flourishing pregnancy with an embryo of 9 weeks. In the last pictures of the clip a thin hypoechogenic endomiomitrial layer is more easily seen. The gestational sac is very eccentric. In none of the scans a connection of the chorion to the endometrial-decidual layer could be demonstrated. Although described in literature (Ackerman, Radiology 1993,189/1/83), I cannot recognize the "interstitial line sign". The patient refused treatment with methotrexate and left the hospital saying that she was leaving for Serbia. She returned on Saturday night with pain in the left lower abdomen. On Sunday night the pain worsened and on Monday mornig we decided to do a laparotomy for symptoms of haemoparitoneum. The patient had a previous laparotomy with salpingectomy for a left tubal pregnancy. On opening we found a moderate haemoperitoneum. The fundus uteri was covered with colon firmly attached to it. During accurate preparation and involuntary pressure on the fundus a 2.5 cm long fetus jumped out of the field. The thin layer of myometrium ruptured. All the chorion was accurately removed and the chorionic bed cleaned. The uterine opening was finally repaired with a continous suture. Best regards Wolfgang.
At Sun, 5 Oct 2003, Terry J DuBose wrote:
>
-- Wolfgang Moroder, MD Prenatal Unit Bolzano General Hospital Italy
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