ABSTRACT
Objective: To assess the effectiveness and safety of non-surgical management for six heterotopic
interstitial pregnancies.
Material and methods: We retrospectively analyzed the data of six women diagnosed with heterotopic
interstitial pregnancies who underwent non-surgical treatment at the CHA Bundang
Medical Center between January 2007 and December 2017. Three heterotopic interstitial pregnancies
were treated with sono-guided potassium chloride (KCl) injections. Two cases were managed
expectantly. One heterotopic quadruplet pregnancy with twin, left interstitial, and tubal
pregnancy was treated by sono-guided KCl injection and laparoscopic left salpingectomy.
Complications and outcomes were measured.
Results: Three cases were treated with sono-guided KCl injection and the intrauterine pregnancy
continued to term. Intrauterine pregnancies were vaginally delivered without complications. One
case that was treated expectantly was delivered at full term, while the other case resulted in
spontaneous abortion. Quadruplet heterotopic pregnancy was successfully managed with sonoguided
KCl injection and laparoscopic salpingectomy. Intrauterine twin pregnancy was successfully
delivered by elective cesarean section at 37þ0weeks of gestation with healthy babies.
Conclusions: KCl injection under ultrasonographic guidance could be a safer and more effective
treatment option than surgical treatment in hemodynamically stable patients with fetal cardiac
activity in interstitial pregnancy. Expectant management could be an option for patients with no
fetal cardiac activity.