Spontaneous interstitial pregnancy on a tubal stump after unilateral adenectomy followed by transvaginal colour Doppler ultrasound

Transvaginal colour and angio Doppler blood flow analysis combined withserial measurement of human chorionic gonadotrophin (HCG) concentration isreported here for the first time to study the local vascularity of acornual pregnancy and to monitor the effectiveness of medical therapy.Interestingly, a strong relationship between morphological changes oftrophoblastic tissue and the intensity of neovascularization was noted.Systemic single-dose methotrexate (MTX) therapy allowed successfultreatment of an interstitial ectopic pregnancy involving part of theproximal portion of a tubal stump. We suggest that, by adding colourDoppler to conventional transvaginal ultrasonography, the outpatientsurveillance of ectopic pregnancy evolution following MTX therapy isgreatly enhanced. This is of particular value in cornual pregnancies whichare highly likely to develop harmful complications during surgicalintervention or even during puncture for local MTX injection.