Angular-interstitial pregnancy treated with minimally invasive surgery after adjuvant methotrexate medical therapy.

BACKGROUND: Angular-interstitial pregnancy is a rare and potentially dangerous occurrence of ectopic pregnancy for which appropriate treatment has not been established. METHODS: A 41-year-old woman with a history of ectopic pregnancy was treated with a combined regimen of conservative treatment comprising medical therapy with methotrexate and a minimally invasive laparoscopic-assisted surgical approach. Results The patient had an unremarkable postoperative course and was discharged after 32 hours. A transvaginal ultrasound scan control 2 weeks later revealed a normal uterine wall, with normal uterine adnexa. CONCLUSION: With our combined treatment approach we avoided hysterectomy, and we achieved a more adequate uterine repair, improving future fertility.