SPONTANEOUS INTERSTITIAL PREGNANCY ON A TUBAL STUMP AFTER UNILATERAL ADENECTOMY FOLLOWED BY TRANSVAGINAL COLOR DOPPLER ULTRASOUND

Transvaginal colour and angio Doppler blood flow analysis combined wit h serial measurement of human chorionic gonadotrophin (HCG) concentrat ion is reported here for the first time to study the local vascularity of a cornual pregnancy and to monitor the effectiveness of medical th erapy. Interestingly, a strong relationship between morphological chan ges of trophoblastic tissue and the intensity of neovascularization wa s noted. Systemic single-dose methotrexate (MTX) therapy allowed succe ssful treatment of an interstitial ectopic pregnancy involving part of the proximal portion of a tubal stump. We suggest that, by adding col our Doppler to conventional transvaginal ultrasonography, the outpatie nt surveillance of ectopic pregnancy evolution following MTX therapy i s greatly enhanced. This is of particular value in cornual pregnancies which are highly likely to develop harmful complications during surgi cal intervention dr even during puncture for local MTX injection.