Interstitial pregnancy is defined as the presence of a gestational sac in the most proximal section of the fallopian tube. Management of interstitial pregnancy remains a debated topic. Depending on hemodynamic stability, size of pregnancy, depth of surrounding myometrium, and desires for future fertility, interstitial pregnancy can be managed medically or surgically. We reviewed the literature in December 2020 using keywords “interstitial pregnancy”, “medical treatment”, “methotrexate”, and “mifepristone”. Articles published from January 1991 until 2020 were obtained from databases EMBASE, SCOPUS, and PUBMED. We describe the case of a patient with an interstitial pregnancy that was managed with a total medical approach in August 2020 at Burlo Garofolo Hospital. The patient was asymptomatic and hemodynamically stable, with a high level of serum β-hCG (22,272 mUi/mL). We used the combination of methotrexate (MTX) and mifepristone. Medical therapy was effective leading to interstitial pregnancy resolution in 51 days without collateral effects for the patient. We found seven previous cases reported in the literature. Our purpose is to underline the efficacy of medical therapy with systemic multidose MTX associated with a single oral dose of mifepristone and also folinic acid when is present a viable fetus and a high serum β-hCG level.

中文翻译：

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间质性异位妊娠：米非司酮在医疗中的作用

间质性妊娠被定义为在输卵管的最近端部分存在妊娠囊。间质性妊娠的管理仍然是一个有争议的话题。根据血流动力学稳定性、妊娠大小、周围子宫肌层的深度以及对未来生育能力的要求，间质性妊娠可以通过药物或手术进行管理。我们使用关键词“间质性妊娠”、“药物治疗”、“甲氨蝶呤”和“米非司酮”回顾了 2020 年 12 月的文献。1991 年 1 月至 2020 年发表的文章来自数据库 EMBASE、SCOPUS 和 PUBMED。我们描述了 2020 年 8 月在 Burlo Garofolo 医院采用全面医疗方法治疗的间质性妊娠患者的案例。患者无症状，血流动力学稳定，血清水平高β -hCG (22,272 mUi/mL)。我们使用了甲氨蝶呤 (MTX) 和米非司酮的组合。药物治疗是有效的，导致间质性妊娠在 51 天内消退，对患者没有附带影响。我们在文献中发现了七个以前的案例。我们的目的是强调当存在可存活胎儿和高血清β -hCG 水平时，全身多剂量 MTX 与单次口服米非司酮和亚叶酸相关的药物治疗的疗效。