Purse-string suture technique to enable laparoscopic management of the interstitial gestation of a heterotopic pregnancy.

OBJECTIVE

To describe the laparoscopic management of an interstitial gestation of a heterotopic pregnancy.

DESIGN

Case report and technique description.

SETTING

Tertiary-level private practice.

PATIENT(S): Woman with a 6-week gestation spontaneous heterotopic twin pregnancy: one twin intrauterine, one interstitial.

INTERVENTION(S): A purse-string suture was applied to the proximal portion of the interstitial heterotopic pregnancy.

MAIN OUTCOME MEASURE(S): To enable a cornual resection to be performed with minimal bleeding and without recourse to laparotomy.

RESULT(S): At 8 weeks gestation an ultrasound scan confirmed a viable singleton intrauterine pregnancy, but a scan at 12 weeks showed a missed miscarriage.

CONCLUSION(S): The embedding of the suture into the uterine serosa prevents slipping of the ligature that could occur with a pretied loop.