Interstitial ectopic pregnancy, a rare clinical phenomenon diagnosed asymptomatically on routine work up in Tanzania: Case report

Introduction: Interstitial ectopic pregnancy is a rare but life-threatening condition, accounting for 2.4 % of all ectopic pregnancies. Diagnosing it can be challenging, as the interstitial portion of the fallopian tube allows for delayed rupture due to its capacity to expand, often leading to significant haemorrhage. Early detection is critical to preventing severe complications. Case presentation: We report the case of a 30-year-old primigravida who presented for routine antenatal care at 12 weeks of gestation, asymptomatic with no identifiable risk factors. Routine ultrasound revealed a suspicious gestation near the left uterine horn, leading to a diagnosis of interstitial ectopic pregnancy via MRI. The patient underwent a laparotomy with successful wedge resection and salpingectomy. She recovered well without complications. Discussion: This case highlights the diagnostic challenges of interstitial ectopic pregnancy, which can remain asymptomatic longer than other types due to the anatomical features of the interstitial segment. Diagnostic imaging is vital for accurate diagnosis, especially in stable patients. Early intervention is key to avoiding catastrophic outcomes like uterine rupture and severe haemorrhage. Advances in imaging and surgical techniques have improved patient outcomes, but careful prenatal follow-up remains crucial for future pregnancies due to the increased risk of uterine rupture. Conclusion: Routine antenatal care and imaging play a pivotal role in the early detection of interstitial ectopic pregnancies. Prompt diagnosis and management can significantly reduce the risk of severe complications, emphasizing the importance of vigilant prenatal monitoring in reducing maternal morbidity and mortality.