Operative hysteroscopy – a minimally invasive procedure to treat interstitial pregnancy: conditions, contraindications, results

Objective. To study the efficacy and short-term outcomes of operative hysteroscopy in the treatment of patients with interstitial pregnancy, to justify the conditions and contraindications for its use in this nosology. Patients and methods. This study presents a prospective and retrospective analysis of medical records of 11 female patients aged 28 to 43 years (34.4 + 2.2 years) with interstitial pregnancy. The diagnosis was verified by hysteroscopy and pathological examination. Results. The gestational age ranged from 4 to 8 weeks, the duration of surgery – from 17 to 25 minutes, and intraoperative blood loss – from 50 to 100 mL. The surgery was performed using an original technique consisting of 4 stages, with the main ones being hydrodissection (stage 2) and atraumatic curettage with a “cold” loop electrode (stage 3). In 24 hours after surgery, serum hCG levels decreased by 46–57% from baseline. The length of hospital stay was 24 hours after surgery, which was due to the need to assess the dynamics of hCG. Conclusion. Under certain conditions, operative hysteroscopy is the treatment of choice in patients with interstitial pregnancy due to its high efficacy combined with minimal invasiveness, allowing to preserve not only the anatomy of the fallopian tube, but also its functional epithelium. © 2025 Elsevier B.V., All rights reserved.