Background: With the increased frequency of diagnosis of interstitial
pregnancy in the early first trimester, non-surgical management of unruptured
interstitial pregnancy has become an important issue. However, management of
unruptured interstitial pregnancy by uterine artery chemoembolization (UACE) with
dactinomycin has never been evaluated via a case series. Methods: With
this aim, a retrospective review of electronic chart records over a five-year
period was performed, and a series of cases of unruptured interstitial pregnancy
during the first trimester was extracted. Diagnostic procedures included
ultrasonography, magnetic resonance imaging (MRI), and laparoscopic examination,
if necessary. Conservative treatment regimen included UACE. Additional
administration of methotrexate (MTX) was considered when an insufficient decline
of serum -hCG was noted. Clinical characteristics and treatment outcomes
are described. Results: Among four women diagnosed with unruptured
interstitial pregnancy at six weeks of gestation, one case was managed by
laparoscopic cornuostomy due to concerns of rupture after the identification of
thinning of the myometrium, whereas the other three cases were initially managed
by UACE. One case of proximal interstitial pregnancy was diagnosed solely by MRI,
whereas two cases of distal interstitial pregnancy was diagnosed by exploratory
laparoscopy. Two cases were successfully managed by UACE alone, whereas one case
required additional systemic administration of MTX to achieve resolution of
gestational products after UACE. Thereafter, one patient conceived spontaneously
and experienced a successful vaginal birth. Conclusions: This small case
series emphasizes that UACE is a feasible minimally invasive option for the
management of unruptured interstitial pregnancy identified in the early first
trimester.