Recurrent Interstitial pregnancy: a new approach in diagnosis with MRI and management with systemic methotrexate along with intra foetal cardiac 10% potassium chloride

We present a case of recurrent interstitial pregnancy in a setting of recurrent pregnancy loss where we used a new modality in the diagnosis and treatment. The patient after diagnosis of interstitial pregnancy by Ultrasonography was very keen to continue her pregnancy so the diagnosis was confirmed with MRI imaging showing the “interstitial sign” that convinced her for termination. In this case presence of active foetal cardiac activity and high Serum βhCG (43000 mIU/ml), made medical management a difficult proposition. Then we conceived a hybrid combined medical management of intra-foetal cardiac 10% KCl and adjuvant systemic multi-dose MTX therapy. This resulted in resolution of ectopic and conserves her fertility.