Exploring the complexities of cornual and interstitial pregnancies-insights from a case series
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20243608Keywords:
Cornual pregnancy, Interstitial pregnancy, Intervention, Gestational age, Hemodynamic stability, Obstetric history, Anatomical considerationsAbstract
Cornual and Interstitial pregnancies represent a rare but potentially life-threatening condition requiring prompt diagnosis and intervention. The current case series highlights the diversity of clinical presentations and management approaches. Each case highlights the importance of individualized care tailored to the patient's unique circumstances, including gestational age, hemodynamic stability, obstetric history, and anatomical considerations. Through these cases, we aim to unravel the intricacies of these ectopic pregnancy subtypes, highlight the importance of precise diagnostic criteria, and tailored management strategies for optimal patient outcomes. Additionally, we present a comprehensive review of existing literature to provide a nuanced understanding of these enigmatic clinical entities. The evaluation will extend to discussing various treatment strategies, highlighting both surgical and medical management.
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References
Faraj R, Steel M. Management of cornual (interstitial) pregnancy. The Obstetrician & Gynaecologist. 2007;9(4):249-55.
Li PC, Lin WY, Ding DC. Risk factors and clinical characteristics associated with a ruptured ectopic pregnancy: A 19-year retrospective observational study. Medicine. 2022;101(24):29514.
Dhanju G, Goubran A, Zimolag L, Chartrand R, Matthew F, Breddam A. Distinguishing between cornual, angular and interstitial ectopic pregnancy: a case report and a brief literature review. Radiology Case Reports. 2023;18(7):2531-44.
Sharma C, Patel H. Ruptured Cornual Ectopic Pregnancy: A Rare and Challenging Obstetric Emergency. Cureus. 2023;15:10.
Ahlschlager LM, Mysona D, Beckham AJ. The elusive diagnosis and emergent management of a late-presenting ruptured interstitial pregnancy: a case report. BMC Pregnancy and Childbirth. 2021;21:1-5.
Sargin MA, Tug N, Ayas S, Yassa M. Is interstitial pregnancy clinically different from cornual pregnancy? A case report. Journal of clinical and diagnostic research: JCDR. 2015;9(4):5.
Sharma N. An Ectopic pregnancy in the tubal interstitium: beware. J Clin Diagn Res. JCDR. 2013;7(1):160.
Alanbay İ, Öztürk M, Karaşahin KE, Yenen MC. Angular pregnancy. Turkish Journal of Obstetrics and Gynecology. 2016;13(4):218.
ESHRE Working Group on Ectopic Pregnancy, Kirk E, Ankum P, Jakab A, Le Clef N, Ludwin A, Small R, Tellum T, Töyli M, Van den Bosch T, Jurkovic D. Terminology for describing normally sited and ectopic pregnancies on ultrasound: ESHRE recommendations for good practice. Human Reproduction Open. 2020;2(4):55.
Ackerman TE, Levi CS, Dashefsky SM, Holt SC, Lindsay DJ. Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy. Radiol. 1993;189(1):83-7.
Timor-Tritsch IE, Monteagudo A, Matera C, Veit CR. Sonographic evolution of cornual pregnancies treated without surgery. Obstetrics & Gynecology. 1992;79(6):1044-9.
Tanaka Y, Mimura K, Kanagawa T, Kajimoto E, Takahashi K, Kakigano A, Fujita S, Kinugasa-Taniguchi Y, Endo M, Kimura T. Three‐dimensional sonography in the differential diagnosis of interstitial, angular, and intrauterine pregnancies in a septate uterus. J Ultras Med. 2014;33(11):2031-5.
Singh N, Tripathi R, Mala YM, Batra A. Diagnostic dilemma in cornual pregnancy-3D ultrasonography may aid. J Clin Diagnos Res. JCDR. 2015;9(1):12.
Kao LY, Scheinfeld MH, Chernyak V, Rozenblit AM, Oh S, Dym RJ. Beyond ultrasound: CT and MRI of ectopic pregnancy. Am J Roentgenol. 2014;202(4):904-11.
Hao HJ, Feng L, Dong LF, Zhang W, Zhao XL. Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis. Medicine. 2023;102(17):33621.
Khalil A, Saber A, Aljohani K, Khan M. The efficacy and success rate of methotrexate in the management of ectopic pregnancy. Cureus. 2022;14:7.
Tuncay G, Karaer A, Coskun EI, Melekoglu R. Treatment of unruptured cornual pregnancies by local injections of methotrexate or potassium chloride under transvaginal ultrasonographic guidance. Pakistan J Med Sci. 2018;34(4):1010.
Feng Q, Zhong J, Liu Y, Li ST, Zong L. Surgical treatment of interstitial pregnancy without cornual resection: A case report. Medicine. 2022;101(26):29730.
Chaudhary P, Manchanda R, Patil VN. Retrospective study on laparoscopic management of ectopic pregnancy. J Obst Gynecol India. 2013;63:173-6.
Pramayadi CT, Bramantyo A, Gunardi ER. Successful procedure in conservative management of interstitial (cornual) ectopic pregnancy. Gynecol and Minimal Invas Ther. 2018;7(4):172-4.
Stock L, Milad M. Surgical management of ectopic pregnancy. Clinical obstet gynecol. 2012;55(2):448-54.
