Minimally invasive surgical management of a cornual ectopic pregnancy, with and without a concurrent intrauterine pregnancy

Delgado, Stephanie; Koythong, Tamisa; Guan, Xiaoming

doi:10.1016/j.fertnstert.2021.06.007

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…The data from our study are consistent with those in the literature in terms of signs and symptoms. In fact, several authors have reported how acute pelvic pain and metrorrhagia represent pivotal symptoms [17][18][19]. The almost constant presence of pelvic pain could be explained by the fact that the uterine horn is more innervated than the rest of the fallopian tubes, so dilatation of the uterine horn would quickly lead to pelvic pain [20].…”

Section: Discussionmentioning

confidence: 99%

Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes

Mraihi,

Buzzaccarini,

D’Amato

et al. 2024

Medicina

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Background and Objectives: Cornual pregnancies (CPs) are rare forms of ectopic pregnancy. When abortion does not occur, it can be a life-threatening condition for the mother and can also impair future fertility. We present our experience in the diagnosis and management of CPs. A systematic review was also conducted to investigate the reproductive outcomes after treatment. Materials and Methods: Between January 2010 and December 2022, we performed a retrospective, cross-sectional, single-center, and descriptive data collection and analysis (ClinicalTrial ID: NCT06165770). The search for suitable articles published in English was carried out using the following databases (PROSPERO ID: CRD42023484909): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Methodology Register), Health Technology Assessment Database, Web of Science, and search register such as ClinicalTrial. Only studies describing the impact of CP treatment on fertility were selected. Results: Two studies were included in the systematic review. Seventeen patients suffering from CPs were selected. In our series, a pelvic ultrasound allowed for the diagnosis of a cornual localization in 35.30% of cases. Thirteen women (76.47%) underwent immediate surgical management. The laparoscopic approach was the most used (76.92%), with a laparotomic conversion rate of 30%. Four patients (23.52%) received medical treatment with methotrexate. After treatment, two patients managed to achieve pregnancy. Conclusions: CP is a rare form of ectopic pregnancy that can quickly become life-threatening for the mother. Ultrasound does not lead to a precise diagnosis in all cases. In the absence of complications and emergencies, laparoscopy is an approach that could be considered valid. For selected asymptomatic patients, medical treatment may be a valid alternative. The data from the studies included in the systematic review, although demonstrating a superiority of medical treatment in terms of future pregnancies, are heterogeneous and do not allow us to reach a definitive conclusion.

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Section: Discussionmentioning

confidence: 99%

Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes

Mraihi,

Buzzaccarini,

D’Amato

et al. 2024

Medicina

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“…Surgical treatment is the most frequently choice for HP ( 8 – 11 ). With the development of equipment and techonology, clinicians have put more and more attention to laparoscopy, rather than open surgery ( 21 – 23 ). In the present study, LA was performed for patients with HP in only 25% (6/24) of cases during the 2006–2012 period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic and open approach in the treatment of heterotopic pregnancy following embryo transfer

Chen

Zhu²,

Xie³

2022

Front. Surg.

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PurposeHeterotopic pregnancy (HP) is a rare disease with the coexistence of an intrauterine and ectopic embryos. There is no consensus on the optimal treatment of HP at present. This research aimed to compare the perioperative and pregnancy outcomes of laparoscopic (LA) and open approach (OA) in patients with HP after embryo transfer.MethodsWomen with HP receiving surgical treatment (LA or OA) were retrospectively recruited in this study between October 2006 and December 2020. The demographic, perioperative and obstetric data were collected and compared between LA and OA group.ResultsTotally, 86 patients were included in this study. Among these patients, 62 underwent LA and 24 underwent OA. There was an increase in the adoption of LA between the 2006–2012 period and the 2013–2020 period [25% (6/24) vs. 90% (56/62), p < 0.001]. Compared with OA, patients treated by LA had much less blood loss [20 (10–50) vs. 30 (20–50) ml, p = 0.036] and fewer days of hospital stay [5.0 (4.0–7.3) vs. 9.5 (7–15.3) days, p < 0.001], but a relatively higher cost (15,580 ± 3196¥ vs. 11,717 ± 3820¥, p < 0.001). During the laparoscopic procedure, no one needed to be converted to open surgery. However, the rates of first trimester miscarriage, preterm, cesarean section, birth weight, 1- and 5-min Apgar were similar between LA and OA group (all p > 0.05).ConclusionsCompared with open approach, laparoscopy was shown to provide a comparable pregnancy outcomes and a better performance on perioperative outcomes in the treatment of HP patients with embryo transfer.

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Minimally invasive surgical management of a cornual ectopic pregnancy, with and without a concurrent intrauterine pregnancy

Cited by 2 publications

References 6 publications

Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes

Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes

Comparison of laparoscopic and open approach in the treatment of heterotopic pregnancy following embryo transfer

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