[Cornual pregnancy: Management and subsequent fertility]

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Cornual pregnancy is a rare form of ectopic pregnancy, accounting for 2% of cases.
• Management protocols for cornual pregnancy are not well-established and often depend on the patient's clinical condition.
• Understanding the impact of management on fertility and obstetric outcomes is crucial for patient counseling.

Purpose of the Study:

• To describe the management approaches for cornual pregnancies.
• To evaluate subsequent fertility and obstetric outcomes in relation to the chosen management strategy.
• To identify potential risk factors and histological findings associated with cornual pregnancy.

Main Methods:

• Retrospective, single-center observational study.
• Included 19 patients diagnosed with cornual pregnancy between 2006 and 2015.
• Data collected via medical records and standardized phone questionnaires; management included systemic/local methotrexate or surgical resection based on hemodynamic status.

Main Results:

• 68% of patients underwent surgical cornual resection, while 32% received systemic methotrexate injection (one failure required surgery).
• Median time for human chorionic gonadotropin (hCG) level decrease was 33 days.
• Of 12 patients desiring future pregnancy, 7 (58%) conceived naturally, irrespective of initial treatment; histological analysis revealed proximal fallopian tube lesions in 76.9%.

Conclusions:

• Cornual pregnancies pose a significant risk of hemorrhagic rupture and potential recurrence.
• Fertility and obstetric outcomes appear unaffected by the initial management method (medical vs. surgical).
• Further research is needed to refine clinical management based on hCG levels and ultrasound findings.