Fertility Outcome after Cornual Resection for Interstitial Pregnancies

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Obstetrics

Background:

• Interstitial pregnancies require surgical intervention, with cornual resection being a common method.
• The impact of cornual resection on future fertility and delivery modes is not fully understood.

Purpose of the Study:

• To evaluate pregnancy outcomes beyond 24 weeks gestation after cornual resection for interstitial pregnancies.
• To assess subsequent delivery modes and uterine rupture rates.
• To compare these outcomes with women who underwent salpingectomy for tubal ectopic pregnancies.

Main Methods:

• A single-center historic cohort study (Canadian Task Force classification II-2).
• Included 40 women with interstitial ectopic pregnancies (2005-2016), with 33 undergoing laparoscopic cornual resection.
• Cases (26 women) were matched with controls (52 women) who had salpingectomy for tubal ectopic pregnancies.

Main Results:

• Subsequent pregnancy rates beyond 24 weeks were similar between cornual resection (46%) and salpingectomy (54%) groups.
• Cesarean delivery was significantly more common after cornual resection (60% vs. 18%).
• Only two subsequent uterine ruptures were reported in the study cohort.

Conclusions:

• Cornual resection for interstitial pregnancies does not negatively affect future pregnancy rates compared to salpingectomy.
• Women undergoing cornual resection are more likely to require cesarean delivery in subsequent pregnancies.
• Cornual resection appears to be a safe fertility-sparing option for interstitial pregnancies.