Angular intrauterine pregnancy

Implantation of the embryo in the uterine angle, medial to the uterotubal junction, may lead to several complications, both during pregnancy (persisting uterine pain and bleeding, spontaneous abortion, ruptured uterus) and in the puerperium (retained placenta). Nevertheless this entity is still rarely discussed in textbooks or in the literature. Its differential diagnosis from interstitial tubal pregnancy and cornual pregnancy is often confused. Four new cases of angular pregnancy with varied outcomes are described and 35 cases from the literature of the past 50 years are reviewed. Uterine anomalies, myomas, and uterotubal implantation may be predisposing conditions in a minority of cases. The differential diagnosis of angular intrauterine pregnancy from interstitial pregnancy, based on the position of the gestational enlargement in relation to the round ligament, is considered and the management discussed.