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The Journal of Obstetrics and Gynecology of India

, Volume 67, Issue 6, pp 414–420 | Cite as

Diagnosis and Management of ‘Cornual’ Pregnancies from 2002 to 2015 at a Tertiary Referral Centre in South India: Insights from Introspection

Original Article

Abstract

Purpose

Interstitial, angular and rudimentary horn pregnancies have all been referred to as cornual pregnancies despite definite diagnostic criteria. Angular pregnancies can be followed up expectantly under close surveillance while interstitial and rudimentary horn pregnancies are terminated by medical or surgical methods. This study aimed to assess accuracy of ultrasound in the diagnosis of ‘cornual pregnancy’ and evaluate management.

Methods

Data pertaining to clinical features, ultrasound findings and treatment modalities of the aforementioned conditions between January 2002 and December 2015 at a tertiary perinatal centre were retrieved from the medical records. The ultrasound images and surgical videos were reviewed by the authors.

Results

Of 62 cases, 35 were interstitial, 26 were angular/eccentric intrauterine, and 1 was a rudimentary horn pregnancy. The accuracy of ultrasonography in the diagnosis of interstitial and angular pregnancies was 71.0 and 46.8%, respectively. Medical management was successful in 33.3% of interstitial pregnancies. Fifteen women with interstitial pregnancy had subsequent pregnancies and nine (75.0%) were Caesarean deliveries. Rupture and recurrence rates of interstitial pregnancy were 34.2 and 2.9%, respectively. The rudimentary horn pregnancy was managed by laparoscopic excision followed by a subsequent term delivery.

Conclusion

This study identified frequent occurrences of imprecise nomenclature that resulted in mismanagement of a few potentially viable angular pregnancies. It is imperative for clinicians and sonologists to use unambiguous nomenclature and avoid the term ‘cornual pregnancy’ altogether.

Keywords

Cornual pregnancy Interstitial pregnancy Angular pregnancy Rudimentary horn Transvaginal ultrasound Methotrexate 

Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

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Copyright information

© Federation of Obstetric & Gynecological Societies of India 2017

Authors and Affiliations

  • Vijaya B. Bayyarapu
    • 1
  • Sirisha R. Gundabattula
    • 1
  1. 1.Department of GynaecologyFernandez HospitalHyderabadIndia

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