Experience in the management of cornual ectopic pregnancy

Abstract

Background: Cornual ectopic pregnancy accounts for 2%-4% of ectopic pregnancies
and is potentially fatal due to uterine rupture and consequent massive hemorrhage,
with a mortality rate of up to 2.5%. There is no consensus on the most appropriate
management of this pathology. Objective: To describe the experience in the
management of cornual ectopic pregnancy at the Instituto Nacional Materno
Perinatal, Lima, Peru. Methods: Descriptive and retrospective study of patients with
a diagnosis of cornual ectopic pregnancy during the year 2022. Data were obtained
from medical records. Statistical analysis was processed in the SPSS 19 program.
Results: Out of 9 cases of cornual ectopic pregnancy registered, 7 met the inclusion
criteria. The mean age was 31 years and the mean gestational age 7.3 weeks. Of the
cases 71.4% had no risk factors. The majority presented vaginal bleeding associated
with pelvic pain (71.4%). The average initial value of β-hCG was 8,262.3 mIU/mL. The
average size of the tumor was 36.7 mm and 28.6% of the cases presented uterine
rupture. 57.1% had surgical treatment consisting of cornual resection, cornuostomy
or local injection of methotrexate. Conclusions: Surgery is the most commonly used
treatment for cornual ectopic pregnancy. In recent years, laparoscopy has become
an important surgical option with certain advantages over laparotomy.