Cornual Pregnancy with Uterine Rupture
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Letter to the Editor
P: 209-210
September 2024

Cornual Pregnancy with Uterine Rupture

Eurasian J Emerg Med 2024;23(3):209-210
1. Kuwait Oil Company (KOC) Ahmadi Hospital, Department of Obstetrics and Gynecology, Ahmadi, Kuwait
2. Ain Shams University Faculty of Medicine Department of Obstetrics and Gynecology, Cairo, Egypt
No information available.
No information available
Received Date: 22.04.2024
Accepted Date: 03.06.2024
Online Date: 27.09.2024
Publish Date: 27.09.2024
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Dear Editor

Elangovan and Pek (1) presented in their published case report, an interesting case report of ruptured cornual pregnancy (CP) at 30 weeks+6d, and mentioned that CP tends to present at 7-12 gestational weeks. Elangovan and Pek (1) reported in a published case report that CP occurs in the interstitial segment of the fallopian tube and invades the uterine muscles.

The published Elangovan and Pek (1) case reports are confusing to readers. William’s textbook considers CP to be a pregnancy that occurs in the rudimentary horn of the uterus with Müllerian anomaly (2-4), while interstitial ectopic pregnancy (IEP) is a pregnancy that occurs in the interstitial segment of the fallopian tube, where it crosses the uterine muscles to enter the uterine cavity (5, 6).

Cornual pregnancies (CPs) are usually diagnosed at mid-trimester of pregnancy (16 weeks for un-ruptured CPs, and 20-21 weeks for ruptured CPs) (7). In the past, interstitial ectopic pregnancies (IEPs) were usually diagnosed at 8-16 gestational weeks following ruptured IEPs (8-10). After advancements in sonographic techniques, IEPs can be diagnosed early (<8-16 weeks), and before rupture using the IEPs diagnostic sonographic findings/criteria which includes an empty uterus with a gestational sac located >1 cm away from the endometrial margin and surrounded by <5 mm myometrium (8-10). The interstitial line is a sonographic line that extends from the gestational sac to the endometrium and represents the interstitial segment of the fallopian tube with 80% sensitivity for diagnosing IEPs (8-10).

References

1
Elangovan V, Pek JH. Cornual Pregnancy with Uterine Rupture: A Case Report. Eurasian J Emerg Med. 2021;20:283-6.
2
Kanshaiym S, Zhurabekova G, Abdelazim IA, Karimova B. Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy. Gynecol Minim Invasive Ther. 2019;8:140-1.
3
Abdelazim IA, Shikanova S, Bekzhanova M. Regarding “Laparoscopic Management 4 Cases of Recurrent Cornual Ectopic Pregnancy and Review of Literature,” J Minim Invasive Gynecol. 2019;26:774.
4
Abdelazim IA, Shikanova S, Mukhambetalyeva G. Regarding “Spontaneous Cornual Pregnancy after Homolateral Salpingectomy for an Earlier Tubal Pregnancy: A Case Report and Literature Review”. J Minim Invasive Gynecol. 2019;26:574-5.
5
Abdelazim IA, Shikanova S, Zhurabekova G, Kanshaiym S, Karimova B, Sarsembayev M. Open cornual resection versus laparoscopic cornual resection in patients with interstitial ectopic pregnancies. Eur J Obstet Gynecol Reprod Biol. 2019;232:107-8.
6
Abdelazim IA, Kanshaiym S, Zhurabekova G. Regarding “Technique for the Laparoscopic Management of a Cornual Ectopic Pregnancy”. J Minim Invasive Gynecol. 2019;26:777-8.
7
Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D. Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol. 2007;30:765-70.
8
Abdelazim IA, Shikanova S, Farag MH, Karimova B. Successful treatment of interstitial ectopic pregnancy using methotrexate. Ginekol Pol. 2023.
9
Abdelazim IA, Donayeva A, Amanzholkyzy A. Regarding Cornual Pregnancy. Gynecol Minim Invasive Ther. 2024;13:66-7.
10
Donayeva A, Abdelazim IA, Amanzholkyzy A. Regarding cornual pregnancy as a rare entity of ectopic pregnancy: A case report. Int J Surg Case Rep. 2024;118:109574.