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Mraihi F, Buzzaccarini G, D’Amato A, Laganà AS, Basly J, Mejri C, Hafsi M, Chelli D, Ghali Z, Bianco B, Barra F, Etrusco A. Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:186. [PMID: 38276065 PMCID: PMC10819158 DOI: 10.3390/medicina60010186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Cornual pregnancies (CPs) are rare forms of ectopic pregnancy. When abortion does not occur, it can be a life-threatening condition for the mother and can also impair future fertility. We present our experience in the diagnosis and management of CPs. A systematic review was also conducted to investigate the reproductive outcomes after treatment. Materials and Methods: Between January 2010 and December 2022, we performed a retrospective, cross-sectional, single-center, and descriptive data collection and analysis (ClinicalTrial ID: NCT06165770). The search for suitable articles published in English was carried out using the following databases (PROSPERO ID: CRD42023484909): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Methodology Register), Health Technology Assessment Database, Web of Science, and search register such as ClinicalTrial. Only studies describing the impact of CP treatment on fertility were selected. Results: Two studies were included in the systematic review. Seventeen patients suffering from CPs were selected. In our series, a pelvic ultrasound allowed for the diagnosis of a cornual localization in 35.30% of cases. Thirteen women (76.47%) underwent immediate surgical management. The laparoscopic approach was the most used (76.92%), with a laparotomic conversion rate of 30%. Four patients (23.52%) received medical treatment with methotrexate. After treatment, two patients managed to achieve pregnancy. Conclusions: CP is a rare form of ectopic pregnancy that can quickly become life-threatening for the mother. Ultrasound does not lead to a precise diagnosis in all cases. In the absence of complications and emergencies, laparoscopy is an approach that could be considered valid. For selected asymptomatic patients, medical treatment may be a valid alternative. The data from the studies included in the systematic review, although demonstrating a superiority of medical treatment in terms of future pregnancies, are heterogeneous and do not allow us to reach a definitive conclusion.
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Affiliation(s)
- Fathi Mraihi
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Giovanni Buzzaccarini
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Antonio D’Amato
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy;
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
| | - Jihene Basly
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Chaima Mejri
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Montasar Hafsi
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Dalenda Chelli
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Zaineb Ghali
- Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, Tunisia; (F.M.); (J.B.); (C.M.); (M.H.); (D.C.); (Z.G.)
| | - Bianca Bianco
- Discipline of Sexual and Reproductive Health and Populational Genetics, Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABC, Santo André 09060-870, SP, Brazil;
| | - Fabio Barra
- Unit of Obstetrics and Gynecology, P.O. “Ospedale del Tigullio”-ASL4, Via G. B. Ghio 9, Metropolitan Area of Genoa, 16043 Chiavari, Italy;
- Department of Health Sciences (DISSAL), University of Genoa, Via Antonio Pastore 1, 16132 Genova, Italy
| | - Andrea Etrusco
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy;
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Gure Eticha T. Unilateral Twin Ectopic Pregnancy: A Case Report from the Eastern Part of Ethiopia, Harar. Int Med Case Rep J 2022; 15:521-527. [PMID: 36157570 PMCID: PMC9507443 DOI: 10.2147/imcrj.s382708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/15/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Twin ectopic pregnancy is the implantation of both embryos outside of the endometrial lining occurring in 1 in 20,000 up to 1 in 125,000 pregnancies. Commonly, twin ectopic pregnancies occur inside the fallopian tube either unilateral or bilateral. Unless early diagnosis and interventions are made, it may rupture causing intraperitoneal bleeding with a high risk of maternal death. Case Report I am reporting a rare type of ectopic pregnancy: unilateral twin ectopic pregnancy with positive cardiac activity on the left side of the fallopian tube in a 30 years old gravida III para II mother. Left side salpingectomy was done for her and discharged from the hospital after two postoperative days. Conclusion Twin ectopic pregnancy with a live embryo is a very rare type of pregnancy that needs a high index of suspicion to diagnose and treat early to prevent complications and maternal death.
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Affiliation(s)
- Tadesse Gure Eticha
- Department of Obstetrics and Gynecology, Haramaya University, Harar, Ethiopia
- Correspondence: Tadesse Gure Eticha, Tel +251913868714, Email
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Jurkovic D. Re: Cornual twin pregnancy following IVF/ICSI treatment. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:424. [PMID: 30835371 DOI: 10.1002/uog.20219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- D Jurkovic
- Institute for Women's Health, University College Hospital, London, UK
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