Cornual Pregnancy
Cornual pregnancy
Cornual Pregnancy is a specific, and variably used, term for pregnancies near the uterine cornua; most contemporary sources use it for an intrauterine gestation in a uterine malformation (such as a rudimentary horn of a unicornuate uterus, or a horn of a bicornuate or septate uterus), distinct from interstitial pregnancy in the intramural (interstitial) segment of the fallopian tube within the myometrium.
Under modern, anatomy-based usage, cornual pregnancy describes an intracavitary implantation within a uterine horn in Müllerian anomalies (rudimentary horn, bicornuate, or septate uterus), rather than within the interstitial tube; this is contrasted with interstitial ectopic pregnancy, which is intramyometrial tubal implantation and is an ectopic pregnancy by definition.
Diagnosis
Imaging terminology distinguishes cornual pregnancy in anomalous horns from interstitial ectopic using features such as sac location relative to the endometrial cavity and myometrial mantle; radiology references emphasize that cornual ectopic refers to sacs in horns of bicornuate or septate uteri, not the interstitial tube segment.
Scholarly reviews note that overlapping and historical definitions necessitate careful anatomical classification to guide management and counseling about rupture risk and viability, especially when differentiating from angular pregnancies that are intracavitary near the uterotubal junction.
Interstitial pregnancies can expand before rupture due to surrounding myometrium and carry high hemorrhagic risk; accurate naming affects urgency and treatment choices, whereas true cornual pregnancies in anomalous horns have distinct surgical considerations (e.g., horn resection).
Standardizing terminology improves patient safety and research reporting; leading reviews and reference works endorse reserving “cornual pregnancy” for pregnancies in uterine horns of Müllerian anomalies and “interstitial pregnancy” for intramural tubal ectopic implantations.
Frequently Asked Questions
What is a cornual pregnancy?
Cornual pregnancy refers to a pregnancy implanted in or near the uterine cornua, a term that is used variably; many modern sources reserve “cornual” for a gestation within a uterine horn in Müllerian anomalies (such as a rudimentary horn or a horn of a bicornuate/septate uterus), distinct from interstitial pregnancy in the intramural segment of the fallopian tube within the myometrium.
How is a cornual pregnancy different from an interstitial pregnancy?
Interstitial pregnancy is an ectopic implantation in the interstitial (intramural) segment of the fallopian tube that traverses the uterine muscle, whereas “cornual” is best reserved for intracavitary pregnancies in an anomalous uterine horn; historical overlap in terms causes confusion, so careful anatomical classification is recommended in reports and clinical decisions.
Why does the distinction matter clinically?
Interstitial pregnancies can expand within the myometrium and rupture later with severe hemorrhage, demanding urgent recognition and tailored management, while true cornual pregnancies in uterine horns involve different surgical considerations (e.g., horn resection) and counseling; precise terminology guides risk assessment and treatment choices.
How are these conditions diagnosed?
Diagnosis relies on targeted ultrasound criteria that localize the sac relative to the endometrial cavity and myometrial mantle, helping differentiate horn pregnancies from interstitial and angular pregnancies; radiology and guideline references emphasize standardized imaging features to avoid mislabeling that could alter management.
What are the treatment options and prognosis?
Management depends on location, gestational age, stability, and reproductive goals, ranging from medical therapy (e.g., methotrexate in selected interstitial cases) to surgical approaches such as cornuostomy, wedge resection, or horn resection; early, accurate diagnosis improves safety, given the higher hemorrhagic risk compared with typical tubal ectopic pregnancies.
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