An ectopic pregnancy is a pregnancy that occurs outside of the uterine cavity 98% of ectopic pregnancies occur within the fallopian tube. There is a rare type of ectopic pregnancy that occurs at the junction between the fallopian tube and the uterus. These are called interstitial or cornual pregnancies and can be extremely dangerous, often times leading to rupture at the site of implantation and internal hemorrhage. Recently, I had a patient who unfortunately developed a cornual ectopic pregnancy one year after having a myomectomy (removal of fibroids). In her situation, the site where the fibroid was removed was at the junction between the fallopian tube and the uterus. The pregnancy implanted at this site and unfortunately the patient ended up needing a hysterectomy to protect her life. There was no way we could salvage the pregnancy or her uterus without causing severe bleeding. The pathology specimen showed that the pregnancy had not only developed at the cornua but it had also started to invade the muscle which would have led to an accreta (placenta gets imbedded in the muscle and at the time of delivery does not detach and causes severe hemorrhaging.
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