A Rare Form of Ectopic Pregnancy… Cornual Pregnancy

Location for ectopic pregnancies
Locations for Ectopic Pregnancies

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.

Uterus with Cornual Pregnancy
Uterus with Cornual Pregnancy
Uterus Removed with Ectopic Pregnancy seen on the Right Corner.  Fibroids also visible.
Uterus removed with fetus seen on the left corner. Fibroids also visible.