Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes
<i>Background and Objectives</i>: 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 s...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/1/186 |
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| author | Fathi Mraihi Giovanni Buzzaccarini Antonio D’Amato Antonio Simone Laganà Jihene Basly Chaima Mejri Montasar Hafsi Dalenda Chelli Zaineb Ghali Bianca Bianco Fabio Barra Andrea Etrusco |
| author_facet | Fathi Mraihi Giovanni Buzzaccarini Antonio D’Amato Antonio Simone Laganà Jihene Basly Chaima Mejri Montasar Hafsi Dalenda Chelli Zaineb Ghali Bianca Bianco Fabio Barra Andrea Etrusco |
| author_sort | Fathi Mraihi |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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. |
| first_indexed | 2024-03-08T10:41:16Z |
| format | Article |
| id | doaj.art-624b9dd687e149ceabc29cc25ff276ea |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-08T10:41:16Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-624b9dd687e149ceabc29cc25ff276ea2024-01-26T17:35:51ZengMDPI AGMedicina1010-660X1648-91442024-01-0160118610.3390/medicina60010186Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive OutcomesFathi Mraihi0Giovanni Buzzaccarini1Antonio D’Amato2Antonio Simone Laganà3Jihene Basly4Chaima Mejri5Montasar Hafsi6Dalenda Chelli7Zaineb Ghali8Bianca Bianco9Fabio Barra10Andrea Etrusco11Gynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, ItalyUnit 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, ItalyGynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaGynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaGynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaGynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaGynecology and Obstetrics Unit “D”, Maternity and Neonatology Center, Tunis University Hospital, Tunis 1001, TunisiaDiscipline 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, BrazilUnit of Obstetrics and Gynecology, P.O. “Ospedale del Tigullio”-ASL4, Via G. B. Ghio 9, Metropolitan Area of Genoa, 16043 Chiavari, ItalyUnit 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<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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.https://www.mdpi.com/1648-9144/60/1/186cornual pregnancyectopic pregnancylaparoscopymethotrexatefertility |
| spellingShingle | Fathi Mraihi Giovanni Buzzaccarini Antonio D’Amato Antonio Simone Laganà Jihene Basly Chaima Mejri Montasar Hafsi Dalenda Chelli Zaineb Ghali Bianca Bianco Fabio Barra Andrea Etrusco Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes Medicina cornual pregnancy ectopic pregnancy laparoscopy methotrexate fertility |
| title | Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes |
| title_full | Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes |
| title_fullStr | Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes |
| title_full_unstemmed | Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes |
| title_short | Cornual Pregnancy: Results of a Single-Center Retrospective Experience and Systematic Review on Reproductive Outcomes |
| title_sort | cornual pregnancy results of a single center retrospective experience and systematic review on reproductive outcomes |
| topic | cornual pregnancy ectopic pregnancy laparoscopy methotrexate fertility |
| url | https://www.mdpi.com/1648-9144/60/1/186 |
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