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What is a Cornual Pregnancy?

A cornual pregnancy is a rare type of ectopic pregnancy. It occurs when a fertilized egg implants in the upper part instead of in the body of the uterus where the fetus can grow and develop normally. This condition can lead to serious health complications.

Having a baby is one of the most magical parts of life. Parents want to experience the most joyful pregnancy and wait for their baby’s healthy arrival. However, some experiences can be difficult such as having to deal with a cornual pregnancy.

Fortunately, cornual pregnancies are relatively rare. They only account for approximately 2-4% of ectopic pregnancies. If left untreated or if not treated promptly, a cornual pregnancy can be life-threatening.

Let’s review important information about cornual pregnancies and what you can do about this unfortunate health occurrence.

Table of Contents

What Are the Types of Cornual Pregnancies?

A cornual pregnancy is categorized as an ectopic pregnancy where the fertilized egg becomes implanted in the cornual region of a fallopian tube. It is close to the junction that connects to the uterus. Let’s discuss the different types of cornual pregnancies.

Partial or “Incomplete” Cornual Pregnancy Still Poses Risks

A partial or “incomplete” cornual pregnancy occurs when the fertilized egg partially implants in the cornual area of the fallopian tube. This means that the gestational sac is only partially embedded in the cornual area, but not completely within it. This condition still poses a risk to the mother.

Complete Cornual Pregnancy Are Very Rare

A complete cornual pregnancy is very rare and occurs when the fertilized egg implants completely in the cornual area of the fallopian tube. These types of pregnancies are very challenging to diagnose as sometimes they are undetectable by an ultrasound. This condition requires immediate medical attention to avoid life-threatening conditions.

Cornual Heterotopic Pregnancy is Highly Complex

A cornual heterotopic pregnancy is very complex because the woman carries two pregnancies simultaneously including a non-viable cornual ectopic pregnancy and viable intrauterine pregnancy. This happens when one fertilized egg implants in the cornual area of the fallopian tube in addition to another egg implanting in the uterus as it normally should.

Cornual Pregnancy With Placenta Percreta Requires Immediate Care

A highly risky pregnancy is the rare cornual pregnancy with placenta percreta. In this case, the placenta expands into the uterus and can penetrate through the tissues leading to severe bleeding. Depending on the severity, the mother may need urgent surgery to manage the condition.

What Are the Causes of a Cornual Pregnancy?

The concrete causes of a cornual pregnancy are still being researched. However, there are risk factors that increase the risk of having this type of pregnancy.

History of Tubal Surgery

Tubal surgeries such as ligation or sterilization increase the risk of having a cornual pregnancy. The scar tissue can affect the structure of the fallopian tube making it challenging for a fertilized egg to mobilize normally.

Congenital Uterine Anomalies

Some women have congenital uterine conditions including a bicornuate uterus. This and other conditions increase the risk of having a cornual pregnancy.

Assisted Reproductive Technology (ART)

The therapies such as in vitro fertilization and other reproductive procedures can alter the normal physiology of conception. The use of ART has increased the number of ectopic pregnancies because it can lead to tubal damage amongst other conditions.

Pelvic Inflammatory Disease (PID)

PID can lead to inflammation and scarring of the fallopian tubes, which can lead to a cornual pregnancy. The fallopian tubes can become blocked or narrowed, making it challenging for the fertilized egg to mobilize as normal.

A Woman’s History of Ectopic Pregnancies

If a woman has experienced an ectopic pregnancy, it makes her more likely to experience another one. The reason for experiencing an ectopic pregnancy in a particular individual is likely to remain the same, which makes it likely to happen again.

Endometrial Tuberculosis Damages the Uterus

A condition such as endometrial tuberculosis alter the lining of the uterus and damage the fallopian tubes. Inflammation and scarring can cause blockage and narrowing of the tubes, which doesn’t allow the fertilized egg to mobilize.

The Mother’s Advanced Age

Advanced maternal age is normally defined as 35 years or older. The risk for conditions such as endometriosis and pelvic inflammatory disease increase with age, therefore raising the likelihood for older mothers to experience ectopic pregnancies.

What Are Signs and Symptoms of a Cornual Pregnancy?

Sometimes a cornual pregnancy is hard to detect because the signs and symptoms are similar to a normal pregnancy, but instead are more severe.

Unusual Vaginal Bleeding

If you experience light spotting, heavy bleeding, or unusual discharge, it may be an indication that a cornual pregnancy has occurred.

Abdominal or Pelvic Pain

Significant pain and discomfort in the abdominal or pelvic region may be a sign of a cornual pregnancy. The sensation can be sharp or may feel like cramps. Also, if it happens on one side of your abdomen, it is likely to be related to an ectopic pregnancy.

Uterine Cavity Distortion or Rupture

This life-threatening event can lead to severe bleeding and even shock. If you become dizzy, lightheaded, weak, or have palpitations, you may be experiencing severe bleeding. It is a medical emergency that requires immediate treatment.

Shoulder Pain or Discomfort

The mother may experience shoulder pain or discomfort because of a rupture or bleeding in the abdominal cavity. The condition irritates the diaphragm, which leads to referred pain in the shoulder.

Nausea and Vomiting From Hormonal Changes

When a woman has a cornual pregnancy, hormones such as human chorionic gonadotropin, or hCG enter the bloodstream. However, this can also happen during a normal pregnancy. Therefore, nausea and vomiting alone are not an indication of a cornual pregnancy. These symptoms must be accompanied by other indications of a cornual pregnancy.

Dizziness, Light-Headedness, or Fainting

If you feel dizzy, light-headed, or faint, it is probably due to abnormal bleeding. It is a medical emergency and you should seek immediate care to avoid life-threatening complications.

Positive Pregnancy From Urinary Test

If you test positive for a pregnancy test, it is likely that you have elevated levels of the hormone called human Chorionic Gonadotropin. However, this also occurs with normal pregnancies requiring further diagnostic tests such as ultrasounds.

What is the Diagnosis of a Cornual Pregnancy?

Diagnosing a cornual pregnancy is challenging because the symptoms can be similar to normal pregnancies and other types of ectopic pregnancies. It is best to have a combination of diagnostic tests, medical history, and physical exams.

Ultrasound Tests

One of the most reliable methods for diagnosing a cornual pregnancy is to have a transvaginal ultrasound test. This method is effective at detecting the fertilized egg and visualizing its exact location.

Blood Studies for Human Chorionic Gonadotropin (HCG) Levels

Another reliable diagnostic tool is a Beta-hCG blood test. This test indicates the level of human chorionic gonadotropin (hCG) in the blood. If the mother has a cornual pregnancy, hCG levels may rise more slowly than they would in a normal pregnancy.

What Are Treatment Options for Cornual Pregnancies?

The correct treatment plan will depend on the mother’s health status, the size of the pregnancy, and the propensity for complications. Treatments include surgical and pharmaceutical options.

Methotrexate for Medical Management

A common pharmaceutical treatment for cornual pregnancies is methotrexate. It works as a folic acid antagonist, which inhibits rapidly dividing cells from growing. The drug is typically administered via an injection. It is an effective treatment for cornual pregnancies that have not ruptured.

Surgical Intervention

In some cases, it is necessary to intervene with surgery. This is especially true if the pregnancy is large and the extent of the implantation. Therapies include laparoscopic procedures, laparotomies, and a cornuostomy.

Watchful Waiting or Expectant Management

This approach to managing a cornual pregnancy includes close monitoring to see if it resolves on its own or if intervention is required. Expectant management is appropriate for early or small cornual pregnancies that have not presented with severe symptoms.

Utilizing Combination Therapy

Combination therapy refers to utilizing various treatment options simultaneously. These may include medication and surgical management. It is an effective way to minimize complications and protect the mother.

What Are Prevention Strategies to Decrease the Risk of Experiencing a Cornual Pregnancy?

Let’s review the various strategies that can decrease the risk of having a cornual pregnancy.

Contraception and Safe Sex

By using contraception, you can prevent all types of pregnancies including cornual types. In addition, practicing safe sex can prevent sexually transmitted infections (STIs) that can lead to scarring and inflammation of the fallopian tubes.

Detect and Treat Sexually Transmitted Infections (STIs) Early

Since STIs can lead to scarring and inflammation of the fallopian tubes, it is critical that they be prevented and treated early. Catching symptoms in the early stages of a condition increases your chances of regaining a normal reproductive system and avoiding cornual pregnancies.

Staying Away From Smoking and Alcohol

Smoking and alcohol weaken the immune system and lead to general inflammation of tissues. Medical experts suggest avoiding these activities if you’re looking to become pregnant. You want your body to be in optimum shape to experience a healthy pregnancy.

Early Prenatal Care is Key

One of the best ways to prevent or manage a cornual pregnancy is by having early prenatal care. It is important to have routine monitoring and testing to help medical professionals identify potential complications including cornual pregnancies.

Surgical Intervention of Structural Abnormalities

Another way to prevent cornual pregnancies is to restructure the reproductive system. Whether the mother has a preexisting condition or is developing a new structural change, it can be addressed with therapies including surgery. By prepping the anatomy for a pregnancy, you will more likely experience normal implantation of the fertilized egg.

FAQ

What is the cause of cornual pregnancy?

There are several causes for having a cornual pregnancy including the abnormal structure of fallopian tubes, hormonal imbalances, history of Assisted Reproductive Technology (ART), pelvic inflammatory disease (PID), prior surgeries, and other conditions.

Can cornual pregnancy survive?

A cornual pregnancy poses a high risk for complications for the mother and fetus. The location of the pregnancy outside the uterus cannot accommodate the entire pregnancy and therefore it cannot survive.

What is the treatment for Cornual pregnancy?

There are medical and surgical options to treat cornual pregnancies. The therapies depend on the size of the pregnancy, the medical history of the mother, and other factors. Pharmaceuticals such as methotrexate can be effective. Surgical procedures include laparoscopic treatment, laparotomies, and a cornuostomy.

What happens in Cornual pregnancy?

Cornual pregnancies are characterized by the implantation of a fertilized egg in the horns of the fallopian tube. Unlike a normal fertilized egg that is implanted in the uterus, a cornual pregnancy does not provide enough room for the egg to grow for normal fetal development. The condition can cause rupturing and severe bleeding, leading to a life-threatening condition for the mother.

Is cornual pregnancy safe?

No, a cornual pregnancy is not safe and needs immediate medical attention. If you experience any unusual symptoms including dizziness or fainting, you must seek emergency care.

Cornual ectopic pregnancy symptoms

Symptoms of a cornual pregnancy include abnormal vaginal bleeding, shoulder pain, nausea, vomiting, signs of shock, abdominal swelling, pelvic pain, and other manifestations.

Cornual ectopic pregnancy treatment

To treat a cornual ectopic pregnancy, a customized approach is necessary for the unique individual. Several factors are taken into account for implementing a combination of therapies including expectant management, pharmaceutical, and surgical.