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Table of Contents
LETTER TO THE EDITOR
Year : 2019  |  Volume : 8  |  Issue : 3  |  Page : 140-141

Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy


1 Department of Obstetrics and Gynecology № 1, Marat Ospanov, West Kazakhstan State Medical University, Aktobe, Kazakhstan
2 Department of Normal and Topographical Anatomy, Marat Ospanov, West Kazakhstan State Medical University, Aktobe, Kazakhstan
3 Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt; Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait

Date of Submission12-Feb-2019
Date of Decision21-Feb-2019
Date of Acceptance09-May-2019
Date of Web Publication29-Aug-2019

Correspondence Address:
Prof. Ibrahim A Abdelazim
Department of Obstetrics and Gynecology, Ain Shams University, Cairo; Department of Obstetrics and Gynecology, Ahmadi Kuwait Oil Company Hospital, Ahmadi

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_128_18

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How to cite this article:
Kanshaiym S, Zhurabekova G, Abdelazim IA, Karimova B. Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy. Gynecol Minim Invasive Ther 2019;8:140-1

How to cite this URL:
Kanshaiym S, Zhurabekova G, Abdelazim IA, Karimova B. Successful Procedure in Conservative Management of Interstitial (Cornual) Ectopic Pregnancy. Gynecol Minim Invasive Ther [serial online] 2019 [cited 2019 Sep 17];8:140-1. Available from: http://www.e-gmit.com/text.asp?2019/8/3/140/265800



To the Editor,

We read the Pramayadi et al. published report in the Gynecol Minim Invasive Ther. Doi: 10.4103/GMIT. GMIT_9_18, with great interest.

Pramayadi et al. presented a successful laparoscopic management of interstitial (cornual) ectopic pregnancy.[1]

Pramayadi et al. stated in their introduction and conclusion that the interstitial (cornual) pregnancy is a rare type of ectopic pregnancy.[1]

We think that Pramayadi et al.[1] considered both the interstitial and the cornual pregnancy in their article as one type or one entity of ectopic pregnancy, although the interstitial pregnancy is totally different type of ectopic pregnancy than the cornual pregnancy.

Moawad et al. wrote “interstitial pregnancy sometimes is mistakenly referred to as cornual pregnancy and frequently confused with angular pregnancy.”[2]

Sargin et al. wrote “interstitial and cornual ectopic pregnancy can be used in the place of each other. However, they actually describe two different entities.”[3]

Rizk et al. stated that the term “cornual ectopic pregnancy” should only be used in a rudimentary uterine horn, a unicornuate uterus, the cornual region of a septate uterus, a bicornuate uterus, or a uterus didelphys.[4]

The current version of William's Obstetrics describes the cornual pregnancy as a conception that develops in the rudimentary horn of a uterus with a Müllerian anomaly [Figure 1] and [Figure 2].[5]
Figure 1: Diagram of the cornual pregnancy in the rudimentary uterine horn

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Figure 2: Transvaginal ultrasound of cornual pregnancy in bicornuate uterus shows continuous endometrial line and no interstitial line sign

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The diagnosis of interstitial pregnancy can be challenging in some cases, and the missed diagnosis of interstitial pregnancy may result in life-threatening internal hemorrhage.[5]

Pramayadi et al. mentioned the sonographic criteria of the intestinal pregnancy.[1] Moreover, an echogenic line detected by transvaginal ultrasound extends from the gestational sac to the endometrium cavity called interstitial line sign is highly sensitive and specific and represents the interstitial portion of the  Fallopian tube More Details [Figure 3] and [Figure 4].[5]
Figure 3: Diagram of the interstitial line sign

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Figure 4: Interstitial gestational sac separated from the endometrial line by the interstitial line and surrounded by thin <5-mm myometrium. Doane B, Perera P. Emergency ultrasound identification of a cornual ectopic pregnancy. West J Emerg Med 2012;13:315

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Interstitial pregnancy is a totally different type of ectopic pregnancy than the cornual pregnancy. Interstitial pregnancy is an ectopic pregnancy occurs after implantation of pregnancy in the tubal segment traversing the muscular wall of the uterus. The term “cornual ectopic pregnancy” should only be used in a rudimentary uterine horn, a unicornuate uterus, the cornual region of a septate uterus, a bicornuate uterus, or a uterus didelphys.


  Comment from the Editor-In-Chief Top


We thank Dr. Sakiyeva Kanshaiym et al. for the opinion of “Successful procedure in conservative management of interstitial (cornual) ectopic pregnancy.” Cornual pregnancy sometimes will be confused in gynecology; the clarification is necessary.

Acknowledgment

The corresponding author is grateful to the co-authors for their effort through revision and editing of this letter to the editor.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pramayadi CT, Bramantyo A, Gunardi ER. Successful procedure in conservative management of interstitial (Cornual) ectopic pregnancy. Gynecol Minim Invasive Ther 2018;7:172-4.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Moawad NS, Mahajan ST, Moniz MH, Taylor SE, Hurd WW. Current diagnosis and treatment of interstitial pregnancy. Am J Obstet Gynecol 2010;202:15-29.  Back to cited text no. 2
    
3.
Sargin MA, Tug N, Ayas S, Yassa M. Is interstitial pregnancy clinically different from cornual pregnancy? A case report. J Clin Diagn Res 2015;9:QD05-6.  Back to cited text no. 3
    
4.
Rizk B, Holliday CP, Abuzeid M. Challenges in the diagnosis and management of interstitial and corneal ectopic pregnancies. Middle East Fertil Soc J 2013;18:235-40.  Back to cited text no. 4
    
5.
Abdelazim IA, Shikanova S, Zhurabekova G, Kanshaiym S, Karimova B, Sarsembayev M, et al. Open cornual resection versus laparoscopic cornual resection in patients with interstitial ectopic pregnancies. Eur J Obstet Gynecol Reprod Biol 2019;232:107-8.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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