Cornual pregnancy: the experience of a level 3 maternity unit in a low-income country

Objective. Cornual pregnancy (CP) is a rare, potentially seri­ous ectopic pregnancy. The incidence varies between 2% and 3% depending on the study. It remains a significant cause of haemorrhagic shock in the first trimester of pregnancy. The aim of this study was the evaluation of our department’s ex­perience in the diagnosis and management of CP.
Materials and Methods. We conducted a retrospective, cross-sectional, monocentric and descriptive study in the gy­naecology and obstetrics unit “D” of the University Hospital of Tunis, Centre of maternity and neonatology. The study last­ed 13 years. It started in January 2010 and ended in December 2022. A total of 11 cases of CP were reported.
Results. The mean age of our population was 32 years. The mean duration of amenorrhoea was 52 days. Initial haem­orrhagic shock was observed in 9.79% of cases. Abdominal tenderness was noted on abdominal examination in 44.7% of cases. Speculum examination revealed metrorrhagia in 68.8% of women. In our series, pelvic ultrasound diagnosed ectopic pregnancy in 100% of cases and cornual location in 45.8% of cases. Of the 11 cases of CP, 8 women underwent immediate surgery. The laparoscopic approach was most commonly used (6 women) with a laparoscopic conversion rate of 30%. All pa­tients had an uncomplicated postoperative course. Methotrex­ate was used as first-line treatment in 3 patients.
Conclusions. Cornual pregnancy is a rare form of ectopic pregnancy. It can rapidly become life-threatening for the mother. In the absence of specific recommendations, treatment of CP is essentially surgical.