Laparoscopic management of 4 cases of recurrent cornual ectopic pregnancy and review of literature.

The objectives of this retrospective case series were to report our experience with laparoscopic management of recurrent cornual ectopic pregnancy in a tertiary care center and to present a review of the literature. Four patients experienced recurrent cornual ectopic pregnancy, and 1 patient had 2 consecutive recurrences. Laparoscopic surgery was performed to treat recurrent cornual ectopic pregnancy in all 4 patients. These 4 cases together with 10 cases collated from the literature review confirm that this entity is rare. Cornual ectopic pregnancy can recur as early as 4 months and as late as 5 years after the first ectopic pregnancy. There seems to be no correlation between the treatment method of the first ectopic pregnancy and the risk of recurrence. The etiology of recurrent cornual ectopic pregnancy is not fully understood, although it shares similar risk factors with tubal ectopic pregnancy. Both medical therapy and surgery are used to treat recurrent cornual ectopic pregnancy, with surgery often performed via laparotomy. These 4 cases constitute the largest case series of recurrent cornual ectopic pregnancy treated laparoscopically. Our experience with laparoscopic management of recurrent cornual ectopic pregnancy in a tertiary care center reveals that it is effective and safe.

Laparoscopic management of 53 cases of cornual ectopic pregnancy.

OBJECTIVE: To present our experience of laparoscopic management of cornual ectopic pregnancy. DESIGN: Retrospective review of 53 cases of cornual pregnancy treated laparoscopically. SETTING: K.K. Women's and Children's Hospital, Singapore. PATIENT(S): Patients who were treated for cornual pregnancy via laparoscopic surgery from 2001 to 2006. INTERVENTION(S): Laparoscopic surgery as a treatment modality for cornual pregnancy. MAIN OUTCOME MEASURE(S): Success rate of laparoscopic surgery and future reproductive outcome. RESULT(S): Fifty-two cases were managed by laparoscopy, and one was converted to laparotomy. Laparoscopic wedge resection was carried out in 33 patients, cornuostomy in 13 patients, and salpingectomy in 7 patients. Nine patients received methotrexate injection after surgery because of persistently high serum beta-hCG. Eighteen patients became pregnant, four had early miscarriages, and ten had pregnancies beyond 24 weeks' gestation. Five delivered vaginally, and three had cesarean section at term. Two patients traveled back to their native countries for delivery. There were no cases of uterine rupture or dehiscence reported. CONCLUSION(S): Laparoscopic treatment of cornual pregnancy can be safely carried out with good results in an institution with trained laparoscopist and adequate facilities.