Comparison of the Clinical Process Outcomes of Non-Surgical and Surgical Treatment for Cornual Pregnancy : A Retrospective Randomized Case-Control Study

Author(s): Eun Hui Joo, Ji Hyon Jang, Bobae Lim, Eun Hee Ahn, Sang Hee Jung, Young Ran Kim

Objectives: To compare the clinical process outcomes of ultrasound (US) - guided intragestational sac injection of methotrexate (MTX) and cornual resection for cornual pregnancies.

Methods: The retrospective case-control study included 31 women diagnosed with cornual pregnancy at a single center, between January 2007 and February 2017. Of these, we enrolled 31 women who had implantation in the cornual area at the time of diagnosis; 12 were treated with local injection of MTX under ultrasound guidance and 19 underwent with cornual resection. Procedure-related outcomes, including operating time, time to normal state β-hCG serum level, and hemoglobin level changes. Statistical significance was assessed using the chi-square test, Mann-Whitney test, and Student’s t-test.

Results: Compared to the cornual resection group, the local MTX treatment group had a much shorter mean procedure time (21.64±7.18 minutes versus 60.53±5.16 minutes p< 0.01) and length of hospital stay (2.40±0.54 days versus 3.43±0.37 days, p= 0.018). Also, decreases in hemoglobin levels post-procedure were lower in the local MTX treatment group (1.59±0.16 g/dL versus 2.54±0.29 g/dL, p= 0.012). There was one case of uterine rupture in a subsequent pregnancy in the cornual resection group.

Conclusion: Non-surgical treatment has better clinical process outcomes than cornual resection for managing cornual pregnancies which desire future pregnancies without uterine rupture.

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