Clinical Analysis Of 61 Cases With Cornual Pregnancy

Objective:Cornual pregnancy is a special type of ectopic pregnancy,clinically less common,without typical clinical manifestations,and easy to be misdiagnosed.Because of the special anatomy,ruptured ectopic pregnancy is later than other types.But once broken,bleeding is rough and can be life-threatening if not handled properly.Because of the increasing uterine cavity diseases of uterine cavity and assisted reproductive technology,the intrinsical situations of pregnant are destroyed.The incidence of cornual pregnancy is increasing.In order to study the development laws of cornual pregnancy in recent years,we retrospectively analysed the clinical cases of cornual pregnancy of the First Affiliated Hospital of Wannan Medical College from 2011 to 2015.Through the analysis of patients' treatments,summing up the disciplines of cornual pregnancy,we try to provide theories for the standard managements of this disease.Methods:61 hospitalized patients of cornual pregnancy from the First Affiliated Hospital of Wannan Medical College were researched retrospectively.Basic physiological statuses of the patients,medical histories and the procedures of different treatments were analysed contrastively.Disciplines were found.The 61 patients were divided into four groups depending on the different treatments.Their were single-deposit-drug treatment group,B-ultrasound-guided curettage,laparoscopy treatment group,and the traditional-open-surgery treatment group.The curative effect and prognosis of different treatments were studied.One case of spontaneous abortion was not included in admission packet.Data of all cases from different groups were analysed statistically and professionally.Results:In 61 hospitalized patients of cornual pregnancy from January 2011 to October 2015,And 46 cases were first diagnosed cornual pregnancy,accounting for 75.4%,misdiagnosis rate was 24.5%.About clinical manifestations at hospitalized,11 cases had no clinical symptoms.Only 13 cases had abdominal pain,8 cases had abdominal pain and vaginal bleeding,6 cases had abdominal pain and hemorrhagic shock.23 cases had a small amount of vaginal bleeding.Aged 19 to 45 years,averaged(30.69±6.77)years.Pregnancy times were from 1 to 6 times.Only one pregnancy occurred in 17 cases,others had 44 cases.There was a history of abdominal surgery in 17 cases.A history of uterine surgical procedures occurred in 44 cases.6 cases were taken IUD,while 5 cases were taken in vitro fertilization and embryo transfer surgery.2 patients had polycystic ovary syndrome.Right cornual pregnancies had 41 cases,while the left cornual pregnancies had 20 cases.In the different treatments of cornual pregnancy,there are 4 cases of single deposit drug treatment group,9 cases of B ultrasound-guided curettage,32 cases of laparoscopy(52.46%),15 cases of traditional open surgery(24.59%).We statistically analysed patients' ages,the time of menopause,mass sizes,hemorrhage quantities during operation,operation time and the levels of HCG.There were significant differences in mass sizes and hemorrhage quantities during operation,in spite of other factors(P>0.05).Statistically,traditional open surgeries were adopted because of the larger masses.The third group had the shortest hospital stay time.Conclusion:Cornual pregnancy is a rare type of ectopic pregnancy,with low morbidity,complicated and non-specific symptoms clinically and easy to be misdiagnosed at the early period.More and more clinical doctors begin to focusing on the disease because of the increasing incidence of cornual pregnancy.Treatments of cornual pregnancy are diversified.Individual therapies should be chosed depending on different patients' conditions in order to lessen damage? Simple drug treatment has the advantages of small injuries and low cost,but long hospital stay and low success rate.Traditional open surgery can lead to a longer postoperative recovery time and greater damage,suitable for patients with severe cornual pregnancy rupture.Laparoscopy surgery is the most common treatment in our hospital and minimally invasived.Relatived to open surgery,Laparoscopy surgery and B-guided curettage have the advantage of less bleeding,less damage and faster recovery,which are suitable for patients small mass,unruptured early cornual pregnancy.