**6. Acknowledgments**

The authors thank Drs. Michiaki Watanabe, Kenji Igarashi, Takashi Yamada, and Tadashi Asakura for help in treating this patient; Dr. Hiroshi Kawamata for angiographic management; and the late Dr. Yoshiharu Ohaki for his pathologic diagnosis.

### **7. References**


**15** 

*UK* 

**Modern Management of** 

Maged Shendy1 and Rami Atalla2 *1MRCOG, Royal Berkshire Hospital, Reading* 

**Cornual Ectopic Pregnancy** 

*2FRCOG, Queen Elizabeth II Hospital, Welwyn Garden City* 

Corneal ectopic or interstitial ectopic is a pregnancy that implants in the intrauterine portion of fallopian tube. Due to its location, there is an inherit difficulty in the diagnosis and

Transvaginal Ultrasound scan is the most useful diagnostic tool for establishing the diagnosis though serial β-HCG and even laparoscopy are sometimes needed to confirm the

Due to the high risk of rupture with serious or fatal bleeding, there is no role for the expectant management. Surgery is the most common management option. Though traditionally laparotomy is the main surgical intervention, recently increasing number of laparoscopic or even hysteroscopic approach have been used. Injection of Methotrexate

Each Fallopian tube is usually 10 cm long with variations in length from 7 to 14 cm. The abdominal ostium is situated at the base of a funnel-shaped expansion of the tube, the infundibulum. Medially, it opens into the thin-walled ampulla forming more than half the length of the tube and 1 or 2 cm in outer diameter; it is succeeded by the isthmus, a round and cord-like structure constituting the medial one-third of the tube and 0.5-1 cm in outer diameter. The isthmus continues through the uterine wall to the uterine cavity forming the interstitial or conual portion of the tube. This segment of the tube is about 1 cm in length

Interstitial (cornual) pregnancy is a rare type of ectopic pregnancy, accounting for 2–4% of all tubal pregnancies (Lau S& Tulandi T, 1999) .The surrounding myometrial tissue allows progression of the pregnancy into the second trimester but rupture at such an advanced gestation may result in catastrophic haemorrhage with a mortality rate of up to 2 %. This high mortality rate is partially due to the difficult challenging diagnosis as well as the speed of haemorrhage. (Tulandi T&Al-Jaroudi D, 2004; Vicino M et al, 2000; Dilbaz S et al, 2005;

treatment leading to high mortality compared with other ectopic pregnancies.

locally or systemically has also been used successfully.

and 1 mm in diameter.(Diamond, 1988)

**1. Introduction** 

diagnosis.

**2. Anatomy** 

**3. Epidemiology** 

Rock J et al, 2003)

