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Lessons Learned

Posted Oct 30 2008 12:00am
There's mistakes that I have made,
Some chances I just threw away,
Some roads,
I never should have taken,
Been some signs I didn't see,
Hearts that I hurt needlessly,
Some wounds,
That I wish I could have one more chance to mend,
But it don't make no difference,
The past can't be rewritten,
You get the life you're given,
Oh, some pages turned,
Some bridges burned,
But there were,
Lessons learned.
~Carrie Underwood, Lessons Learned~

What is a cornual pregnancy?

Good question.

A few folks have asked me this. I can understand why since it's not all that common (studies have said 1 in 100,000 to 1 in 400,000 pregnancies). There also isn't a great deal of concise information about it online. Most of it is contained in medical journals that the average person can't access without a subscription.

I had to learn my lessons about cornual pregnancy the hard way. I figure some good has to come from my experience - so I'm sharing what I learned.

Lesson #1: Here is a diagram showing a cornual pregnancy . As you can see, the pregnancy is in the uterus, but it's right at the opening of the tube. Since it's not in the main part of the uterus, it's considered ectopic. These types of pregnancies either grow into the uterine cavity or rupture the corner of the uterus.

Lesson #2: Symptoms of a cornual pregnancy are similar to those of many other early pregnancy issues - cramping, bleeding, and a tender lower abdomen. Don't think the worst if you have these symptoms, but go get them checked out as soon as possible.

Lesson #3: There are factors that put a woman at higher risk for a cornual pregnancy - tube damage, IVF, uterine shape, etc. I have a slightly t-shaped uterus, so that may have been why I had one. I did not have any other risk factors with this pregnancy.

Lesson #4: Cornual pregnancies are typically diagnosed using imaging. They'll look at the position of the pregnancy and the thickness of the myometrium (uterine muscle layer) around it. Ask for an MRI if you are diagnosed with a possible cornual pregnancy via ultrasound. Yes, they're expensive, but they're more definitive than ultrasound.

Lesson #5: There are several ways to manage a cornual ectopic - 1) expectant (watch with serial ultrasounds with the hope that it grows into the uterus 2) medical (use of methotrexate) 3) surgical (laparoscopy or laparotomy). Your doctor will look at circumstances pertaining to your pregnancy when recommending an approach. With me, they did expectant and then surgical (laparotomy).

Lesson #6: If the pregnancy is managed surgically, you may need a cornual wedge resection. This means they remove the cornua area of your uterus (the very corner). They also typically cut the tube, because there is no longer an entry point on that side.

Lesson #7: I've read that uterine surgery may increase risk of rupture in a subsequent pregnancy - especially when it's high in the uterus, like a cornual wedge resection. You may want to discuss with your doctor.

Lesson #8: Get a second opinion if you are medically stable. Go see another OB at another hospital, get another ultrasound, and ask about their management approach - obviously you want to do this rather quickly. If you are hospitalized, ask for someone else in the practice to review your case ASAP if at all possible (there may not be time depending upon your case).

Lesson #9: If you are searching online for information about cornual pregnancy, try using the search terms interstital pregnancy or angular pregnancy. Some publications use them synonymously.

Lesson #10: The info. online is pretty doom and gloom. Before you come to the conclusion that no good will come of your diagnosis, gather the info. and talk to the doctor.

There are a few more factoids listed in my first blog post .

I hope this info. is interesting and helpful.

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