E1774. Eccentrically Located Pregnancies: Distinguishing Between Subtypes of Pregnancy
Authors
Shenyece Ferguson;
Lewis Katz School of Medicine at Temple University; Temple University Hospital
Edward Choe;
Temple University Hospital
Bhishak Kamat;
Temple University Hospital
Blachy Davila;
Temple University Hospital
Omar Agosto;
Temple University Hospital
Background
The terms cornual, angular, and interstitial, are often used interchangeably to describe pregnancies, however they are distinct entities. The term cornual technically describes an intrauterine pregnancy that has implanted in the horns of a bicornuate or septate uterus, however it has interchangeably been used in the literature to describe intrauterine and extrauterine pregnancies. In comparison, angular pregnancy is defined as an intrauterine pregnancy in which the fetus is implanted in the lateral angle of the uterus. This must be distinguished from an interstitial pregnancy, which is intrauterine, but implants outside of the uterine cavity in the interstitial segment of the fallopian tube. These pathologies can be difficult to distinguish clinically, each presenting with abdominal pain, bleeding, or asymptomatically. Imaging modalities, such as ultrasound and MRI can be used to distinguish between them. It is imperative that distinctions are made between these pregnancies as they require different management. While angular pregnancies can sometimes be carried to term depending on the growth of the fetus, interstitial pregnancies are essentially nonviable. Without intervention, interstitial pregnancies can result in uterine rupture, severe hemorrhage, and maternal death. This educational exhibit aims to discuss the unique imaging features demonstrated by these pathologies and improve the ability to distinguish them from each other.
Educational Goals / Teaching Points
The purpose of this educational exhibit is to define and compare angular and interstitial pregnancies; highlight the imaging features that can be used in diagnosis of each; and discuss the importance of distinguishing between the different pathologies.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will discuss the ultrasound and MRI appearance of cornual, angular, and interstitial pregnancies; compare and contrast the features that allow them to be distinguished from each other; provide examples of these features with images.
Conclusion
Cornual, angular, and interstitial pregnancies are conditions that can have significant effects on a woman and her fetus. Imaging can be used in diagnosis to identify and distinguish between the two. Imaging modalities such as ultrasound and MRI can be used to detect both types of pregnancies and aid in decision-making regarding management of the patient’s condition.
