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Forum: Trying to Conceive after Loss

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  #1  
February 27th, 2013, 01:26 PM
MadMay's Avatar Super Mommy
Join Date: Nov 2011
Location: WA
Posts: 620
Had my first post surger appointment today and got some horrible news. The doctor says I can never labor as there would be a very good case that my uterus would rupture killing both the baby and possibly myself. That I will have a high risk pregnancy my uterus may burst at anytime if it cant handle stretching out!

For those of you that do not know I had a Cornual pregnancy they attempted to treat with mxt but it didnt work and that corner of my uterus ruptured. If it had been any other doctor I would have had a hysterectomy. So at least I can still have a baby.

I need help finding info on pregnancy after a cornual pregnancy if you all could help me I would really appreciate it! thank you!
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  #2  
February 28th, 2013, 06:54 AM
momology's Avatar Platinum Supermommy
Join Date: Oct 2012
Location: Houston, Texas
Posts: 6,296
I am so sorry you are going through this!!! This is such a difficult thing to research!!! I was able to pull a journal article from my online library I belong to and I summarized it below:

The Obstetrician & Gynaecologist
Review Management of cornual (interstitial) pregnancy
Authors: Radwan Faraj / Martin Steel

General Definition: Cornual gestation is one of the most hazardous types of ectopic gestation. The diagnosis and treatment are challenging and frequently constitute a medical emergency. The interstitial part of the fallopian tube is the proximal portion that lies within the muscular wall of the uterus. It is 0.7 mm wide and approximately 1–2 cm long,with a slightly tortuous course, extending obliquely upward and outward from the uterine cavity. Pregnancies implanted in this site are called interstitial (cornual) pregnancies.

Future pregnancy:One of the concerns of future pregnancy is rupture of the interstitial portion of the tube (uterine rupture). The postulated mechanism is through a defective
area of uterine wall. There is general agreement that suturing the uterine wall should be performed in cases where the cornual pregnancy sac extends into the endometrial cavity.

The second concern after conservative management of cornual pregnancy is recurrence of ectopic pregnancy, particularly cornual pregnancy on the same side. Tubal pathology is often the primary factor blamed for recurrence. Tubal pathology, together with assisted conception and non-invasive management of cornual pregnancy, have been shown to contribute to a higher risk of recurrence of cornual pregnancy. In general, the available literature provides conflicting guidance as to appropriate counseling regarding future pregnancy risks and optimum mode of delivery.

Summary: Cornual pregnancy is very difficult to diagnose and challenging to treat. There is also a greater maternal mortality risk than tubal pregnancies. Trans-vaginal sonography can be helpful but often is not conclusive. Early clinical diagnosis aided by ultrasound or laparoscopy may help to contribute towards effective conservative management. The serious consequences of cornual pregnancy are caused mainly by rupture after 12 weeks of pregnancy, leading to catastrophic hemorrhage and even death. Cornual excision or hysterectomy used to be the traditional treatment for such cases. Conservative management has, however, been increasingly practiced successfully.This includes laparoscopic conservative treatment and medical treatment with systemic methotrexate. Sonographically guided, minimally invasive treatment can be a safe and effective alternative to surgical and systemic medical therapy. Appropriate individual counseling is needed regarding risks of future pregnancy and mode of delivery.

If you are able to carry the pregnancy the way they monitor it is through a weekly U/S throughout pregnancy.

I really think your best advice will all come from your doctor. Are you seeing a high risk doctor? It seems like there is a huge variant of this type of pregnancy so it really must be done on a case by case basis. Hopefully you are able to set up a consultation with the doctor where you are able to talk about what your options are and how best to proceed in your specific case. I did read through several chat boards (all from several years ago) where women went on to have healthy babies !!!

Again I am so sorry you are going through all of this and so sorry for your loss. I wish you the best of luck!
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  #3  
March 4th, 2013, 12:46 PM
lelila's Avatar Mega Super Mommy
Join Date: Mar 2012
Posts: 2,950
I can't imagine going through what you are. How scary! I know nothing about the condition you have experienced. I just wanted to say I wish you all the best and I hope you get your rainbow baby!
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  #4  
March 6th, 2013, 05:59 PM
MadMay's Avatar Super Mommy
Join Date: Nov 2011
Location: WA
Posts: 620
THANK YOU so much momology for the information it was really hard for me to find any information!

So as I stated before my doctor told me that I will be high risk and I will have to have constant u/s during my pregnancy to help monitor the pregnancy and to watch for warning signs of possible rupture. I have to admit that the new has been devastating and without the help of recent anti depressants I dont know what kind of mess I would be. Six months after Feb 14 I can start trying again in the mean time I am on the birth control patch at that point my doctor will do a procedure where she puts dye in my uterus to make sure that there is no way sperm can impregnate eggs from my right side. and in six months if I am not pregnant she will run all the fertility testing. She did do open surgery not laprascopic like I had originally thought so she was able to see my left tube and ovary said my other they normal and healthy.

As far as my doctor has told me this was a in her words "Freak occurrence" as the cornual pregnancy implanted in the remaining nub of what was left of my right tube which was removed and that it almost made it into my uterus. A person who has had their tubes tied has the same chance that I had of getting pregnant from that side.
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