Abstract Objective To examine the feasibility of laparoscopic cornual resection for the treatment of heterotopic cornual pregnancy. Study design Women who underwent laparoscopic cornual resection for ...heterotopic cornual pregnancy at our hospital between January 2003 and March 2015 were retrospectively analyzed. We evaluated significant parameters such as operative complications and postoperative pregnancy outcomes of concomitant pregnancy. Results Thirteen patients with heterotopic cornual pregnancy were included in the study. All were pregnant through assisted reproductive technology, and the diagnosis was made at a median of 6 + 6 weeks (range 5 + 4 - 10 + 0). They were successfully treated with laparoscopic cornual resection and admitted for a median of 4 days (range, 2 - 7) postoperatively. The median operative time was 65 min (range, 35 - 145 min) and estimated blood loss was 200 mL (range, 10 - 3,000 mL). There was a spontaneous abortion at 7 + 6 gestational weeks in a patient who received bilateral cornual resection. Seven patients delivered babies at term and 3 at preterm. All 10 women delivered without any maternal or neonatal complications. Two were lost to follow-up. Conclusions Laparoscopic cornual resection is a feasible primary approach for the management of heterotopic cornual pregnancy.
Evaluation of relative fetal growth in the form of estimated fetal weight discordance (EFWd) is a necessary element of any ultrasound examination in twin pregnancies. It is one of the criteria for ...the diagnosis of selective fetal growth restriction (sFGR) according to the most established worldwide guidelines. Apart from the effectiveness of this parameter for the diagnosis of sFGR, it may also be used as an independent factor for risk stratification of neonatal and maternal complications. Furthermore, numerous studies have proven the greater prognostic value of EFWd in dichorionic pregnancies, which may result from differences in the pathogenesis of fetal growth abnormalities in mono- and dichorionic pregnancies. Because of the variability of this parameter throughout pregnancy, there is an ongoing discussion regarding replacing or individualizing it with percentile charts. An additional element, complementary to EFWd in assessing the risk of complications in twin pregnancies is the use of this measurement in combination with Doppler assessment, which increases its predictive value. The use of EFWd as one of the factors influencing care and decision-making in dichorionic twin pregnancies seems to be a simple and effective method, however, further research assessing the use and possible applications of this indicator is necessary.
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