Interstitial ectopic pregnancy (EP): Pregnancy occurring in interstitial (intramural) portion of fallopian tube
Synonym: Intramural EP
Cornual pregnancy: Older term often used interchangeably with interstitial EP or to refer to pregnancy in cornua of abnormal uterus (horn of uni- or bicornuate uterus or lateral 1/2 of septate uterus); recent calls in literature to abandon this term to avoid confusion
Uterine scar EP: Pregnancy at site of previous uterine surgery, e.g., myomectomy or C-section
Synonyms: Scar EP, C-section scar EP
Cervical EP: Pregnancy in wall of cervix below level of internal cervical os
Ovarian EP: Intraovarian implantation
Abdominal EP: Implantation in peritoneal cavity
Primary: Direct peritoneal implantation; secondary (more common): Reimplantation of ruptured extrauterine pregnancy in peritoneal cavity
Heterotopic pregnancy: Concurrent intrauterine pregnancy & EP
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Jensen KK et al: Imaging of acute pelvic pain: pregnant (ectopic and first-trimester viability updated). Radiol Clin North Am. 58(2):347-61, 2020
Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
Ramanathan S et al: Magnetic resonance imaging of common, uncommon, and rare implantation sites in ectopic pregnancy. Abdom Radiol (NY). 43(12):3425-35, 2018
Baltarowich OH: The term "cornual pregnancy" should be abandoned. J Ultrasound Med. 36(6):1081-7, 2017
Mausner Geffen E et al: Pitfalls and tips in the diagnosis of ectopic pregnancy. Abdom Radiol (NY). 42(5):1524-42, 2017
Ghaneie A et al: Unusual ectopic pregnancies: sonographic findings and implications for management. J Ultrasound Med. 34(6):951-62, 2015
Tanaka Y et al: Three-dimensional sonography in the differential diagnosis of interstitial, angular, and intrauterine pregnancies in a septate uterus. J Ultrasound Med. 33(11):2031-5, 2014
Parker RA 3rd et al: MR imaging findings of ectopic pregnancy: a pictorial review. Radiographics. 32(5):1445-60; discussion 1460-2, 2012
Izquierdo LA et al: Three-dimensional transvaginal sonography of interstitial pregnancy. J Clin Ultrasound. 31(9):484-7, 2003
Ackerman TE et al: Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy. Radiology. 189(1):83-7, 1993
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Interstitial ectopic pregnancy (EP): Pregnancy occurring in interstitial (intramural) portion of fallopian tube
Synonym: Intramural EP
Cornual pregnancy: Older term often used interchangeably with interstitial EP or to refer to pregnancy in cornua of abnormal uterus (horn of uni- or bicornuate uterus or lateral 1/2 of septate uterus); recent calls in literature to abandon this term to avoid confusion
Uterine scar EP: Pregnancy at site of previous uterine surgery, e.g., myomectomy or C-section
Synonyms: Scar EP, C-section scar EP
Cervical EP: Pregnancy in wall of cervix below level of internal cervical os
Ovarian EP: Intraovarian implantation
Abdominal EP: Implantation in peritoneal cavity
Primary: Direct peritoneal implantation; secondary (more common): Reimplantation of ruptured extrauterine pregnancy in peritoneal cavity
Heterotopic pregnancy: Concurrent intrauterine pregnancy & EP
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Jensen KK et al: Imaging of acute pelvic pain: pregnant (ectopic and first-trimester viability updated). Radiol Clin North Am. 58(2):347-61, 2020
Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
Ramanathan S et al: Magnetic resonance imaging of common, uncommon, and rare implantation sites in ectopic pregnancy. Abdom Radiol (NY). 43(12):3425-35, 2018
Baltarowich OH: The term "cornual pregnancy" should be abandoned. J Ultrasound Med. 36(6):1081-7, 2017
Mausner Geffen E et al: Pitfalls and tips in the diagnosis of ectopic pregnancy. Abdom Radiol (NY). 42(5):1524-42, 2017
Ghaneie A et al: Unusual ectopic pregnancies: sonographic findings and implications for management. J Ultrasound Med. 34(6):951-62, 2015
Tanaka Y et al: Three-dimensional sonography in the differential diagnosis of interstitial, angular, and intrauterine pregnancies in a septate uterus. J Ultrasound Med. 33(11):2031-5, 2014
Parker RA 3rd et al: MR imaging findings of ectopic pregnancy: a pictorial review. Radiographics. 32(5):1445-60; discussion 1460-2, 2012
Izquierdo LA et al: Three-dimensional transvaginal sonography of interstitial pregnancy. J Clin Ultrasound. 31(9):484-7, 2003
Ackerman TE et al: Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy. Radiology. 189(1):83-7, 1993
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