European journal of obstetrics, gynecology, and reproductive biology · 2026
Surgical management of interstitial (cornual) pregnancy: a systematic review of perioperative and reproductive outcomes with meta-analysis of hospital stay.
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Marchand Greg, Anderson Dakota, Mera Sarah, O'Connell Brooklynn, Robinson McKenna, Palma Adriana, Herrera Daniela Gonzalez, Ibrahim Fatma, Azadi Ali
Аннотация
OBJECTIVE: To review perioperative outcomes after surgery for interstitial pregnancy and examine subsequent fertility and uterine rupture.
DATA SOURCES: PubMed/MEDLINE, Embase, Web of Science and CENTRAL were searched through 5 July 2026, with ClinicalTrials.gov and reference-list screening. The registered 1992 start date was applied only in Embase (PROSPERO CRD420261424165).
STUDY SELECTION: Duplicate screening identified 353 reports. The search used restrictive surgical terms; reasons were recorded for 78 of 233 full-text exclusions. Comparative pooling required extractable data specific to interstitial pregnancy; reproductive outcomes were described separately.
RESULTS: Case reports and small series predominated. Two observational cohorts (102 patients) contributed to hospital-stay pooling: mean difference -1.25 days for laparoscopy versus laparotomy (95% CI -1.75 to -0.76; I-squared 0%). A modified Knapp-Hartung sensitivity interval was -4.47 to 1.96 days; the two-study base cannot establish homogeneity. Transfusion was not pooled because interstitial-specific outcome counts were unavailable in one comparative cohort. Fertility findings were not pooled because populations, endpoints and denominators differed. Subsequent uterine ruptures included two in the broader Svenningsen cohort and events in other catalogued reports. Treated-case totals do not provide a valid denominator for later-pregnancy rupture risk.
CONCLUSION: Limited observational evidence suggests shorter hospitalization after laparoscopy, but the estimate is sensitive to statistical assumptions. Evidence does not establish equivalence in other perioperative outcomes or provide a precise estimate of subsequent fertility or uterine rupture risk. Search and selection-record limitations constrain completeness. Future studies should report treatment-specific reproductive outcomes, intention to conceive, subsequent pregnancies and follow-up losses.
DATA SOURCES: PubMed/MEDLINE, Embase, Web of Science and CENTRAL were searched through 5 July 2026, with ClinicalTrials.gov and reference-list screening. The registered 1992 start date was applied only in Embase (PROSPERO CRD420261424165).
STUDY SELECTION: Duplicate screening identified 353 reports. The search used restrictive surgical terms; reasons were recorded for 78 of 233 full-text exclusions. Comparative pooling required extractable data specific to interstitial pregnancy; reproductive outcomes were described separately.
RESULTS: Case reports and small series predominated. Two observational cohorts (102 patients) contributed to hospital-stay pooling: mean difference -1.25 days for laparoscopy versus laparotomy (95% CI -1.75 to -0.76; I-squared 0%). A modified Knapp-Hartung sensitivity interval was -4.47 to 1.96 days; the two-study base cannot establish homogeneity. Transfusion was not pooled because interstitial-specific outcome counts were unavailable in one comparative cohort. Fertility findings were not pooled because populations, endpoints and denominators differed. Subsequent uterine ruptures included two in the broader Svenningsen cohort and events in other catalogued reports. Treated-case totals do not provide a valid denominator for later-pregnancy rupture risk.
CONCLUSION: Limited observational evidence suggests shorter hospitalization after laparoscopy, but the estimate is sensitive to statistical assumptions. Evidence does not establish equivalence in other perioperative outcomes or provide a precise estimate of subsequent fertility or uterine rupture risk. Search and selection-record limitations constrain completeness. Future studies should report treatment-specific reproductive outcomes, intention to conceive, subsequent pregnancies and follow-up losses.