Objective: To study the clinical characteristics of
cornual pregnancy and compare the effects of various surgical methods on the outcomes. Methods: This was a single-center retrospective study. The clinical records of patients with
cornual pregnancy who underwent surgery in Peking Union Medical College Hospital from June 2012 to December 2020 were collected. Surgical interventions included
curettage (guided by ultrasound or monitored by
laparoscope), and cornuostomy/cornectomy (the surgical approach by laparoscopy or
laparotomy). The baseline data, perioperative treatment and whether persistent
ectopic pregnancy (PEP) occurred after surgery were collected and analyzed statistically. Results: A total of 109 patients with
cornual pregnancy diagnosed by surgical treatment were included in this study, whose average age was (32.9±4.8) years. Among them, the incidence of postoperative PEP was 16.5% (18/109). The risk of PEP in multipara was significantly higher than that in nulliparous women (OR=7.639, 95%CI: 2.063-28.279, P=0.001). The risk of PEP in patients with the maximum diameter of lesion<1.5 cm was significantly higher than that in patients with the maximum diameter of lesion≥1.5 cm (OR=8.600, 95%CI: 2.271-32.571, P=0.002). Among all surgical approaches for
cornual pregnancy, the proportion of PEP in
curettage under ultrasound monitoring was the highest (56.0%, 14/25), which was higher than that in
curettage under
laparoscope monitoring (1/10; χ2=6.172,P=0.013); the proportion of PEP in
curettage group (42.9%, 15/35) was higher than that in cornuostomy/cornectomy group (4.1%, 3/74; χ2=25.950,P<0.01). Neither
salpingectomy in the operation nor the routine use of
methotrexate (MTX) in
perioperative period could significantly reduce the incidence of PEP (all P>0.05). Conclusions: Among the patients with
cornual pregnancy, multipara, the maximum diameter of lesion<1.5 cm and ultrasound-guided
curettage are the risk factors of PEP after operation. Cornuostomy or cornectomy is recommended for patients with
cornual pregnancy. If the patients would perform the
curettage operation, laparoscopic monitoring is recommended. For patients with possible satisfactory operation outcome, it is not recommended to use MTX as a routine preventing measure.