Table 1: Details of intramural pregnancies identified in January 2015-November 2020.

Authors

Years

Gestational age

History of gynecology and Obstetrics

Manifestations

Imaging features

Management

Wang, et al.

2015

21

G3P1A1; D&C (×2) (second for intrauterine residues)

Vaginal bleeding

Ultrasound and MRI showed an empty endometrial cavity and a GS with a fetus implanted in the right posterior lateral side of the uterus fundus

Laparotomy with resection under temporary balloon occlusion of abdominal aorta

Nees,

et al.

2015

32

D&C (×1)

Vaginal bleeding

-

Laparotomy with hysterectomy

Li, et al. [14]

2016

20

G1P0

-

A 14 × 14 cm GS on the right posterior lateral side of the uterus fundus

Laparotomy with resection under temporary balloon occlusion of transfemoral aorta

Bechev, et al. [11]

2017

28

G1P0; LSCS (×1); Salpingectomy of the left

tube, Isthmic obstruction

of the right tube; IVF-ET

-

A GS with presence of yolk sac measuring 1.2 cm were scanned in the posterior wall of the uterus, Completely surrounded by myometrium

US-guided MTX injected in the GS

Kong, et al. [10]

2017

20

G1P0; D&C (×1)

-

The GS at a distance from the cavity, With a compressed myometrium between the two of them; MRI showed the GS was embedded into the myometrium in the right posterior wall of the uterine

Laparotomy with resection under UAE

Mahmoud,

et al. [1]

2017

33

G8P7; CS (×1)

Vaginal bleeding and Abdominal pain, Nausea and Vomiting

An empty uterine cavity and a 28 mm, Well-

defined GS located in the anterior myometrium of the lower uterine segment

Laparotomy with resection

Mahmoud, et al. [1]

2017

34

G2P1;

-

Ultrasound and MRI indicated a mixed echogenic mass measuring 5.1 × 4.6 cm located within the posterior wall of the uterine fundus with an abundant blood supply

Hysteroscopy and laparotomy with resection following MTX-based chemotherapy

Liu, et al. [10]

2017

34

G2P1; D&C (×1);

Laparoscopic surgery for

endometriosis

 

-

A heterogeneous mass measuring 3.7 × 3.3 cm in the posterior wall, Extending to the uterineserous layer; MRI indicated an irregular signal area in the left wall within the myometrium of the uterus

Hysteroscopy and Laparoscopic resection

 

 

19

G1P0; D&C (×1)

Vaginal bleeding and Vomiting

A heterogeneous mass measuring 4.2 × 2.9 cm in the left posterior wall of the uterus

 

Laparoscopic resection

 

 

40

G4P0

Severe abdominal pain

A heterogeneous echogenic mass (5.4 × 4.4 cm) in the right side of the uterine wall, close to the corneal tissue, and the embryo bud not connected with the endometria

Hysteroscopy and Laparoscopic resection

Lyu, et al. [7]

2018

26

G2P0; Right salpingectomy; IVF-ET (twin pregnancy)

-

Intrauterine pregnancy with another mass measuring 2.0 × 2.0 cm in the left cornua separate from uterine cavity and surrounded by musculature

Laparoscopic resection (another led to a live birth)

Vagg, et al. [2]

2018

34

G2P2; Open

Myomectomy (×1)

-

A GS measuring 8.0 × 7.9 × 7.0 cm within the myometrium of the right uterine cornua

Laparotomy, Hysterectomy and

Bilateral salpingectomy

Yang, et al. [13]

2019

31

-

-

A GS measuring 3.0 × 2.0 × 1.1 cm in the righthorn of the uterus surrounded by the myometrium

Hysteroscopy and Laparoscopic

resection with injection of

terlipressin (6U)

You, et al. [9]

2019

35

G5P3; IUD (×1);

Adenomyosis

Severe pelvic pain and Hypotension

A mass (7.0 × 5.0 cm) was located in the

uterus

Laparoscopic resection

Zhang, et al. [3]

2019

30

G1P1; CS (×1)

Vaginal bleeding

A mass measuring 4.0 × 3.0 × 3.0 cm was observed in the posterior wall below the left horn of the uterus

Laparoscopic resection with injection of terlipressin (6U) and MTX (50 mg)

Chaikof,

et al. [8]

2020

35

G2P2; D&C (×1);

Asherman syndrome

-

The GS was located within 3 mm of the

uterine serosa

Local resection

Liu, et al. [5]

2020

28

G2P1; Right

salpingectomy; IVF-ET

-

A ill-defined hypoechogenic structure with

14 × 13 mm in size was between the right

ovary and the uterus contour

Hysteroscopy and Laparoscopic

resection

Nees, et al. [4]

2020

24

CS (×1)

-

A 4.3 × 3.5 cm mass containing a GS with a

viable embryo was seen on the left side of

the uterus

Laparotomy with uterine wedge

resection

This report

2020

33

G4P1; D&C (×1)

Vaginal bleeding,

Slight chest tightness and Nausea

A mass measuring 38 × 43 × 40 mm with uneven echo located in the right lateral wall of uterus

Chemotherapy of EMA-CO, Hysteroscopy and Laparotomy with resection

D&C: Dilatation and Curettage; GS: Gestational Sac; LSCS: Laparoscopic Hysteromyomectomy; MTX: Methotrexate; IVF-ET: In Vitro Fertilization and Embryo Transfer; UAE: Uterine Artery Embolization; IUD: Intrauterine Contraceptive Device; CS: Cesarean Section