IMP Registry
Research type
Research Study
Full title
Intramural pregnancy registry
IRAS ID
337244
Contact name
Davor Jurkovic
Contact email
Sponsor organisation
UCL
Clinicaltrials.gov Identifier
Z6364106/2024/05/117, UCL Data Protection Registration number; tbc, Research Registry
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Intramural pregnancy (IMP) is a rare form of ectopic pregnancy, on which there is little published literature regarding diagnosis, management, or natural history. The published literature on IMP is limited to under 80 cases.
IMP is a diagnostic challenge for two reasons. First, it is so rare that most early-pregnancy clinicians have no, or minimal experience of the condition. Second, the presenting symptoms are non-specific. Thus, it is rare that the diagnosis is considered. Presentation of a suspected IMP on ultrasound can vary from a clearly visible pregnancy with a heartbeat to a solid heterogeneous mass within the myometrium, which may be difficult to differentiate from other uterine pathology, such as adenomyotic cysts or cystic fibroids that can mimic pregnancy structures.
Most published case reports describe surgical or medical management of IMP, with only nine cases managed expectantly, so little is known about the natural history of expectantly managed IMP. Expectant management of live IMP can be associated with significant maternal morbidity, including uterine rupture and abnormally adherent placenta, both of which may cause massive obstetric haemorrhage requiring life-saving hysterectomy. However, given the relatively small number of cases in the medical literature there is no strong evidence regarding these risks and therefore the decision on how to counsel women with regards to whether to terminate or continue the pregnancy is very difficult. The largest case series of IMP (n=18) showed that there was no single standard treatment algorithm for women with an IMP and only 50% were diagnosed correctly at the initial visit.
We aim to develop an international registry of IMPs, as through collection of large numbers of anonymised cases of IMP we will have more data on diagnosis, natural history, and management, which will allow us to develop standardised diagnostic criteria and treatment protocols to improve patient care.
REC name
North of Scotland Research Ethics Committee 2
REC reference
24/NS/0104
Date of REC Opinion
17 Sep 2024
REC opinion
Unfavourable Opinion