scholarly journals A rare case report of cornual pregnancy

Author(s):  
Priyanka Bansal ◽  
Gargi Aggarwal ◽  
Isha Bansal

Cornual pregnancy is a rare type of ectopic pregnancy in which embryo implants in the junction between the fallopian tube and uterus. Ectopic pregnancy is more common in the ampullary region of the fallopian tube. However, cornual (interstitial) pregnancy is seen in 2-4% of ectopic pregnancies. It is more dangerous than other ectopic as it may lead to catastrophic hemorrhage, shock with mortality rate of 2-2.5%. A cornual pregnancy is diagnosed at 7+3 week of amenorrhea in 27-year-old healthy woman. Ultrasound examination showed a right live cornual pregnancy with CRL corresponding to 6+4week of gestation with fetal heart pulsation. We performed right cornuostomy by laparotomy without any immediate or delayed postoperative complications. Cornual pregnancy poses significant diagnostic and therapeutic challenge; early diagnosis may help to select the proper management and treatment according to the clinical presentation, hemodynamic stability, serum b-hCG level and ultrasound findings. Early diagnosis and management remain the mainstay for tackling maternal mortality due to cornual pregnancy.

2019 ◽  
Vol 10 (1) ◽  
pp. 64-67
Author(s):  
Tanzeem S Chowdhury ◽  
Homaira Hasan ◽  
TA Chowdhury

Ectopic pregnancy is a condition where gestational sac is located outside the uterine cavity. Cornual pregnancy, also known as interstitial pregnancy, is a rare type of ectopic pregnancy that develops in the interstitial portion of the fallopian tube and invades through the uterine wall. It poses great diagnostic challenge because of its unusual presentation and late diagnosis. Cornual pregnancy, if not diagnosed early, may present with massive and uncontrollable bleeding even leading to maternal death. We hereby report an unusual presentation of cornual pregnancy which was diagnosed and subsequently managed successfully. Birdem Med J 2020; 10(1): 64-67


Author(s):  
Sreelatha S ◽  
Sumayya Sana ◽  
Pruthvi S ◽  
Yashaswini . ◽  
Shruthi K ◽  
...  

Cornual pregnancy is a rare type of ectopic pregnancy with incidence of about 2-4% of all ectopic pregnancies. The mortality rate is about 2-2.5%. The diagnosis and management is challenging and frequently constitute a medical emergency. We report a case of a 33year old second gravida, para 1, living 1 with previous LSCS with 13weeks 2days period of gestation presenting to the casualty with complaints of severe pain abdomen and signs of hypovolemic shock. Ultrasound revealed gross hemoperitoneum with ruptured right adnexal gestation. Emergency laparotomy was done and cornual end was found ruptured and was sutured successfully and hemostasis achieved. Intra operative two units of packed cells was transfused. Patient was discharged stable on post-op day 7.


2018 ◽  
Vol 24 (3) ◽  
pp. 167 ◽  
Author(s):  
Mohannad AbuFaza ◽  
Ibrahim A. Abdelazim

<p>Interstitial pregnancy is a rare variety of ectopic pregnancy, it can have disturbed 8-16 weeks of amenorrhea (later than the distal tubal ectopic pregnancy), due to the dispensability of the myometrium covering the interstitial segment of the fallopian tube, with subsequent massive internal hemorrhage.<br />A 29-years-old female, Gravida 3, Para 2, presented with severe abdominal pain, vomiting, and syncope 3 days after her missing period, and positive pregnancy test. Trans-vaginal ultrasound showed empty uterine cavity, free pelvic fluid with severe cervical motion tenderness. She was diagnosed with ruptured ectopic pregnancy. Ruptured ectopic pregnancy in the proximal segment of right fallopian tube was confirmed with laparotomy.<br />The ruptured pregnancy was managed by right salpingectomy, and hemostatic stitches at the right uterine corn. Her hemoglobin was 8 gr on admission, and she received 3 units of packed RBCs (one intra-operative, and two post-operative). Her post-operative hemoglobin was 10.5 gr, and she was discharged from the hospital on the 3rd post-operative day in good general condition for follow up in the outpatients` department. <br />This case report represents a rare variety of ectopic pregnancy, which is the interstitial pregnancy, because it can rupture few days or weeks after the missed period with subsequent massive internal hemorrhage. <br />Interstitial pregnancy is a rare form of ectopic pregnancy, the obstetricians should be aware of rare forms of ectopic pregnancies, it can have disturbed few days or weeks after the missed period leading to subsequent significant morbidity.</p>


2020 ◽  
pp. bmjsrh-2020-200888
Author(s):  
Clara I Duncan ◽  
John J Reynolds-Wright ◽  
Sharon T Cameron

IntroductionRoutine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.MethodsRetrospective case record review of women requesting abortion over a 5-year period (2015–2019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.ResultsOnly 29/11 381 women (0.25%, 95% CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.ConclusionsEctopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.


2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Fouzia Rasool Memon ◽  
Mini Poothavelil ◽  
Samreen Memon

Objectives: To find out the negative laparoscopy rate for suspected ectopic pregnancy. Study Design: Retrospective cohort study. Setting: Electronic medical record databases in North Cumbria University Hospital, Carlisle, United Kingdom. Period: August 2014 to August 2018. Material and Methods: The data of total 150 laparoscopies performed for ectopic pregnancy management was collected for gestational age at presentation, symptoms, serial beta human chorionic gonadotrophic hormone (HCG) levels, ultrasound findings, time interval for diagnosis, time to surgery and histology. Results: One hundred and fifty patients (52 under 5 weeks and 98 over 5 weeks’ gestation) were incorporated into this study. The primary presenting symptoms were pain and vaginal bleeding. Suboptimal rise in serial beta HCG (performed 48 hours apart) was seen in 69 patients (46%) while other 81 patients (54%) had confirmed ectopic on USS and were offered surgical management after the scan. One hundred forty for women (96%) went for surgical management and one patient had conservative management as she was asymptomatic with low HCG(less than 1000IU) at the first visit and rapid drop in serial BHG results. Fifty three women (35%) had surgery on the same day when they had ectopic pregnancies seen on USS, 63 (42%) went to theatre for surgery between 0-6 days, while 34 patients (23%) had surgery between 7-14 days of USS. All women were operated through laparoscopic route and tubal ectopic pregnancies were confirmed at laparoscopy. There was no negative laparoscopy in our study period. Conclusion: Judicious and timely surgical intervention made it possible to treat every case through laparoscopic route with zero negative laparoscopy rate.


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


Author(s):  
Neelotparna Saikia ◽  
Sukalyan Halder ◽  
Punam Jain

Cornual ectopic pregnancy accounts for 2-4% of all the ectopic pregnancies with a mortality rate 6-7 times higher than that of the ectopics in general. It is a diagnostic and therapeutic challenge to the clinician with a significant risk of rupturing and bleeding. As of yet, the incidence of recurrent cornual ectopic pregnancies is unknown. This report described the case of a patient who developed two cornual ectopic pregnancies within a span of 3 years with an intervening full term normal vaginal delivery. The 1st cornual ectopic was successfully managed by laparoscopic resection, which was followed by an uneventful postoperative course. The following contralateral cornual ectopic was managed by laparotomy since the patient presented with large hemoperitoneum.


2021 ◽  
pp. 548-551
Author(s):  
Marina A. Kiyok ◽  

Ectopic pregnancy (EP) is a rare and severe complication of assisted reproductive techniques (ART). A specific feature of EP after ART is a high frequency of rare atypical forms of EP, the absence of a specific clinical picture and a high probability of recurrent EP, which makes certain difficulties in terms of diagnosis. Interstitial pregnancies occur in 1–6% of all ectopic pregnancies and in 7.3% cases of EB which were the results of in vitro fertilization programs (IVF). The anatomical features of the blood supply in the intramural segment of the fallopian tube provide favorable conditions for the progression of pregnancy on the average up to 10 weeks of gestation, simulating the intra-uterine pregnancy. Chorionic villi, growing into the thickness of the myometrium, create a high risk of profuse intra-abdominal bleeding. The article presents a clinical case of a rare form of ectopic pregnancy in the interstitial segment of the fallopian tube after IVF. The patient had previously undergone a bilateral salpingectomy by tubal pregnancies. This clinical example shows the meaning of precise diagnosis and timely provision of highly qualified specialized medical care.


2014 ◽  
Vol 4 (1) ◽  
pp. 50-51
Author(s):  
MI Khan ◽  
R Nyeer ◽  
R Laila ◽  
S Jahan

Cornual pregnancy is a specific variety of ectopic gestation which occurs in the rudimentary horn of the uterus. It often rupture later than other tubal pregnancies because the myometrium is more distensible than the fallopian tube. Traditionally, the treatment is cornual resection (removal of rudimentary horn) or hysterectomy where the pedicle is short and the attachment is wide. Here, we report a case where cornual pregnancy was diagnosed at 17 weeks of gestation after uterine rupture and profound haemorrhage. The patient underwent laparotomy followed by cornual resection with salpingectomy. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18558 Birdem Med J 2014; 4(1): 50-51


Sign in / Sign up

Export Citation Format

Share Document