Undiagnosed Cornual Pregnancy Complicated by Large Uterine Fibroid: A Rare Case Report

Abstract

A cornual pregnancy is a rare form of ectopic pregnancy with the incidence rate of 2 – 4% of all ectopic pregnancies. It has a higher mortality rate, which is 6 – 7 times higher than other ectopics. Diagnostic approach can be done by transvaginal sonography and serum β-hcg test, however reaching the diagnosis itself is quite challenging. Due to the greater distensibility of myometrium covering interstitial segment of the fallopian tube, undiagnosed cornual pregnancy usually ends with rupture in 8 to 16 weeks of pregnancy, which lead to significant maternal hemorrhage then hypovolemic shock. Reported case is a 35 years old woman who presented to the emergency room with chief complain of severe abdominal pain in a state of hypovolemic shock. She was admitted for emergency exploratory laparotomy. On exploration, we found a point of rupture at the left cornual area from the 20-22 weeks gestational age sized uterus. The 12 weeks old fetus inside the intact gestational sac was found in the abdominal cavity. The patient then underwent cornual wedge resection, myomectomy and bilateral salpingectomy, since the uterus was not viable for another pregnancy. All procedures were done successfully, and the patient was discharged in a good condition. Keywords: Cornual Pregnancy , Ectopic Pregnancy , Rupture Ectopic Pregnancy DOI: 10.7176/JMPB/73-07 Publication date: September 30 th 2023