Laparoscopic management of cornual pregnancy: A case report

Authors

Keywords:

Laparoscopy, Ectopic pregnancy, Cornual pregnancy

Abstract

The incidence of cornual or interstitial pregnancy is approximately 2% of all pregnancies. Interstitial pregnancy is one of the rare form of ectopic pregnancies, with 1-6% of all ectopic pregnancies. In our case report, we present successful laparoscopic resection of a cornual pregnancy with positive fetal cardiac activity and laparoscopic suturing of cornu uteri. A 26-year-old pregnant; gravida 2, para 0, abortus 1; was admitted with a complaint of left lower quadrant abdominal pain. An ultrasound examination was performed. The ultrasound examination revealed a 4-cm ectopic gestational sac with positive cardiac activity in the left adnexa. Laparoscopy was planned. A left uterin approximately 3x4 cm cornual pregnancy was observed, under direct visualization, one 5-mm coagulating dissector was used to perform the resection and seal of the cornu uteri. After the sealing, two times laparoscopic suturing was applied. Detecting interstitial pregnancy is more difficult than revealing other ectopic pregnancy types. Severe hemorrhage could occur during the resection of the cornu uteri. Therefore, a laparoscopic approach should only be attempted if the surgeon is well skilled in laparoscopic technique, and has the capability to convert the operation quickly to a laparotomy.

Downloads

Download data is not yet available.

References

Soriano D, Vicus D, Mashiach R, Schiff E, Seidman D, Goldenberg M. Laparoscopic treatment of cornual pregnancy: a series of 20 consecutive cases. Fertility and sterility. 2008 Sep 1;90(3):839-43.

Jermy K, Thomas J, Doo A, Bourne T. The conservative management of interstitial pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology. 2004 Nov 1;111(11):1283-8.

Chan LY, Fok WY, Yuen PM. Pitfalls in diagnosis of interstitial pregnancy. Acta obstetricia et gynecologica Scandinavica. 2003 Sep;82(9):867-70.

Saraswathi K, Prasad MS, Kumari BK. Tubal ectopic pregnancy: comparative study of laparoscopy vs laparotomy. JOURNAL OF EVOLUTION OF MEDICAL AND DENTAL SCIENCES-JEMDS. 2015 Nov 5;4(89):15447-9.

Sel G, Harma Mİ, Harma M, Barut A, Arıkan İİ. Case report of a Successful Treatment of Interstitial Pregnancy with Systemic Methotrexate. Abant Med J. 2017;6(3):120-2.

Goran A. Spontaneous uterine rupture. In: Acute Abdomen During Pregnancy. Springer, Cham, 2014. p. 495-527.

Ong C, Su LL, Chia D, Choolani M, Biswas A. Sonographic diagnosis and successful medical management of an intramural ectopic pregnancy. Journal of Clinical Ultrasound. 2010 Jul;38(6):320-4.

Grobman WA, Milad MP. Conservative laparoscopic management of a large cornual ectopic pregnancy. Human reproduction (Oxford, England). 1998 Jul 1;13(7):2002-4.

Moawad NS, Mahajan ST, Moniz MH, Taylor SE, Hurd WW. Current diagnosis and treatment of interstitial pregnancy. American journal of obstetrics and gynecology. 2010 Jan 1;202(1):15-29.

Ng S, Hamontri S, Chua I, Chern B, Siow A. Laparoscopic management of 53 cases of cornual ectopic pregnancy. Fertility and sterility. 2009 Aug 1;92(2):448-52.

Weissman A, Fishman A. Uterine rupture after conservative surgery for interstitial pregnancy. Eur J Obstet Gynecol Reprod Biol 1992;13(44):237–9.

Downloads

Published

2019-06-28

Issue

Section

Case Report

How to Cite

1.
Sel G, Özaydın D, Tekin AO, Harma M, Harma M İbrahim. Laparoscopic management of cornual pregnancy: A case report. J Surg Med [Internet]. 2019 Jun. 28 [cited 2024 Apr. 18];3(6):456-8. Available from: https://jsurgmed.com/article/view/522344