Uterine rupture following previous cornual ectopic pregnancy: a rare obstetric emergency

Abstract

Uterine rupture in pregnancy following previous cornual ectopic pregnancy surgery is an uncommon but potentially catastrophic obstetric emergency. Prior cornual surgery may result in localized myometrial weakness, predisposing to rupture during a subsequent pregnancy. A 25-year-old gravida 2 abortion 1 woman at 30+2 weeks of gestation presented with sudden onset abdominal pain, vaginal bleeding, and absent fetal movements. She had undergone laparoscopic salpingectomy for a cornual ectopic pregnancy one year earlier. Clinical examination revealed absent fetal heart sounds and features suggestive of intra-abdominal bleeding. Emergency laparotomy demonstrated hemoperitoneum and rupture at the previous cornual surgery site with extrusion of the fetus into the peritoneal cavity. Uterine repair was performed successfully. Previous cornual ectopic pregnancy surgery should be recognized as a significant risk factor for uterine rupture in subsequent pregnancies. Early diagnosis and prompt surgical intervention are essential to improve maternal outcomes.