A rare case of unruptured cornual pregnancy at 13 weeks

Abstract

Interstitial pregnancy is a rare form of ectopic pregnancy in which implantation occurs within the interstitial portion of the fallopian tube. Although it may remain asymptomatic for longer than other tubal ectopic pregnancies, rupture can result in severe intra-abdominal haemorrhage because of the vascularity and distensibility of the surrounding myometrium. We report a 24-year-old primigravida diagnosed with an unruptured left interstitial pregnancy at 13 weeks of gestation during routine ultrasonography. The patient was haemodynamically stable and underwent exploratory laparotomy with left cornual resection and ipsilateral salpingectomy after counselling and informed consent. A well-formed fetus with placenta was identified within the resected specimen. The postoperative course was uneventful, and serial serum β-human chorionic gonadotropin measurements were followed until complete biochemical resolution. This case highlights the possibility of an unruptured interstitial pregnancy persisting beyond the first trimester and the importance of early ultrasonographic localisation of pregnancy. Timely diagnosis permits planned treatment before rupture and catastrophic haemorrhage.