A case of cornual pregnancy at ten gestational age accompanied by heterotopic pregnancy

Authors

  • Jisun Yun Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
  • Jong-wook Seo Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
  • In Ok Lee Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
  • Jae Eun Chung Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205795

Keywords:

Cornual pregnancy, Heterotopic pregnancy, Gestational age 10 weeks, Myomectomy

Abstract

Objective of the study was to report a case of cornual pregnancy at 10 weeks gestational age, accompanied by heterotopic pregnancy. A 41-year-old woman was transferred to the emergency department of the national health insurance service Ilsan hospital at amenorrhea 10 weeks 5 days after being diagnosed of cornual pregnancy from a primary hospital. The patient was nulliparous with a history of 1 induced and 2 missed abortions. Other than a previous myomectomy, her medico-surgical history was not significant. She was initially diagnosed with blight ovum at amenorrhea 8 weeks 4 days, and dilatation and curettage were performed at the primary hospital of which she was referred from. At amenorrhea 10 weeks 5 days, another gestational sac was noted at the left cornu of the uterus by ultrasonography. The tentative diagnosis was cornual pregnancy accompanied by heterotopic pregnancy. Serum ß human chorionic gonadotrophin (hCG) at the time of arrival was 84573.8 mIU/ml. Trans-abdominal ultrasonography showed a mass protruding from the left cornu of the uterine cavity, containing a gestational sac (mean sac diameter 39.0 mm, 10 weeks size) and an embryo of cranio-caudal length of 38.2 mm (10 weeks 5 days size). There was no sign of intraperitoneal hemorrhage. Emergency operation was planned under the diagnosis of cornual pregnancy. Entering the abdominal cavity, a 5×5 cm sized conceptual mass surrounded by thin and fragile myometrium was noted on left uterine cornu. Open wedge resection of the left cornual pregnancy with left salpingectomy was performed. The resected mass was 4.0×3.5 cm2 in size. An embryo with 45 mm size was confirmed inside the mass.

Author Biography

Jae Eun Chung, Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea

 

 

References

Breen JL. A 21-year survey of 654 ectopic pregnancies. Am J Obstet Gynecol. 1970;106(7):1004-19.

Jansen RP, Elliott PM. Angular intrauterine pregnancy. Obstetrics Gynecol. 1981;58(2):167-75.

Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. Canadian Medic Assoc J. 2005;173(8):905-12.

Divry V, Hadj S, Bordes A, Genod A, Salle B. Case of progressive intrauterine twin pregnancy after surgical treatment of cornual pregnancy. Fertil Steril. 2007;87(1):190:e1-3.

Coady D, Snyder J, Goldstein S, Subramanyan B. Ultrasound diagnosis of interstitial pregnancy. NY State J Med. 1985;85(11):655-6.

Sherer DM, Allen T, Singh GS, Woods Jr JR. Transvaginal sonographic diagnosis of an unruptured interstitial pregnancy. J Clin Ultrasound. 1990;18(7):582-5.

Song MH, Seong YM, Kim KJ. A case of cornual pregnancy found in 32 gestational weeks of pregnancy. Obstet Gynecol Sci. 1995;38(1):111-21.

Felmus LB, Pedowitz P. Interstitial pregnancy: a survey of 45 cases. Am J Obstet Gynecol. 1953;66(6):1271-9.

Dor J, Seidman DS, Levran D, Ben-Rafael Z, Ben-Shlomo I, Mashiach S. The incidence of combined intrauterine and extrauterine pregnancy after in vitro fertilization and embryo transfer. Fertility sterility. 1991;55(4):833-4.

Dumesic DA, Damario MA, Session DR, editors. Interstitial heterotopic pregnancy in a woman conceiving by in vitro fertilization after bilateral salpingectomy. Mayo Clin Proceedings. 2001;76(1):90-2.

Pan H-S, Chuang J, Chiu S-F, Hsieh B-C, Lin Y-H, Tsai Y-L, et al. Heterotopic triplet pregnancy: report of a case with bilateral tubal pregnancy and an intrauterine pregnancy: Case report. Human Reproduction. 2002;17(5):1363-6.

Stiller RJ, de Regt RH. Prenatal diagnosis of angular pregnancy. J clinical ultrasound. 1991;19(6):374-6.

Deckers E, Stamm C, Naake V, Dunn T, McFee J. Hysterotomy for retained placenta in a term angular pregnancy. A case report. J Reprod med. 2000;45(2):153-5.

Sasso R. Laparoscopic diagnosis and treatment of cornual pregnancy. A case report. J Reprod Med. 1995;40(1):68-70.

Tulandi T, Vilos G, Gomel V. Laparoscopic treatment of interstitial pregnancy. Obstet Gynecol. 1995;85(3):465-7.

Lau S, Tulandi T. Conservative medical and surgical management of interstitial ectopic pregnancy. Fertil Steril. 1999;72(2):207-15.

Timor-Tritsch IE, Monteagudo A, Matera C, Veit CR. Sonographic evolution of cornual pregnancies treated without surgery. Obstet Gynecol. 1992;79(6):1044-9.

Barnhart K, Spandorfer S, Coutifaris C. Medical treatment of interstitial pregnancy. A report of three unsuccessful cases. J Reprod Med. 1997;42(8):521-4.

Benifla J-L, Fernandez H, Sebban E, Darai E, Frydman R, Madelenat P. Alternative to surgery of treatment of unruptured interstitial pregnancy: 15 cases of medical treatment. Eur J Obstet Gynecol Reprod Biol. 1996;70(2):151-6.

Brandes MC, Youngs DD, Goldstein DP, Parmley TH. Treatment of cornual pregnancy with methotrexate: case report. Am J Obstet Gynecol. 1986;155(3):655-7.

Chandra P, Koenigsberg M, Romney SL, Koren Z, Schulman H. Unruptured interstitial pregnancy. Diagnosis and treatment. Obstet Gynecol. 1978;52(5):612-5.

Downloads

Published

2020-12-26

Issue

Section

Case Reports