A rare form of ectopic pregnancy-cornual ectopic

V S Thrupthi¹, Indira H^2*, Dwarakanath L³, Girish B L⁴

¹Post Graduate, ²Professor and Head, ³,⁴Professor, Department of Obstetrics & Gynaecology
Sri Siddhartha Medical College, SSAHE, Tumkur,
Karnataka, India

* Corresponding author

Abstract
Background : Interstitial and cornual ectopic pregnancy is rare, accounting for 2–4% of ectopic pregnancies and remains the most difficult type of ectopic pregnancy to diagnose due to low sensitivity and specificity of symptoms and imaging. The site of implantation of embryo occurs in the intrauterine part of the fallopian tube and invasion through the wall of uterus make this pregnancy tough to differentiate from an intrauterine pregnancy on ultrasound examination. Mortality is high in this type of pregnancy due to delay in diagnosis ,rupture at the site of implantation,internal haemorrhage in addition to speed of hemorrhage. Case report: A 29-year-old lady, G3P2L2, referred to our hospital at 7+3 weeks of gestation as a suspected case of cornual ectopic pregnancy. She presented with bleeding since 15 days, On admission, she was stable hemodynamically. Abdominal examination was normal. On per vaginum examination OS was closed with minimal bleeding,uterus was bulky with right forniceal tenderness and cervical motion tenderness. USG done outside shows thick walled cystic lesion with significant peripheral vascularity in the right adnexa/corneal end of right fallopian tube measuring 5.9x4.4cms suggesting cornual ectopic. On admission, her Beta-hCG was 9169 IU/l.She was conselled and she opted for surgery.OT findings were right cornual ectopic of size 6x6cms extending intramurally.Hysterectomy is done after taking consents to stop bleeding.After excising the specimen fetal pole with membranes present.HPE confirmed ectopic gestational sac. Follow-up was done with weekly serum beta hCG till it became <2 IU/l and pelvic USG. Subsequent decline in serum beta hCG and reduction in size of ectopic gestational sac were noted on USG.
Key words: Ectopic,Cornual Ectopic,Interstitial Ectopic,Hysterectomy.