Laparoscopic Wedge Resection in a Late Second Trimester Cornual Pregnancy

Abstract

Cornual pregnancy happens when implantation occurs in the cavity of a rudimentary horn of the uterus, which may or may not be communicating with the uterine cavity. The diagnosis of cornual pregnancy remains challenging, and rupture of a cornual pregnancy usually causes massive bleeding. Early diagnosis and treatment, therefore, are very crucial and key to prevent mortality. Historically, the management of cornual pregnancies included wedge resection through open surgery or even hysterectomy. In this case report, we would like to highlight a case of late second trimester cornual pregnancy, at 19-week and 3-day gestation, which was managed laparoscopically.

A Case of Cornual Pregnancy after Ipsilateral Salpingectomy for Isthmic Pregnancy

“…Cornual pregnancies account for 2%–4% of all tubal pregnancies, with a rupture mortality rate of 2%–2.5%, which is reportedly more than 7 times higher than that of other ectopic pregnancies. [ 9 10 11 ] It has been reported that the detection rate of cornual pregnancy by transvaginal ultrasonography is 71.4%, and early detection can be facilitated by combining transvaginal ultrasonography with serum hCG level assessment. [ 12 13 ] In the future, it seems that surgery combined with hysteroscopic and laparoscopic surgery will be possible.…”

Distinguishing between cornual, angular and interstitial ectopic pregnancy: A case report and a brief literature review

“… [75] 2008 1 Not reported Rudimentary horn 19 wk Nonviable Shahid et al. [76] 2009 1 Not reported Rudimentary horn 16 wk Nonviable Safiee & Ghazali [77] 2021 1 Not reported Right cornual region 19 wk 3 d Live fetus; Pregnancy terminated Ozeren et al. [78] 2004 1 Not reported Rudimentary horn 17 wk Live fetus; Pregnancy terminated Prenaud et al.…”

Modified Laparoscopic Cornual Resection for Cornual Pregnancy

“…[ 1 ] Conventional laparoscopic management includes cornuostomy, cornual resection, and wedge resection. [ 2 3 ] Possible issues with these procedures are disruption of the fetal capsule, injury to the myometrium accompanied by bleeding, and persistence of trophoblastic tissue. [ 1 2 3 ] Our modified cornual resection method can avoid the issues mentioned above.…”