A Case Report: Misdiagnosed Ectopic Cornual Rupture with Positive Fetal Heart at 13 Weeks Gestation

Prevalence and presentation of ectopic pregnancy in a tertiary hospital in Enugu south-east Nigeria: A 10-year retrospective study

“…This result is comparable with the 86.9% reported by Musa et al 33 in Jos and 84% by Eke et al 16 but higher than the 70% reported in Sokoto. 13 It is lower than the 93%, 93.5%, 95.6%, 99.2%, 100% reported by Thonneau et al 8 , Ali et al 28 , Lawani et al 22 , Adewunmi et al 12 , and Udigwe et al 32 in Sudan, Guinea, Abakiliki, Lagos, and Nnewi respectively. These very high prevalence rates of ruptured ectopic pregnancy illustrate the clear risks and the challenges of management of ectopic pregnancy in Sub-Saharan Africa.…”

“…It calls to question the health seeking behaviours of African women especially in early pregnancy when symptoms and signs of pregnancy are still vague. It has been shown that some women may not be aware that they are pregnant yet while some may underestimate the seriousness of their symptoms prior to the rupture of the ectopic gestation 28,29 . Even with early presentation, late diagnosis and sometimes outright misdiagnosis may compound the situation and increase the risk of rupture 31 .…”

“…The case fatalities from ectopic pregnancy in many developed countries have been on the decline due mainly to improved diagnostic techniques especially the use of transvaginal ultrasonography and prompt interventions employing medical and or new surgical management approaches 8,27 . These newer interventions are not readily available in low resource settings like ours where the exact burden of ectopic pregnancy is unclear due to shortcomings in documentation and reporting, delays in seeking or reaching healthcare facilities, difficulty in making diagnosis or outright misdiagnosis, and the use of different denominators for reporting ectopic pregnancy rates 8,[28][29][30][31] . Open laparotomy and salpingectomy still remained the commonest treatment modality for tubal ectopic pregnancy in our region 8,15,29 . This study was meant to develop the first basic and original data on ectopic pregnancy in our centre, being the first retrospective study on this subject matter since the institution became a teaching hospital.…”

Misdiagnosed ruptured cornual ectopic pregnancy: Case report and literature review

“…Because of the ability of the myometrial tissues surrounding the ectopic gestational sac to stretch to variable degrees, a cornual rupture generally occurs after 9 weeks and as late as 20weeks 5 . Rupture of the gestational sac at such an advance age is often associated with catastrophic haemorrhage and up to 2.0-2.5% maternal mortality rate which is 6 -7 times higher than that in other forms of ectopic pregnancies 1,6 . About 4 out of 11 deaths from ectopic pregnancies result from cornual ruptures because haemorrhagic shock is found in almost a quarter of the patients 6 .…”

“…Interstitial and cornual ectopic pregnancies are rare but are the most dangerous forms of ectopic pregnancies accounting for 2-4% of all ectopic pregnancies 1 . An interstitial pregnancy is defined as a gestational sac that implants within the proximal intramural portion of the fallopian tube that is enveloped by the myometrium 2,3 .…”