Cornual Heterotopic Pregnancy after Bilateral Salpingectomy and Uterine Septum Resection Resulting in Term Delivery of a Healthy Infant

Abstract

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her second in vitro fertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

Angularectopicpregnancy: About a Case Study at the Teaching and Department Hospital of Borgou Alibori

“…Other researchers have reported some cases of ectopic pregnancy associated with intrauterine pregnancy normally progressed and led to a planned caesarean at 39 weeks of amenorrhoea [6]. Similar cases have been observed after an in vitro fecundation reported by Oral [7].…”

“…Whatever the treatment is, the prognosis of fertility and the ulterior obstetrical prognosis seem good underscores Nikodijevic, Peker and Oral [3,6,7].…”

Management and outcome of heterotopic interstitial pregnancy: Case report and review of literature

“…Most authors advise an elective cesarean section to deliver the continuing intrauterine pregnancy. 2,22,28,29 This advice is supported by peroperative findings of a thinned out 22 and even preruptured state 4 of the affected cornu, even after expectant management of a nonviable interstitial heterotopic pregnancy. 4 Nevertheless, some authors have described a successful vaginal delivery after early treatment for interstitial pregnancy.…”

Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature

“…Many cases were reported since then as treated successfully using minimal invasive techniques with very good outcomes as a fertility-preserving management of choice [9,[19][20][21][22][23]. The use of robotic surgery has been tried in many trials where authors followed the same principles of devascularization of the uterine wall and removal of the ectopic with part of the uterus then suturing the defect [24][25][26]. Another trial was done using double-impact devascularization technique where they used hemostatic suture as a compression method to decrease bleeding [27].…”