1450 Laparoscopic Cornual Resection of Heterotopic Cornual Pregnancy

Abstract

Video Objective Laparoscopic heterotopic cornual pregnancy resection. Setting A 41 y/o woman, with history of G3P0E1(status post right salpingectomy)SA1 got pregnancy via IVF with frozen embryo transferred. Four embryos were transferred. However, at about gestational age 6 weeks, two intrauterine gestational sac and one right cornual gestational sac were found. All the fetus had heart beats. Thin uterine wall at right cornus about 0.53cm in size was also noticed. To preserve normal intrauterine pregnancy, surgical intervention was suggested, and the patient received laparoscopic cornual resection surgery. Interventions During operation, to prevent fetus injury, we didn't use uterine manipulator or pitressin injection. We also avoided electrical energy device to decrease thermal effect to fetus. Because of the rich blood flow of uterus, we hoped to decreased the surgical time, and barbed suture was used. Multiple suture layers for uterus was applied. We also used vaginal ultrasound during operation to check the uterine condition. After checking bleeders, adhesion barrier was used. For postoperative medication, progesterone was prescribed for tocolysis. We checked ultrasound after the surgery, and only one fetus with fetal heart beat was noticed. Conclusion Laparoscopic heterotypic cornual pregnancy resection is feasible with the advantages of decreased hospital stay, less wound pain, and less use of analgesics. Further obstetrics outcome is reassuring in current studies.