A new technique in the laparoscopic resection of cornual ectopic pregnancies: a case series

Abstract

Cornual ectopic pregnancies are a challenging dilemma faced in the early pregnancy setting. They are associated with high morbidity and mortality rates when compared to standard tubal ectopic pregnancies mainly due to their late presentation and significant haemorrhage and hysterectomy risk. Laparoscopic resection has been described successfully; however, the procedure can be technically very challenging and can carry significant potential risks of bleeding and conversion to laparotomy. Carboprost is a synthetic prostaglandin analogue, used widely in the management of obstetric haemorrhage, with its main mode of action being myometrial contractions. We present a series of four cases where intramyometrial carboprost injection was used successfully, prior to the laparoscopic resection of cornual ectopic pregnancies, to produce consistent and reproducible surgical benefits including prolonged myometrial contractions and subsequent reduced uterine blood flow. This results in a significant reduction in intraoperative blood loss as well as a clearer demarcation of the ectopic pregnancy and a technically easier resection.