Misdiagnosed ruptured cornual ectopic pregnancy: Case report and literature review

Abstract

Ruptured ectopic pregnancy is a leading cause of maternal morbidity and mortality worldwide. Cornual ectopic pregnancy is a specific type that occurs at the horn of the uterus. It often ruptures later that than the more common tubal ectopic pregnancies because of the more distensible myometrial tissues surrounding the gestational sac. The diagnosis of cornual pregnancy poses a lot of challenges to sonographers because of its closeness to the body of the uterus necessitating a lot of skill and expertise. Rupture of a cornual ectopic pregnancy is life threatening because of associated massive haemorrhage. Treatment is mostly by emergency laparotomy and cornual resection with salpingectomy or hysterectomy. Here, we report a case of cornual ectopic pregnancy at 11 weeks gestational age that was misdiagnosed as intra uterine gestation until it ruptured. Patient had laparotomy with right cornual resection and ipsilateral salpingectomy. Ruptured cornual ectopic pregnancy and its morbidities and mortalities should be prevented through detailed early first trimester examinations. Ultrasonography especially the transvaginal modality remains a very helpful but occasionally inconclusive tool in the diagnosis of this life-threatening condition.