Cornual ectopic pregnancy with attempted conservative approach

Abstract

Objective: To report a case of cornal ectopic pregnancy that occurred in a maternity hospital in the interior of the state of São Paulo - Brazil, aiming to discuss possible different diagnoses and approaches, considering that, when diagnosed early, it reduces the risks of morbidity and mortality inherent to the clinical picture Case details : This is a patient, 27 years old, G6P2A3C2, admitted complaining of abdominal pain, menstrual delay and vaginal bleeding, associated with a beta-HCG dosage of 14120mIU/mL and transvaginal ultrasound with anechoic paraovarian image measuring 5.6cm (sac gestational) with non-viable embryo. The surgical approach was chosen, which revealed an intact cornual ectopic pregnancy on the left intraoperatively, requiring its removal. Final considerations: Interstitial or cornual ectopic pregnancies are those in which the implantation of the blastocyst occurs in the region where the uterine tube is inserted into the muscular layer of the uterus and correspond to 2% of all ectopic pregnancies. The approaches depend on factors such as the size of the mass, initial dosage of beta-HCG and the patient's hemodynamic stability. In this case, the treatment was surgical with cornual and subtotal hysterectomy. Given the possible complications of ectopic pregnancies, early diagnosis and therapeutic approach directly influence maternal morbidity and mortality in the first trimester of pregnancy.