Diagnostic Difficulty of Cornual Pregnancy: A Case Report
Erna Suparman *
Department of Obstetrics and Gynecology, Faculty of Medicine, Sam Ratulangi University, Prof. Dr. R. D. Kandou General Hospital, Manado, North Sulawesi, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Objective: To report a rare case of cornual pregnancy that we diagnosed during the antenatal period; and to provide a further review of diagnostic difficulty, based on appropriate literature and guidelines available.
Methods: A Case Report
Case: A 25-year old primigravida woman was diagnosed with cornual pregnancy (17-18th weeks of gestation) and intra-uterine singleton live fetus via ultrasonography. The patient experienced progressively severe abdominal pain which radiated throughout the whole abdomen with acute onset of fewer than 24 hours. Abdominal examination revealed distended abdomen, pain with a muscular defense on palpation throughout the whole abdominal regions, and decrease intestinal sound. Vaginal examination revealed motion tenderness on cervical palpation, the uterine cavity was difficult to evaluate due to pain, and no rectovaginal pouch enlargement was noted. Due to unstable progression of the patient’s condition, laparotomy surgery was performed, in which left cornual resection with wedge resection technique was performed followed by bleeding control.
Conclusion: Cornual pregnancy is a part type of ectopic pregnancy that is often difficult to diagnose, due to its similarity with normal intrauterine pregnancy on transabdominal ultrasonography. Adequate history taking, physical examination, and additional diagnostic modalities are necessary to establish the diagnosis. Routine antenatal care with ultrasonography in the early trimester, can potentially reduce maternal mortality and increase the maternal quality of life.
Keywords: Diagnostic difficulty, cornual pregnancy