Laparoscopic management of a cornual pregnancy following failed methotrexate treatment: case report and review of literature

Abstract

To describe a rare case of a singleton 8-week cornual pregnancy (CP), treated by laparoscopic incision of the uterine wall, the ectopic pregnancy was removed and the uterine site was sutured with interrupted sutures. A 21-year-old woman was admitted for suspected singleton CP at week 8. Clinical examination, b-hCG increase, and transvaginal ultrasonography (TU) were used to monitor the suspected diagnosis of an ectopic pregnancy. Following failure of methotrexate administration, surgeons performed a laparoscopy. The CP removal was performed by laparoscopic incision, enucleating the corneal mass and suturing the uterine site of the ectopic pregnancy with interrupted sutures. Intraoperative and postoperative complications and uterine integrity preservation were studied. Postoperative recovery period was normal, without intraprocedural or postprocedural complications.Uterine integrity was preserved. No further therapeutic interventions were needed in follow-up. This study confirmed the feasibility, safety and efficacy of performing a safe, minimally invasive, laparoscopic treatment of an early unruptured CP, without intraoperative and postoperative complications, with a normal postoperative recovery period and preservation of uterine integrity.

摘要

我们报告一例罕见的8周宫角妊娠（CP）, 经腹腔镜切开子宫壁, 切除异位妊娠后, 间断缝合子宫。一名21岁妇女于第8周因怀疑单胎宫角妊娠而入院。通过临床检查, b-hCG升高和经阴道超声（TU）对疑似异位妊娠诊断的患者进行监测。甲氨蝶呤治疗失败后, 外科医生进行了腹腔镜探查术。腹腔镜手术切除子宫CP, 清除宫角妊娠组织, 间断缝合异位妊娠子宫部位。研究术中、术后并发症、保持子宫完整性。术后恢复正常, 无术中或术后并发症, 并保持了子宫的完整性。随访中不需要进一步的治疗干预。本研究证实了安全、微创的腹腔镜治疗早期未破裂的CP的可行性、安全性和有效性, 术中及术后无并发症, 术后恢复时间正常, 子宫完整。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Cornual pregnancy
• ectopic pregnancy
• hysteroscopy
• laparoscopy
• methotrexate

Disclosure statement

No potential conflict of interest was reported by the authors.