A Case of a Ruptured Cornual In vitro Fertilization Pregnancy

Cornual pregnancy is the most dangerous type of ectopic pregnancies but fortunately it occupies 2-4% of them. Its mortality rate is 6-7 times higher than that in all ectopic pregnancies. We reported a case of a uterine rupture in a 10 week cornual pregnancy. A 40 years old woman, gravida 2, para 1 was admitted to our emergency service with the complaint of an acute onset abdominal pain of about 6 hours duration. She was known to be in her 10th weeks of gestation after in-vitro fertilization (IVF) and embryo transfer. On examination, a severe degree of pallor, with a pulse of 104 bpm and a blood pressure of 70/40 mm of Hg was detected. Pelvic ultrasonography showed a thickened endometrium and an empty uterine cavity. In the right cornual fetus with a crown-rump length of 10 weeks of gestation was detected with a positive heart rate. The abdomen was filled with blood and blood clots. The haemoglobin level was detected as 5.8 g/dl. An emergency laparotomy was performed because of hemodynamic instability. Cornual pregnancies are very life threatening emergency conditions. Our case report demonstrates how a woman may come close to death while trying to have a child. To save lives of women generally immediate intervention instead of expectant management should be preferred as we did fortunately. So, more detailed examination by transvaginal ultrasonography guides the clinician for accurate diagnose before rupture occurs.