Laparoscopic management of second trimester ruptured cornual heterotopic pregnancy with subsequent live birth delivery: A case report and literature review

Taiwan J Obstet Gynecol. 2023 Mar;62(2):363-368. doi: 10.1016/j.tjog.2022.07.013.

Abstract

Objective: Heterotopic pregnancy (HP) is the coexistence of extra- and intrauterine gestation implantation sites. A rare case of a second-trimester ruptured cornual HP (CHP) treated with laparoscopic cornual resection with the primary repair is presented. Risk factors, clinical presentations, treatments, and outcomes of CHPs are also reviewed.

Case report: A 35-year-old pregnant woman with CHP presented with lower abdominal pain with hemoperitoneum and her hemoglobin level dropped. Laparoscopic management of a ruptured HP was performed, leaving the surplus intrauterine fetus intact. She delivered a 2360 g male infant via cesarean section at 34 weeks' gestation due to preterm premature rupture of membranes. We found a well-healed wound over the left uterine cornua during the cesarean section.

Conclusion: Ruptured CHP is a rare but life-threatening complication of an obstetric emergency. Although the pregnant uterus becomes congested and fragile, using reliable laparoscopic energy devices and barbed sutures, successful treatment is feasible.

Keywords: Artificial reproductive technology; Cornual heterotopic pregnancy; Heterotopic pregnancy; in vitro fertilization.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • Female
  • Humans
  • Infant, Newborn
  • Laparoscopy*
  • Live Birth
  • Male
  • Pregnancy
  • Pregnancy Trimester, Second
  • Pregnancy, Cornual* / surgery
  • Pregnancy, Heterotopic* / surgery