CORNUAL PREGNANCY



LAPAROSCOPIC MANAGEMENT OF CORNUAL PREGNANCY

Recai Pabuccu 1 Prof. M.D. , Mine Kiseli 1 M.D. , Aslı Yarcı Gursoy 1 M.D. , Emre G. Pabuccu 1 M.D. , Gamze Sinem Caglar 1 Assoc. Prof., M.D. 1

Ufuk University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey

Cornual pregnancy is an uncommon type of ectopic pregnancy. Laparoscopic management mainly depends on surgical skills and experience. Cornual resection is mostly performed in unruptured and hemodynamically stable cases. Laparoscopic management and evacuation of trophoblastic material is presented here. Thirty seven years old woman was admitted to the gynecology clinic after two days delay of menstruation. Following confirmation of cornual pregnancy, surgical intervention was decided. At laparoscopy, a left intact cornual pregnancy was observed with slight adhesions of the tube to left paracolic region. First adhesiolysis was done in order to obtain a normal anatomy. Unipolar coterization with needle tip on the surface of cornual pregnancy was performed. Hydrodissection was also used to dissect the trophoblastic tissue from the myometrium. With the help of grasping forceps, trophoblastic tissue was removed. Vasopressin injection to the myometrium helps to control bleeding as well. After removing the ectopic tissue, bipolar cauterization to the bleeding sites was further used for heamostasis. Now it’s time to repair the defect in the myometrium. Intracorporeal suturing with 2.0, polyglactin 910 suture material was used for restoration of the uterus. Technique is important especially in cases planning future pregnancy. The patient was discharged in two days from hospital without any problem. Follow-up of the patient was performed until undetectable levels of βhCG was confirmed. As a conclusion; cornual pregnancy can be managed laparoscopically if the surgeon has experience and skills. Cornuostomy and evacuation of the trophoblastic material can be a safe option rather than cornual excision procedure.