Diagnosis of Cornual Pregnancy in the Emergency Room: A Rare Case Report

Abstract

Introduction: Ectopic or extrauterine pregnancy is a life-threatening medical condition in which a fertilized egg is implanted elsewhere than in the uterine cavity, commonly in the fallopian tubes. However, it can also occur in the peritoneal cavity, ovaries, and cervix. There are several etiological factors contributing to ectopic pregnancies, such as a history of pelvic inflammatory diseases, habitual abortions, and miscarriages, previous ectopic pregnancies, fertility procedures, as well as increased maternal age that has been correlated with a higher risk of carrying an ectopic pregnancy. Often, the first alerting sign in any ectopic pregnancy is a pain in the pelvic region, along with vaginal bleeding usually spotted between the 6th and 11th gestational week. Other symptoms include vomiting, nausea, tachycardia, and in severe cases hypovolemic shock due to internal bleeding induced by the rupture of the tubes. The key to diagnosing an ectopic pregnancy is transvaginal ultrasound, alongside the measurement of beta human chorionic gonadotropin hormone (beta-hCG) concentrations, which are usually found to be low in such cases. The management of ectopic pregnancy is either medical or surgical.

Case report: We are reporting the case of a 32-year-old pregnant woman, who presented to the emergency department for diffuse abdominal pain and recurrent episodes of vomiting and diarrhea of one-week duration. The patient was stable on admission, but later on, she showed a rapid shift in her vital signs. Blood tests were obtained, and pelvic ultrasound was done, followed by a Computed Tomography (CT) scan that revealed the presence of a right cornual ectopic pregnancy. A rapid surgical intervention was carried out to save the patient’s life and alleviate the pain.

Conclusion: Ectopic pregnancy is an urgent condition that needs to be treated immediately to avoid its fatal consequences. Several risk factors stand behind it, and a usual history and physical gynecological examinations are insufficient to detect it, hormone screening tests additionally to ultrasounds are highly recommended to decrease the incidence of mortality. A proper follow-up with a specialist could avoid the risk of an ectopic pregnancy as well as its undesirable outcomes.