Case Study: Woman Experiences Rare Cornual Ectopic Pregnancy, This Is What Doctors Do Next...

Seven months postpartum, the patient realised she had missed her periods. The pregnancy test turned out to be positive. During the vaginal and abdomen sonography, however, it was difficult to detect the pregnancy...

It was a rarest-of-rare case that challenged even the doctors. A 33-year-old pregnant patient had to undergo a life-saving surgery just months after delivering her first child via C-section. Within seven months of giving birth to her boy, the woman became pregnant again. But, since she had a history of complicated pregnancies -- including an ectopic pregnancy -- this one turned out to be a strange one, too. Her rare cornual ectopic pregnancy went unnoticed until a routine check-up. But, thanks to a timely diagnosis and laparoscopic surgery, a team of doctors was able to address the complicated and life-threatening pregnancy, ultimately saving the patient's life and preventing long-term damage to her health. Read on to find out more about this case and what unfolded.

The Difficult Road To Pregnancy

The case was handled by a team led by Dr Surabhi Siddhartha, consultant obstetrician and gynecologist at Motherhood Hospital, Kharghar. According to a statement shared by the hospital, the patient -- an IT professional and a resident of Navi Mumbai -- had a rather difficult pregnancy journey, having endured a lot of physical pain and emotional trauma.

In 2020, the woman suffered from a ruptured ectopic pregnancy, which led to the removal of one fallopian tube. Fortunately, she ended up conceiving again last year and successfully delivered her baby boy via C-section. Seven months into this postpartum journey, life took an unexpected turn for her -- she discovered she was pregnant again, while being under the care of Dr Surabhi.

A Rare And Life-Threatening Pregnancy

According to Dr Surabhi, the patient realised her periods were late. A pregnancy test confirmed it for her. During the vaginal and abdomen sonography, however, it was difficult to detect the pregnancy. "Even ultrasound revealed no pregnancy inside the uterus or fallopian tubes, which led to a suspicion of an ectopic pregnancy or another complication. The beta HCG test was done for the evaluation of potential ectopic pregnancy. A repeated ultrasound, performed after a week, revealed the pregnancy was located in the cornual part of the uterus, a very rare location for pregnancy, particularly on the same side where the fallopian tube had been previously removed...a cornual ectopic pregnancy was confirmed," the doctor mentioned.

What Is A Cornual Ectopic Pregnancy?

According to the doctor, cornual ectopic pregnancy is very rare. It happens when the embryo implants in the upper part of the uterus, near the fallopian tubes. In this patient's case, although the pregnancy was outside of the uterus, it was still within the uterine wall, making it harder to detect.

"Cornual ectopic pregnancy is often mistaken for other conditions, such as fibroids or polyps, especially if the ultrasound is not detailed," the doctor explained, adding that such pregnancies are high-risk because if the pregnancy grows too large, it can cause a rupture of major blood vessels after 8-10 weeks, leading to severe internal bleeding and shock.

"Bleeding due to rupture is the cause of maternal mortality. For this patient, it was crucial to have frequent follow-up exams, beta hCG tests, and high-quality sonography to detect the pregnancy early and prevent any life-threatening complications," Dr Surabhi stated.

How The Pregnancy Was Terminated

The doctor mentioned that the patient was scheduled for a laparoscopic surgery to remove the pregnancy. It was successful. The surgery lasted for an hour and the uterus was preserved. Dr Ujjwal Mahajan and Dr Anita Roy from Motherhood Hospitals, Kharghar, were a part of the surgery, too.

The Need To Raise Awareness

Dr Surabhi stressed on the importance of awareness and regular check-ups, especially for women with a history of complicated pregnancies. "Even if you are lactating or not having regular periods, it is essential to take pregnancy tests. Hormonal changes during lactation can mask the signs of pregnancy, making it crucial to keep track of any unusual symptoms. Regular follow-ups, monitoring beta hCG levels, and getting detailed ultrasounds are vital in detecting potential risks early on, and ensuring the best possible outcomes for both the mother and baby."