Case Report

Treatment of cornual ectopic pregnancy with metotrexat and fetocide

  • Volkan Turan
  • Gülşah Demirtaş Selvi
  • Ömer Demirtaş
  • Fuat Akercan
  • Nedim Karadadas

Turk J Obstet Gynecol 2010;7(1):49-52

Objective:

The diagnosis, follow up and the treatment of a patient with cornual ectopic pregnancy

Case:

We present a case who has a pregnancy on the left cornual side of the uterus and seen corresponding with 7 weeks 2 days after ultrasound investigation with positive fetal heart rate (FHR +). Myometrial thickness was thinner than normally in this area. 2cc potassium chloride was injected into the gestationel sac under the guidance of transabdominal ultrasonography. Detection after 12 hours, we determined that gestationel sac had collapsed and FHR was negative. For residüel trophoblastic activity 75 mg intramusculer methotrexate was applied. The patient was followed up with the level of ß hCG and transvaginal ultrasonography for 19 days. Partial resolution of sac and deceleration at the level of ß hCG was determined. Uterin cavity was evacuated and gestationel sac was impaired totally under the guidance of transabdominal ultrasonography after these following processes.

Result:

Cornual ectopic pregnancy is rarely seen. It is so important that maternal mortality is higher than the other ectopic pregnancies. Ipsilateral salpengectomy, previous ectopic pregnancy, in vitro fertilization, pelvic adhesions are predisposing factors for interstisyel pregnancy. Treatment can be conservative or operative. Although preserving fertility is an advantage of our method, sometimes hysterectomy can be necessary. So the treatment shows difference patient to patient.

Keywords: cornual ectopic pregnancy, potassium chloride