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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
BANUELOS-VIZCARRA, Esmeralda et al. Uterine rupture secondary to ectopic pregnancy in the second trimester. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.1, pp.67-73. Epub Mar 09, 2021. ISSN 0300-9041. https://doi.org/10.24245/gom.v87i1.2096.
BACKGROUND:
The cornual ectopic pregnancy has an unusual location representing 2% of the prevalence and because of its location close to the uterine arteries it has a maternal mortality of 10%.
CLINICAL CASE:
A 42-year-old patient with a pregnancy of 20.2 weeks of gestation attended the emergency department for oppressive, intense pelvic pain of 24 hours of evolution; physical examination: blood pressure of 80/70 mmHg and heart rate 112 beats per minute in addition to Murphy positive, laboratory studies were collected with blood count that reported leukocytes: 22.4/mL) and hemoglobin of 10.7 g/dL. An ultrasonographic scan was performed, finding a single 21-week live product with a heart rate of 152 beats per minute, placental grade 0-1, normal amniotic fluid, with abundant free fluid in the retroperitoneal space. Control of hemoglobin was requested with decrease to 5.38 g/dL, so it was decided to go to exploratory laparotomy, finding broken left cornual ectopic pregnancy, which was extracted product of conception and subtotal hysterectomy was performed and subsequently moved to the Intensive Care Unit achieving an adequate evolution.
CONCLUSION:
The diagnosis of cornual ectopic pregnancy continues to be difficult to perform among medical entities, its clinical picture can simulate other entities with possibility of failure in the diagnosis by 50-90% depending on the skill of the ultrasonographer and clinical suspicion.
Keywords : Cornual ectopic pregnancy; Abdominal pain; Subtotal hysterectomy.