Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 270-272, September 2005

Delayed Uterine Rupture After Fetal Reduction in a Case of Cornual Heterotopic Pregnancy

  • Mei-Tsz Su
    • ,
  • Pao-Lin Kuo

      Affiliations

    • Corresponding Author InformationCorrespondence to: Professor Pao-Lin Kuo, Department of Obstetrics and Gynecology, National Cheng Kung University Medical Center, 138 Sheng Li Road, Tainan 704, Taiwan
  • Keng-Fu Hsu

      Affiliations

    • Department of Obstetrics and Gynecology, Chi-Mei Medical Center, Tainan, Taiwan

Department of Obstetrics and Gynecology, National Cheng Kung University Medical Center, Tainan, Taiwan

Received 17 December 2004; received in revised form 18 December 2004; accepted 18 December 2004.

Article Outline

Summary 

Objective

Assisted reproductive technology has contributed to the rising rate of multiple and ectopic pregnancies. We report a case of heterotopic cornual pregnancy with delayed uterine rupture despite successful fetal reduction. To our knowledge, this has not been previously reported.

Case Report

A 32-year-old woman, gravida 2, para 0, had secondary infertility. She had undergone laparoscopic tuboplasty for bilateral tubal obstruction and laparoscopic bilateral salpingectomy for hydrosalpinx. Successful pregnancy was achieved after transfer of five frozen embryos for this pregnancy. At 7 weeks of gestation, routine pelvic sonography identified three gestational sacs, two in the intrauterine cavity and one in the right cornua. Fetal reduction with potassium chloride injection into the cornual pregnancy was performed at 8 weeks of gestation in a private clinic. At 13 weeks of gestation, she had sudden-onset low abdominal pain and hypovolemic shock. Emergency laparotomy revealed right cornual rupture, with a 3.4-cm translucent sac extruding into the peritoneal cavity. The uterus was repaired by simple closure of the right cornua. The twins survived the operation and were born smoothly at 34 weeks of gestation by cesarean section due to preterm labor and malpresentation.

Conclusion

Uterine rupture can occur in women who have undergone successful fetal reduction for cornual heterotopic pregnancy.

Key Words:  cornual pregnancy , fetal reduction , uterine rupture

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References 

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PII: S1028-4559(09)60152-2

doi:10.1016/S1028-4559(09)60152-2

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 270-272, September 2005

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