CORNUAL 'ECTOPIC' IN A SUB-SEPTATE TYPE BICORNUATE UTERUS

YP Gouden

 

INTRODUCTION
Interstitial pregnancy occurs in 2–4% of ectopic pregnancies and is defined as implantation of the trophoblast in the interstitial part of the tuba uterina.1 The distinction must be made between an ectopic pregnancy in the interstitial portion of the tube or a rudimentary uterine horn, and a pregnancy implanted in the horn (cornu) of a bicornuate uterus or cornual pregnancy.

In the absence of previous documentation of a bicornuate uterus, the ultrasonic distinction between a true cornual ectopic or interstitial pregnancy and a cornual pregnancy in the horn of a bicornuate uterus is difficult, as they share similar sonographic features.2 The distinction is clinically important as management of these two conditions is very different. Interstitial pregnancy is described as typically rupturing in the second trimester with catastrophic often life threatening haemorrhage. This paper describes a case in which the ultrasound examination was indistinguishable from a cornual ectopic but the pregnancy was shown at laparoscopy to be in the horn of a bicornuate uterus.