Thirteen-week cornual ectopic pregnancy.

Area of Science:

• Obstetrics and Gynecology
• Emergency Medicine
• Maternal-Fetal Medicine

Background:

• Cornual ectopic pregnancies are rare, accounting for a small percentage of all ectopic gestations.
• These pregnancies pose significant risks due to potential for rupture and severe hemorrhage.
• Early diagnosis is critical for effective management and improved patient outcomes.

Observation:

• A 13-week cornual ectopic pregnancy was identified in a patient presenting with a protuberant abdomen.
• The patient exhibited signs of intoxication (cocaine and alcohol) and was hemodynamically compromised.
• Fetal movement was noted despite the advanced gestational age and concerning clinical presentation.

Findings:

• Bedside emergency ultrasonography facilitated the rapid and accurate diagnosis of the cornual ectopic pregnancy.
• The advanced gestational age and presence of fetal movement in a cornual location are highly unusual.
• Hemodynamic compromise in the context of substance intoxication complicated the clinical picture.

Implications:

• This case highlights the importance of point-of-care ultrasound in diagnosing emergent obstetric conditions, even in complex presentations.
• It underscores the potential for viable fetal development in unusual ectopic pregnancy locations, necessitating careful diagnostic evaluation.
• Management strategies must consider the patient's overall condition, including substance use and hemodynamic stability, alongside the specific pregnancy complication.