Reliability of combined hysteroscopy and laparoscopy for management of cornual ectopic pregnancy

ABSTRACT

Active surgical treatment in the form of hysteroscopy under laparoscopic control was carried out on 15 women with diagnosed cornual ectopic pregnancy over 3 years period. The mean age of the patients was 26.2 years and most of cases were suffering from acute abdomen and vaginal bleeding after a period of amenorrhoea. Transvaginal ultrasound examination revealed an empty uterus, gestational sac separated <1cm from the most lateral edge of the uterine cavity and thin myometrial layer surrounding the sac. Color Doppler mapping of cornual region showed a vascular ring at the periphery. Serial beta hCG quantitative levels were static. General physical and abdominal examinations as well as laboratory profile of all cases were within normal. Patients were scheduled for operation within hours from their attendance, in all cases hysteroscopic management was done by using a small suction cannula for complete removal of the conceptus, avoiding the need for forceps or curette. Performing the procedure under laparoscopic control and injecting vasopressin minimised the risks of bleeding and rupture. The average operation time was 60 minutes and hospital stay ranged from [1-2] days. All patients tolerated the surgical procedure without complication. Based on the preceding results it would appear that this procedure is expeditious and showed immediate evidence of success or failure