**5. Presentation**

The wide spread of specialised early pregnancy units and the abundance of ultrasound facilities led to early diagnosis of cornual ectopics. There is an increasing incidence of asymptomatic ectopics compared with more traditional presentation of lower abdominal pains and vaginal bleeding.

Ruptured ectopics can however present with typical signs of haemorrhagic shock, which include pallor, tachycardia, hypotension and oliguria. The assessment of the uterine size is rarely helpful and cervical excitation is not a specific sign in cornual ectopic.

Modern Management of Cornual Ectopic Pregnancy 241

Fig. 3. Bicornuate uterus mimicking cornual ectopic pregnancy. Transverse transabdominal

The use of 3-D and 4-D improves sensitivity of establishing the diagnosis especially when contrast is used. (Lee GS et al, 2005; Chou MM et al, 2005). However, lack of its availability

Ectopic pregnancy is known to be associated with a suboptimal increase or plateau of serum β hCG. (Banerjee S et al, 1999; Hajenius P et al, 1995) With a detection rate of 97% and a specificity of 77%, serial serum β hCG is useful to establish the diagnosis of ectopic

In cornual ectopics, there are reports of doubling of serum β hCG, therefore the value of performing serial serum β hCG is doubtful and the results should be interpreted with

Laparoscopy is an essential diagnostic tool as well as a possible treatment method route for suspected cornual ectopics. However, in cornual ectopics, difficulty arises with small ectopic

Experienced laparoscopic operator is crucial in such cases in order to have the ability to deal with possible high risk of heavy bleeding when treatment of cornual ectopics is

Early diagnosis allows a varied choice of treatment options with a high possibility of

pregnancy in association of the sonographic findings. (Cacciatore B et al, 1990)

view shows bicornuate uterus with a pregnancy in right horn

in many units limits their use as the recommended methods.

caution. (Abraham D & Silkowski C, 2010)

**6.2 Serial β hCG** 

**6.3 Role of laparoscopy** 

masses that can be missed.

preserving fertility.

accomplished laparoscopically.

**7. Management of cornual ectopic** 
