USG guided Methotrexate Application for a Cornual Pregnancy
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Introduction
Cornual pregnancy is an uncommon form of ectopic pregnancy and represents 1%–6% of all ectopics. Diverse therapeutic options exist for the management of this pathology. Surgical management has been the treatment of choice which involves either laparoscopy or laparotomy and either cornual resection or hysterectomy. Medical treatment involves MTX or KCL administration and is associated with treatment failures that may result in uterine rupture and life-threatening hemorrhage. Therefore, when the medical treatment is considered, it is recommended in the case of a symptom-free patient with a beta HCG value <5000?IU/L with either systemic or ultrasound-guided injection of MTX to the cornual gestational sac. However, ultrasound-guided puncture and injection carries the risk of bleeding or rupture at needle puncture site. In this paper we want to report an interesting medical treatment complication of a cornual pregnancy case.

Case Report
A 39-year-old, gravida three, para two woman referred to our clinic because of suspected cornual pregnancy. She did not remember her last period date. The patient's systemic and gynecologic examination were normal, vital signs were within normal range, and she was hemodynamically stable. Our first beta HCG value was 22000?mIU/mL and TVUSG showed an empty uterine cavity, a 15?mm endometrial thickness, no free fluid in the cul-de-sac, and a right cornual gestational sac with a diameter of 11 × 9?mm including a suspicious embryonic pole with a yolc sac.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335668/
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