Cornual heterotopic pregnancy in its first trimester. Case report

Abstract

Introduction: heterotopic pregnancy is a rare multiple gestation, where an intrauterine pregnancy coexists with an ectopic one. This circumstance entails enormous difficulty in preoperative diagnosis, and is potentially dangerous for both the mother and the intrauterine fetus.

Objective: to present a patient with a cornual heterotopic pregnancy diagnosed in the first trimester, based on her specific symptoms, using the clinical method.

Case presentation: female patient of urban origin, 36 years old, mixed-race skin color and weight of 70 kg. At nine weeks gestation, she underwent a voluntary interruption and an intrauterine device was placed. After two days, she had mild intermittent pain in the lower abdomen, nausea, dizziness and headache. The vaginal examination revealed that the uterus was of normal size, and a tumor mass was palpated in the painful right adnexal. The pregnancy test was positive. The operation and the postoperative period were satisfactory. The patient was admitted for seven days, and was subsequently discharged from the hospital.

Conclusions: although the diagnosis of the cornual heterotopic pregnant woman is difficult, the symptoms that the patient presented were suspicious of the disease. The diagnostic impression obtained by the clinical method was corroborated in the imaging examination and, later, in the surgical intervention. Timely medical action allowed the patient to recover without complications. The importance of paying special attention to the symptoms of the patients in these cases is highlighted.