Laparoscopic management of unruptured cornual pregnancy without myometrial incision: a case report.

BACKGROUND: Cornual pregnancy represents a rare but clinically significant condition that poses substantial risks to maternal health. Conventional surgical approaches frequently face challenges in achieving both effective haemostasis and preservation of uterine structure. CASE PRESENTATION: We present the case of a 23-year-old woman who presented of amenorrhoea with 53 days and vaginal spotting. The serum human chorionic gonadotropin level was 24,953 mIU/mL. Transvaginal ultrasound revealed a hyperechoic area containing a 15 mm in diameter gestational sac within the right cornual region of the uterus (26 × 20 mm), with visible primitive cardiac pulsations. To minimise intraoperative bleeding and reduce the risk of myometrial injury, a conservative laparoscopic approach was employed, adhering to the following key surgical principles: (1) purse-string suture applied on the base of the cornual pregnancy mass. (2) transcervical suction evacuation of the cornual pregnancy followed with immediate tightening of the purse-string suture. (3) using the same stitching method to to invaginate the purse-string suture and reinforce the cornual wall. The total operative time was approximately 20 min, with an estimated blood loss of 15 ml. The patient was discharged on the second postoperative day, and serum human chorionic gonadotropin levels returned to zero within two weeks. CONCLUSIONS: We describe a laparoscopic surgical technique that avoids myometrial incision, thereby minimising blood loss and preserving uterine integrity. CLINICAL TRIAL NUMBER: Not applicable.