Delayed Diagnosis of Ruptured Cornual Pregnancy following IVF after Bilateral Salpingectomy

Abstract

Cornual (interstitial) pregnancy is a rare but potentially life-threatening form of ectopic pregnancy, accounting for approximately 1% of ectopic gestations. Owing to the vascularity of the uterine cornua, rupture can result in significant haemorrhage and maternal morbidity. Although bilateral salpingectomy significantly reduces the risk of tubal ectopic pregnancy, implantation may still occur within the interstitial segment of the fallopian tube, particularly following assisted reproductive technology (ART).

We report the case of a 35-year-old nulliparous woman who presented at 4+6 weeks’ gestation following in vitro fertilisation (IVF) performed abroad, with embryo transfer dated 23 February 2025. Her surgical history was significant for bilateral salpingectomy performed prior to IVF to reduce ectopic pregnancy risk. She was receiving progesterone support, low molecular weight heparin and β-hCG supplementation. At four weeks’ gestation, serum β-hCG measured 1931 IU/L.