[Angular pregnancies apropos of an exceptional case of uterine rupture during twin pregnancy in an angular position].
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Angular pregnancies which result from implantation of the fertilised oocyte in the mucosa of a uterine horn are very rare. They are usually demonstrated by a picture of rupture which is associated with severe abdominal pain, the syndrome of internal haemorrhage, often a state of shock and all occurring usually between the 6th and the 12th week of pregnancy. Although many authors have shown that there is congenital abnormality of the uterus in these cases this does not always happen and the aetiology of "idiopathic angular pregnancies" is ill understood. The treatment is carried out according to the clinical state: endometrial curettage under laparoscopic control, removal of the uterine horn together with the tube on the same side or even hysterectomy.
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A case of angular pregnancy was diagnosed by ultrasound examination after curettage of abortion hemorrhage. The rarity and clinical management of this condition are discussed, as well as the importance of ultrasound investigation for early diagnosis.
A perforated angular pregnancy, unsuspected and asymptomatic, was diagnosed in a 35-year-old woman during elective pregnancy termination in the first trimester. The pregnancy, along with free blood in the abdomen, was found when laparoscopy and then laparotomy were performed for suspected uterine perforation during suction and curettage. Cornual resection and salpingectomy were performed.
BACKGROUND: Angular placentation may be a cause of retained placenta and may require hysterotomy. CASE: A 33-year-old woman with a prior cesarean section underwent an uncomplicated vaginal delivery, had a retained placenta with postpartum hemorrhage and required hysterotomy because the placenta was inaccessible due to its angular location. CONCLUSION: Antepartum ultrasound diagnosis may be possible in some cases of angular placentation.
A clinical case of ruptured uterus in the ninth week of an angular intrauterine pregnancy is presented.
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