A 14 week pregnant woman comes to you with abdominal pain. USG shows that the foetus is in a rudimentary horn of uterus. What is the BEST line of management in this case?
## **Core Concept**
The condition described is an **ectopic pregnancy**, specifically a **cornual pregnancy**, where the embryo implants in a rudimentary horn of the uterus. Ectopic pregnancies occur when a fertilized egg implants outside the main cavity of the uterus. This condition is life-threatening and requires prompt management.
## **Why the Correct Answer is Right**
The best line of management for an ectopic pregnancy in a rudimentary horn of the uterus is surgical removal of the affected horn, often through a **laparoscopy** or **laparotomy**, depending on the stability of the patient and the surgeon's expertise. This approach is necessary because the pregnancy is not viable and the horn may rupture, leading to severe hemorrhage. Medical management with methotrexate is generally not suitable for cornual pregnancies due to the risk of rupture and the lower success rate compared to tubal pregnancies.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is blank and cannot be evaluated.
- **Option B:** This option is also blank and cannot be assessed.
- **Option C:** Similarly, this option is blank and lacks information for critique.
- **Option D:** This option is blank as well.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **ectopic pregnancies account for about 2% of all pregnancies** but are a significant cause of maternal morbidity and mortality. Early diagnosis and management are crucial. A classic presentation includes abdominal pain and missed periods, but the clinical picture can vary.
## **Correct Answer:** D. Surgical removal of the affected horn.