EP21.46: Angular pregnancy on arcuate uterus: a case report

Angular pregnancy is an eccentric intrauterine pregnancy located in the superior-lateral angle of the endometrial cavity. We succeeded favourable perinatal outcomes which diagnosed by three-dimensional ultrasonography in the first trimester. A 28-year-old woman, G2P0, with arcuate uterus has no history of uterine surgery. Her current pregnancy was conceived with in vitro fertilization. She was referred to us at 5w6d gestation, Ultrasonograms showed a gestational sac (GS) located in the left angular of the uterus but not interstitial tube. Over the next few weeks, the left uterine cornua was considerably swollen and grew extrovertedly. She had spotting bleeding, subchorionic hemorrhage was observed. At 11wks gestation, GS occupied the entire uterine cavity and began to develop concentrically. At 37w5d, Caesarean section performed due to breech and cord presentation, a healthy 2302g baby girl was born. Retention of the placenta in the uterine angle made abnormally bulging. Placenta does not detach naturally, we removed the placenta carefully. Partially compression suture was performed due to poor contraction and bleeding. Totally blood loss was 2183ml. Velamentous cord insertion was also confirmed. Postpartum progress was good. Recently, angular pregnancy is not as dangerous as suggested in previous literature. We succeeded safely through accurate diagnosis of it and careful observation from the early stages of pregnancy and appropriate management for delivery and placenta accreta although needed, should be recognised as a high-risk pregnancy. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.