Abstract:

A 36-year-old woman, who conceived via assisted reproductive technology, was diagnosed with heterotopic pregnancy involving intrauterine and right cornual pregnancy (dichorionic diamniotic twins). Selective reduction of the right cornual pregnancy was performed under transvaginal ultrasound guidance at 10⁺⁴ weeks of gestation. The cornual fetus was successfully selectively reduced, while the intrauterine embryo continued to develop normally. The patient delivered a live infant by cesarean section at 35⁺² weeks of gestation, with a favorable maternal and neonatal outcomes. Cornual heterotopic pregnancy after embryo transfer is clinically rare. Due to the thin myometrium at the cornual region, the risk of rupture and hemorrhage is high in the second and third trimesters, making management challenging. Early and accurate diagnosis is essential for such patients, with priority given to protecting the intrauterine pregnancy and avoiding blind curettage or excessive intervention. Meanwhile, this case indicates that single embryo transfer is strongly recommended in assisted reproductive technology to effectively reduce the risk of such high-risk heterotopic pregnancies.

Key words: Pregnancy, cornual, Heterotopic pregnancy, Pregnancy reduction, multifetal, Reproductive techniques, assisted, Ultrasonography