Definition: - Pregnancy occurring in the rudimentary horn of Bicornuate uterus is Cornual Pregnancy.
The horn usually does not communicate with the uterine cavity.
The impregnation is presumed to occur by spermatozoa which passes through the normal half of the uterus and tube.
It then fertilizes an ovum either in the Peritoneal cavity or in the tube connected to rudimentary horn.
The concerned ovum is usually shed from the ovary on the same side of rudimentary horn.
- Inflammation or infection.
- Fertility treatments.
- Tubal surgery.
- Choice of birth control.
- Previous ectopic pregnancy.
EFFECT OF CORNUAL PREGNANCY
The general and local reactions are similar to those in the tubal pregnancy. But these are intensified and pregnancy may continue for a longer time period.
Termination by rupture is inevitable between 12-20 weeks with massive intraperitoneal hemorrhage.
COMPLICATIONS: - the most common complication is rupture with internal bleeding which may lead to hypovolemic shock.
DIAGNOSIS: - The condition is commonly diagnosed as fibroid or Ovarian tumour with pregnancy. Even on Laparotomy, the exact position is confused with interstitial pregnancy.
Position of the round ligament which is attached to the sac and the long pedicle by which it is attached to the uterus are the diagnostic points.
HOMOEOPATHIC APPROACH OF MANAGEMENT OF CORNUAL PREGNANCY: -
1) SEPIA: - chilly patient, predisposed to take cold at the change of weather. Past history of repeated Abortions. Nausea with sour eructations specially in morning before eating,from sight or thought of food.
2) COLCHICUM: - Nausea and faintness from the odour of cooking food, fish,eggs or fat meat. Vomiting of mucus, bile and food. Nausea is better by lying quietly and perfectly still.
3) ARSENIC ALBUM: Nausea, retching, vomiting especially after eating or drinking. Cannot bear the sight or smell of food.
4) IPECACUANHA: constant and continual nausea with no relief even after vomiting. Vomiting of food, bile, blood, white glairy mucus, sometimes immediately after meal. Vomiting worse by stopping.