Re: Please send your manuscript » mse oe a Qa Meso tan wives Torre acmontn sara renee manre an cma grainy Cuenta bape ose 1 Seta ame ton a: sesame Nay he tc penn 3: 6 me mine Pe om ayn mye {crv all corn cao nn Spm Eeh nee nl ncn ee ada fiay scoped manag en i ng ncn pn oa ie nr ape wena og Ono (roe oor ne Ros Seto 1 Hey, Wet Beng ne 99 W770 | 101 1692122, Watt: 99 BNTS2TO8 Ses Poor 7 Rep Cwet Lamon Wc Uk Par sa SOUS 429| ‘ons, sn 2202254 AM Sty Pann Bana a> wo ‘centmamin,nave ae eat ob suomi uma nae 3a Sen a am ay ein apr sien ow co tow tar ou gang pate enw? Wendt aah ny aera ele 202 ae osc? For sney ‘one attachment «S:anredby Snail Tl oresietce ay 0 ee sumer @ oF es ssn a Mase mbar: 222 RIES Tk “Dara ely of ar Prgraney ACA pe” wt S| teres ernie Vet ces etn main carpenter ameter ope = outl¥yuhav sanjay Aye asad op of ba aa pm carta naman i eh a ‘cme Put Urpin sn Gm ston ie ‘ovengertm biotin pe ais be eso cli rns nannmanananetdeh ‘uma use chew USD rp ems BY Sea TamloweenySD 2 Pa jor rn nun 2000.Status of Manuscript Number: 2022/ARUGO/G2408 > ms ree Manono tor FE sceetna nereneune 4 ‘rc tan al Ram aunty Oi mance AMG Yad an ‘Pea ale rn his COVD-9 panani uaton We ih bn th you od you ey mr a Ge ou xs, ret Hout Sop na TST SCI aes BATES Ring Seeger onan ruc Poe sae ACC $012 wttdoineieneconentos © ven mar eer Dee Catepue, Pease tach hr he cetarce tr or manus mune 27 ARIGOA24E8, nes par Ws Rome Bop eg One ra Goes ou Rat Svet no Hoh Wet Berg ne BYP 9 NEL aA: 181 61772708 ‘One stachment » Seen by Ga$B Mention Sesion) ora t, ‘ne tahment «Scared Gn@ sine ar 5 festy) (o> Forward) © nessa feSD Publisher Group Date ar 2022 “pbs tin acon ari rm or tannin amr 28/ E0240 abd ea alee rtm ase anancrpt Number: 202/A8)60/02408 “ate ‘ignti iy arma Pregnancy: A Cate Rep” Autor} ma Sapam ‘ewer ithe lesen Were ier yuh yr er ily scp ‘rpc eh oma yc act ‘Thankingyon. ‘Chie Managing itor<= Asian Research Journal of Gynaecology and Obstetrics 719 1-5, 2022; Article no ARIGO.52408 Diagnostic Difficulty of Cornual Pregnancy: A Case Report Ema Suparman * * Department of Obstatic and Gynecology, Feculy of Medicine, Sam Ratlen! Univers, Prot De FD. Kandou General Hoop, Manos, Now Sule inant. Authors contribution ‘ho sole author designed, analyze, interpreted and propared the manuscript Article nformation en Per Revi tony ‘rset aneepe Fe eve ty ry oft Rew, he) oa Ree ae ‘Received 05 November 2024 ‘Acpted 07 anuary 2022 [ease stety Piolahed 10 January 2022 AnsTRACT ‘Objective: To repr a rare ase of conial prognancy hat we dagnosed diring tho anfonatal pelo and 2 rove ater row of daghoste dey, axed en appropiate Meare ang {ules avalaia Methods: A Care Report (Case:A 25 year ld primigavida woman was dagnosed wth corel pregnancy (178th weeks of Sesion) and fra utrne snglton ive flun via uttenograpty. The pation exporionces Progrossvely severe abdominal pan whieh radiated twoughou tho whole abdomen wih ocule nae of fewer than 24 hours. Abdominal examination vevesied datended abortn, pain wit © ‘osedar defense on palpation twoughout the whole abgomial ragens, and decreose huss ‘ound. Vaginal examinaton revealed moton tendemess on ceria! papaton, the were cay ‘a dieu to ovausla de fo pan and ro reclovaginal pouch erargemon! was ted. Due 1 Unstable progression ofthe patents condion. lpartomy sugory was beformed, in whieh Ie ‘amualraecton wih wodge recocionteemigue wa performed felled by Boeding conta, Cnetusion: Cormual pregnancy fs a par typo of ecto prgnaney that Ts ofan dict to Giagnose, "due Hy. smarty wth normal intautarine pregnancy on vansabdome Utrasonegraphy. Adeauate nator akg, eyes examanaon an sadtonal dagnosve medals tare nocossar to erabieh the clagnoe. Rowine arena care wih ulvesonog'apy in ho carly temaster- can plertally reduce matrnal motalty and ineease the maral quay oe‘Sipamen 1060, 115 2am Ant na seuCo.2Ie8 Keywords: Diagnostic acu comualprognaney. 4. INTRODUCTION Conduced in a. pary heath cine with ro proveus. abrermaties” suspecteg Hor oat Interstal or coms! pregnancies are oth feretl petod was on June *¥" 2021, wih raided fre ant potrlypracrous forma _urvemastable menstuel htry, The pet hod of eck pregnancies, amen comprae (Wo censeculve prevous maa! hsleres, the Shorocmatey 2 of ah conte pregnancy st tree yess of mariage ended in 2019, at [Elec (12) acd on tw cetiton’ the tara the ape of 18 whe bw seoond less than @ year oma pregrancy’ "is used lo. desctbe orago ended in 201, athe age of 24, She pregnany tssea In whic the mponiation and reclea having no Ntiy of ny conracoptve Atopment ofthe goststoral soe cceur onthe use. Spe wos a nena, reracahle, ad Upper eral sogmen of fe wer [24] The has no Nery ef dug abuse” She has nether ‘re erste areas apposite ess than persorel_nor fam history of conn O'rmmmnwah and -2mmminienghaong win aonormaltis, dabees, fyperenson, end cher the suneunding myomtal leer afows te dae Bessy of pregnancy grow url the second Fmester novernasa, erat of rupture titel general examinton reveled he paint in te nevably nigh ach consequent causes severe pan with ave! analog score (VAS) ot Severe oeang snd morelty n apprommaey 8, wih ict consciousness nd ueraradie Ror at cope pregnancy cates (72) Esope vial sans. Abdominal enaminaion revealed broanancy dagroes iad "incues agus dsiended abdomen, pan wih a muscular fivenorton eateabominal pa ae vagal dfenae on ‘papain trougheut th whole Hood, which are ef found in 40% cf af abdominal regions, and” cecrensentetnal fasee However cncaly dftrentstng coma sound, whie shifting ulness was aft to ‘wih ineautrno or other types of scope Cvauaie due to Severe pin. Vuvewsin! Pregnancy cases wie sett rebing’oniepecton end. speculum examinations were Final” eymplone-cigns and’ "soncgaphe wtn normal iis of pregnant women. Vegiel raga modaites can'be compicaled. tnefein xaminaton revedied. moton Tondomoss) on artcue tthe procmty of cram pregnancy 56M papain, the wring couty wns dc Restos (587) Dept fe ctu. cl 1 eehste Ge Yo pln, and no retvegl trating pono wc regan ann 01h as Pech nga eed i tndanetal in cetemining. proper management aporeach, espeday in he recant Trensabéorival | sonography revealed Gowlopmont "ct comeratve surges! esiorable sign ‘iaedne prograncy management or comua' pregnancy cases which mth Bo posteory mplnd plocerts, pote Shes beter cutoros In fry preseraton fel near and. fel movements; bemete Beto, Toor we consered Gecisdons assessment of pare dameter (BPO) and fegahg| ths, meter rlovart "and potrly abdomina cecupfrenc (AC) was wth neal Ubaaintne fed Costes and ymaclegy. fis of 10°17 weeks of geslaion pregnancy. the poner ‘nw tporied 2 cate of conus) te amnbic fh index wes within normal kits prea, when we prenatal Sagrosed and and no fee fd callcion was noted. nl Managed cur shuts ced “gynecology Soret ee count was tae with gh tmergency department lewhemogidin level of 5 idk rated Besed on the fst overall pression of the examinators 2. CASE REPORT Conducted appendelts rupue was suspected fated by'a rupued extops pregnancy. The _A2syearold pimigraida woman (GPO) oa har Palio! 28 iialysiabiizes hoeeyramicaly ee ee ee ee) ith wa sgn ahd pain ovavaton beard gynecology emergency deparimont The potent Peedi. Srperosced. progrostiely revere borin Brin with aouto onet of fowor han 26 hour THe paint complained | of | ncreasinay Fhe ‘pain radiated. toured the whelo Pooressve abdominal pain wihin the next four Ablonbea cing me cpaectte ‘ean’ "the ous, and the second complete blood count Patnt donied experiencing vagnal bleedng or Sxeminalen rovenod 9 sirifcanly decreased Gecharge tvoughou pregnancy The patenthaa emodiobn, evel of 6.3 idl, and acute her fest and only previous antenatal checkup Sbdomina! bleeding was suspected, henceerhlaparotomy wes decided to be done along wih Deed ranetsion. Laparotomy surgery revealed baie the sbdomina! ea, ne mombrane ae ‘iptred rovesing sighy cougy arnt fs Furor abdominal expioreon reveoied rupture fof te let uletine corn (Per) in wah a ‘coma! reseeton was pefonmed using wedge fesedton Tocgue folbwed by malvese. anc ‘continuous sure with chromic 0.2 for bloeding ‘onto, Right hysroraipine asso found ot ‘Sbdominal” expiozation = In wen ght fnlpingeciomy wae performed lowed by Beeang contol and asdominal tid ingaton to remove cose blod ets. (Fi. 1). The sugary ‘ram nd wth an inrasbdomsnal rin insalod Posturgieal evaluation and bio raneuson ‘ware paramed thoughout the next few days {na maternal" canditon provera wat ‘Sigeanty ete. 3. DISCUSSION 3.4 Diagnosti Difficulty Comual pregnancy 1s 2 potentaty precarious ‘valant of ectope pregnancy. Delrminng proper ‘aly dagrerte, medatly” and” management Sepa ARGO, 4 22m Anema ARsCO 2008 remains a chalnge for medcal_person ‘cepocisly for theno. woking In tho fed of ‘obstenes anc ‘Gynecaogy. Ruptured ectopic prograrcy "Is, “consiored an obstetical ‘mergonoy, ‘which "conxtes to maternal rmonally. Eady dogrosis of rupted econ Preonarcy can te eblanes tough comple History taking. general physical exaninatons, ‘ytecclogcal xamunatons,ecallona laboratory ‘xaminatens, and imaging modais [1] Ruptured ectopic pregnancy diagnose iad Includes cule amenortea ote pened, ate lower abdominal pain and vaginal Bleding [7 Besod on the sory tkig conductog Wom our patton, ho patent had progresive severe lower Shdominal pam with a history of late rmenataton [1-13 CGonoral and vial signs examinations of the patent wero ‘rather unveraable, howover Sbdominalsuarinstone tevesied tendorness ‘wth @ muscular efense 09 papain, an pele ‘xaminatons. reveled cesiea maton ‘pain Zeitanal supporing _siagnoste modalities pomnes inthis case. are. vansabdominal Fenography and comploto blood examinations. Fig. 1 (A) Explorative laparotomy revesld fetus covered in amniotic membrane with alighty, loud amniotic Mul (B,C) Rupture ofthe lft uterine cornu and ight hydresalplnx(D) 17-18" "week fetus post-surgeryThe intial hemoglobin love! is 9.6 fl. Conunuous evaluation of hemoglobin levels ‘seontal rupures ocepleprograncy caves. A Signicant decease of remoglebin levels wits inf than 24 hours ndeates severe bad os need of prompt emodyaamicsabizaton Lteasonography ie fundamental in idontiyng Pregnancy "and “is "complnatons Inckiseg hplured ectople pregnancy, The presence of & ‘geslatonal sec surcuned bythe myoretiure Lyris the hatmark of irauterne prgnancy. ‘The diagnosis of ects pregnancy especialy ‘omial or intortti oeaton varant rrsine haloge, jst 8 6009 nour cage in Which ro ‘ekg pregnancy wee supacted a at" ‘Te sonographic citron fines pregnancy ‘eludes an empty urine cavy, the gostalona fc located fr atoal fom the rine cv. 2nd the myemetial ayer surrounding the gstatona ac [a] "ierstel ines” coe aso. be ‘Siated in wen there fa extnaion ofthe Upper usin agian nt the bocndores between ‘he trata rgion ad te fabian tube (5. (Ou case, coral pregnancy was proven tcllowig laparotomy. Aer the nil sonographic ‘amination, suspioon of eetopt regrancy Was Shite przonts Untke an ectopic pregnancy, poston an balormatryresperse othe partoneu, whieh {ane caused by lnranbdominl argon niechon Perforation. or” penealon wound ofthe [2bdomen (3, General manfestaton of partons eludes” fever, acuto abdominal pa, 2rd ‘Sbdominal miscor” dofonse” Both ace Abdominal pain and muceuar defense wore ‘ented nutcase, however, aight fever ‘wes Wenthad 3.2 Management The pincile of rusted ectopic reprancy management” nls ial hemodynamic ‘Seblzation and surgery to Went the bleeding fource and conta Bleeding Management ca be sasaved frtor io. medeaon and om medion managomert (9) Surgeal management was. considered in. Wis aae due to@ sgnfca! decrease n hemoginn ies ftom 06 to 63 gid oar potiodea ‘valiaton, and the patert appeared pale on piysal examination. Surgical management can be perormed in bth reptured oF ner-upured ‘ectose pregrancies depending onthe patent's inal condone. Possbie surgical Spr: ARGO, 15 BBR ier ARO 0 management option for somal pregnancy (comual resection) ineudes const surgery tring wesge roocton feotmque wien 1005) Inegity fe maintained and rads! surgery f whieh the falopin be is excised. Conservative Surgery is further classed into sapingostomy ‘and sapingoomy.Corudlresecion wa Performed on hee flgian ube of eur pati land salpngocomy was performed on the Aah {alopian tube of ou paient wih ydrosaline ‘Ate surgery, the poten was. evaluated ord ‘bserved fr several days wih improving clrical ‘condos [1 3.3 Prognosis ‘The_pation’s circal condtion.signiianty improves air sirgry ths pat due he featy onset of management gen. The pent was re-evaliated for adequate recovery The Patent was also alven proper ecucalon for Erg "wound managemertbelore bee ‘charged home. One posse competion tis Patent might have i Inertity due to radical femoral of “the “right ‘alopian "ube (eapingecomy) (0) 4. CONCLUSION CComual pregnancy 3 8 pat type of ectope pregnancy tats aten Seu 0 Sagnoes, se fo as simlarly wth "ermal hautarne Pregnancy on wansabdomira ulrasonogaphy ‘Adoquste hor taking, pysioa examin ‘and addona) hagroste” modarlos ecossery to eatablah the agnosis. Routine ‘ntoatal cae wth ulvasonography into eary ‘nestor, can potently reduce” materal rmoraly and merase be ates quay oie ETHICAL APPROVAL, [As por iferatonal standard of university Standard ‘ton thea! approval has been ‘olected and preserved by the author(s). ‘CONSENT [As per iteration standard or university Standar, ‘pater wlan consent as been ‘olecied and preserve bythe authors). ‘COMPETING INTERESTS ‘Author has declared that no competing inerosts onREFERENCES 1. Aatout | Honemayer U, Strauss A, Tne Av Mahal, lerat Wat at Clfeal Diagnosis and. Treamont_of Ectopic Pregnancy. ‘Obstoveal “Gynecological Survey 2019:60(8):571 53, 2. 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