Introduction

An angular pregnancy is a gestation that implants within a lateral angle of the endometrial lining of the uterus and just medial to the cornu [1]. These pregnancies are rare and high risk for both the mother and the fetus [2]. Due to the rarity of these cases, lack of physician awareness, and anatomic proximity making them difficult to distinguish from interstitial or cornual pregnancies, the true prevalence of angular pregnancies is unknown. Some sources report fewer than 100 cases in the literature [3].

Live angular pregnancies are diagnosed via ultrasound by anatomic location within the angle of the uterus, but angular pregnancy that results in spontaneous abortion can be diagnosed using hysteroscopy [4]. They most often result in a live birth, but these pregnancies can end in early pregnancy loss and uterine rupture [5]. Uterine rupture is a well-documented risk associated with angular pregnancy, though reported rates vary considerably across studies.

We report a rare case of angular pregnancy resulting in spontaneous abortion with the aim of increasing obstetrician, radiologist, and sonographer awareness of this diagnosis and encouraging clinicians to consider it in the differential when evaluating early pregnancy location.