Conservative surgical management of a ruptured non-communicating rudimentary horn of pregnancy at 13 weeks period of gestation in previous caesarean delivery: A rare case report (original) (raw)
Related papers
2009
reported to be 1/100.000 to 1/140.000 pregnancies.1,2 Despite the recent advances in the ultrasound, the diagnosis of this condition is difficult. It can be misdiagnosed or diagnosed at lapratomy due to rupture of the pregnancy. The majority of the cases are reported to occur at the noncommunicating horn of the uterus.3 A rudimentary horn results from an arrest in the development of one of the mullerian ducts with the inappropriate fusion with the contra lateral side. Connection of horn with the uterus may be fibrous or fibro muscular. There is no communication between two cavities at 70-90% of the cases.3 Because of the variable musculature of the uterine horn duration of pregnancy may differ to end at second
Rudimentary horn of Uterus: A diagnostic challenge in pregnancy
When the development of the mullerian duct is normal on one side, but imperfect on the other side, a lateral fusion defect often with obstruction, described as rudimentary horn, is produced. Most rudimentary horn are non functional and some are attached to the functioning contralateral horn by means of fibrous bands. If the endometrium lining the cavity of the non communicating rudimentary horn is functional, retention of menstrual blood causes cyclic abdominal pain and spillage of blood into the abdominal cavity via the tubal ostium may lead to endometriosis. Sometimes a narrow communicating channel exists between the rudimentary horn and the opposite uterine cavity. Under these circumstances pregnancy is possible, most of the patients present with symptoms suggestive of an ectopic pregnancy including of uterine rupture causing catastrophic bleeding and circulatory collapse. We present a similar case where laparotomy was done thinking of ruptured ectopic pregnancy.
A Successful Outcome in a Case of Ruptured Rudimentary Horn Pregnancy
2021
Introduction: Mullerian anomalies occur owing to developmental defect at various stages. They range from Mullerian agenesis to mild arcuate uterus. Lateral fusion defect results in the formation of the rudimentary horn of the uterus. Incidence of rudimentary horn pregnancy is known to occur in 1/100,000 and 1/140,000 pregnancy. Aims: To evaluate a case of the second trimester ruptured rudimentary horn pregnancy Methodology: A 23-year-old primigravida at 18 weeks 4 days gestation presented in shock with gross hemoperitoneum. Results: Prompt intervention with exploratory laparotomy with excision of the rudimentary horn with massive blood transfusion and ventilatory support was lifesaving. The patient conceived spontaneously 4 months of laparotomy and gave birth to a term male baby by caesarean section. Conclusion: Uterine anomalies though rare must be kept in differential diagnosis for any pregnant women presenting with shock and hemoperitoneum as early diagnosis and management can re...
Abstract: Pregnancy in non-communicating rudimentary horn of unicornuate uterus is an uncommon form of ectopic pregnancy usually resulting in rupture during second trimester with grave consequences for the mother and fetus. We report a case of ruptured non-communicating rudimentary horn at 28 weeks of gestation in woman with previous Caesarean section in unicornuate uterus. She presented to emergency with pain abdomen since four days. Laparotomy was done and the rudimentary horn excised. Post-operative recovery was uneventful. High index of suspicion of uterine anomaly and its early diagnosis in cases of second trimester rupture is required to save this catastrophic event. Keywords: unicornuate uterus; non-comunicating rudimentary horn; ectopic pregnancy; rupture.
Pregnancy in a Non-Communicating Rudimentary Horn of Uterus: A Clinical Case Report
Bangladesh Medical Journal, 1970
Pregnancy in non-communicating rudimentary horn is extremely rare. It carries grave risk to mother and fetus due to rupture of rudimentary horn in second trimester of pregnancy. Here is a case of ruptured rudimentary horn pregnancy at gestation of 14 weeks. Laparotomy was done and the rudimentary horn was excised. Postoperative recovery was uneventful.
Ruptured rudimentary horn pregnancy with a history of an uneventful vaginal delivery
Journal of Medical Ultrasonics, 2014
Pregnancy in a rudimentary uterine horn is a rare event with an estimated incidence of 1 in 76,000 to 1 in 1,40,000 pregnancies. Unicornuate uterus with a rudimentary horn has a high incidence of obstetric and gynecological complications. Ruptured ectopic pregnancy in the rudimentary horn is one of the most dreaded complications, which can have grave consequences for both mother and fetus. In the majority of the cases, it is detected after rupture of the horn, usually during the first or second trimester of pregnancy. An ultrasonographic diagnosis made prior to rupture of the rudimentary horn may prevent this catastrophic outcome. We report a case of a G2 P1 L1 with a ruptured left rudimentary horn pregnancy at 16 weeks of gestation that was misdiagnosed as a pregnancy in the left uterine horn of a bicornuate uterus on prior prenatal ultrasound. The patient presented to our hospital with abdominal pain and vaginal bleeding. A diagnosis of ruptured left rudimentary horn pregnancy was made on the basis of emergency ultrasound and was later confirmed on laparotomy. The left rudimentary horn along with the ipsilateral fallopian tube was excised.
Ruptured rudimentary horn pregnancy at 25 weeks with previous vaginal delivery: a case report
Case reports in obstetrics and gynecology, 2012
Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. ...
Early diagnosis of rudimentary horn pregnancy and its excision by laparoscopy: Case Report
Türk jinekoloji ve obstetrik derneği dergisi, 2012
Rudimentary horn is one of the mullerian canal anomalies, the probability of rudimentary horn pregnancy is between 1/76000 and 1/150000. Usually, it is diagnosed after the rupture. In this case report, a patient who had a cesarean section before and who had an early diagnosis of rudimentary horn pregnancy in the eighth pregnancy week is mentioned. The rudimentary horn is excised by laparoscopy in this patient.
Unruptured pregnancy in non-communicating rudimentary horn of uterus: a case report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Pregnancy in non-communicating rudimentary horn of unicornuate uterus is very rare type of ectopic pregnancy. Only few of such cases rupture in first trimester, but eventually ninety percent of such cases rupture in second trimester. A high index of suspicion and careful ultrasound examination can detect the condition earlier before rupture. Here we report a case of 32years old G3P2L2, presented with 7weeks of gestation with acute abdomen. On ultrasonography, unruptured cornual ectopic pregnancy was suspected. Emergency exploratory laparotomy was done. Intra-operatively there was unruptured ectopic pregnancy in non-communicating horn of a unicornuate uterus. The rudimentary horn with unruptured pregnancy was excised and bilateral tubectomy was done. This case is reported because of its rarity as well as to stress the need for high index of suspicion and role of ultrasonography in the diagnosis this rare and dreadful entity.
Ruptured ectopic pregnancy in non-communicating right rudimentary horn: A case report
Keywords: Acute abdomen Hemoperitoneum Rudimentary horn Rupture Ultrasound a b s t r a c t Rudimentary horn is a developmental anomaly of the uterus, and pregnancy in a noncommunicating rudimentary horn is very difficult to diagnose before it ruptures. As the fetus enlarges in the rudimentary horn, the chances of rupture in the first or second trimester are increased. Catastrophic hemorrhage results in increased maternal and perinatal mortality and morbidity. To date, management of such cases remains a challenge due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management are lifesaving in such cases. A case of undiagnosed rudimentary horn pregnancy presented to our department in shock with features of acute abdomen, and the diagnosis was confirmed at laparotomy that revealed ruptured rudimentary horn pregnancy. And excision of the accessory horn was done.