Ruptured Rudimentary Horn Pregnancy: A Case Report (original) (raw)
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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...
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.
Rupture of Rudimentary Horn Pregnancy at 16 Weeks of Gestation
Case Reports in Obstetrics and Gynecology, 2021
Pregnancy in the rudimentary horn is rare and a life-threatening. Rupture of pregnant rudimentary horn in the second trimester is a usual presentation. Early diagnosis and fast management are necessary to decrease the mortality and the morbidity of this pathological entity. This report confirms the diagnostic and therapeutic difficulties of the pregnant rudimentary horn. An emergency laparotomy was taken, and ruptured right rudimentary horn was diagnosed. A hemi-hysterectomy was carried out. The patient’s postoperative follow-up was uneventful, and she left the hospital 5 days after.
Rudimentary Uterine Horn Pregnancy; Pre-rupture Diagnosis and Management: Case Report
2019
Introduction: Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in a rudimentary horn is rare. The Diagnosis of the rudimentary horn pregnancy is very difficult and needs high index of suspicion. Case: We present a case of pregnancy in a non-communicating rudimentary horn that was difficult to diagnosis in the 1 st presentation. The diagnosis was suspected when the case did not respond to the medical termination of pregnancy by misoprostol; and also by mechanical methods. Following that a suspicion of an abnormally located pregnancy was made and confirmed by radiology modalities. Patient had surgical resection of the rudimentary horn. Conclusion: Despite recent advances in ultrasound, the diagnosis of pregnancy in the rudimentary horn remains difficult, and high index of suspicion is needed in these cases.
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. ...
Rudimentary Horn Pregnancy Mimicking Ruptured Uterus
Journal of Gynecologic Surgery, 2014
Background: Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates by rupture in second trimester of pregnancy. Thus, excision of the rudimentary horn is advised when it is diagnosed. Case: A 25-year-old woman, gravida 2, para 1 + 0, presented as a case of an acute abdomen. She had a rare case of an intact pregnancy that had reached 26 weeks of gestation in a noncommunicating rudimentary horn, and this was misdiagnosed by ultrasound as a case of a ruptured uterus. The rudimentary horn, with the pregnancy in situ, the right tube, and the right ovary were excised. The fetus was not alive by the time of this surgery. Results: The patient's postoperative period was uneventful, and she was discharged to go home 3 days after her surgery had occurred. Conclusions: Despite being rare, rudimentary-horn pregnancy should be suspected regardless of the fetus' gestational age. Rudimentary-horn pregnancy should also be considered as an unusual presentation of a ruptured uterus. Excision of the rudimentary horn remains the ''gold standard'' method for treating these patients. (J GYNECOL SURG 30:162
Pan African Medical Journal, 2014
Rudimentary uterine horn pregnancy is rare and, to our knowledge, has not been previously reported in Cameroon. We herein report the case of a 22 year old second gravida referred for acute abdominal pain at 17 weeks of gestation. Physical examination revealed hemoperitoneum with hypovolemic shock. After resuscitation, an emergency exploratory laparotomy was done and we found hemoperitoneum of 3,500 milliliters, a bicornuate uterus with a ruptured right rudimentary communicating horn containing a non viable foetus. There were no other abnormalities. We performed an excision of the rudimentary horn with ipsilateral salpingectomy. Post-operative course was uneventful and the woman was discharged seven days later. This case emphasizes the importance of good antenatal care to avoid complications.
Ruptured rudimentary horn pregnancy at sixteen weeks
Journal of the Turkish German Gynecological Association, 2010
Pregnancy in a non-communicating rudimentary horn is very difficult to diagnose before it ruptures, leading to life-threatening intraperitoneal hemorrhage. A 22-year-old second gravida patient presented at the Emergency Center of the University Clinical Center of Kosova with a 16-week history of amenorrhea and acute onset of severe abdominal pain. She was resuscitated and taken for an emergency laparotomy under general anesthesia. Intraoperatively, there was a massive hemoperitoneum with a ruptured right rudimentary horn Given their rarity, ruptured rudimentary horn pregnancies are of interest.
Rupture of a Rudimentary Uterine Horn: A Case Report
Pregnancy in an abnormal uterus is a high-risk situation in obstetrics. Uterus bicornis unicollis with a rudimentary horn is often discovered incidentally. The aim of this report is to warn obstetricians about recurrent abdominal pain in the second trimester of pregnancy without any cause identified. Pregnancy can proceed in the rudimentary horn. We presented a case of a rupture of the rudimentary horn which occurred at 25 weeks of amenorrhea in an unmarried 19-year-old primigravida. The rudimentary horn was removed after performing an emergency laparotomy for an intraperitoneal hemorrhage with signs of shock. This abnormality is often revealed by uterine rupture, which usually occurs in the second trimester of pregnancy. Conclusion: We emphasize the importance of early diagnosis of this uterine abnormality, before pregnancy if possible. Undiagnosed, this condition evolves towards uterine rupture during pregnancy and requires emergency surgery with excision of the rudimentary horn.
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.