Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: a case report (original) (raw)
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Ruptured rudimentary horn of the unicornuate uterus at 16 weeks of pregnancy: a case report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
Pregnancy in the rudimentary horn of the uterus is a rare form of ectopic pregnancy; most of the cases were being diagnosed at laparotomy for haemorrhagic shock due to rupture when the patient presents in the second trimester. Prerupture diagnosis is possible in the early pregnancy in suspicious cases. Pregnancy in the rudimentary horn has a poor maternal and foetal outcome and 90% of them present with intraperitoneal haemorrhage in the second trimester due to rupture of the horn. We report a case of ruptured rudimentary horn pregnancy at 16weeks, in shock with severe anaemia. Excision of the rudimentary horn with right salpingectomy was done.
Pregnancy in Non-communicating Rudimentary Horn of Unicornuate Uterus: A Case Report
Case reports in clinical practice, 2022
A unicornuate uterus with a non-communicating rudimentary horn has always been a notorious uterine malformation threatening normal pregnancy continuation. Pregnancy in the rudimentary horn of the uterus is rare, but it plays an essential role in maternal morbidity and mortality. Early detection of rudimentary horn pregnancy is vital because poor musculature can lead to the dangerous complication of uterine rupture. When a Rudimentary horn pregnancy is diagnosed, surgical treatment to excision the horn with ipsilateral salpingectomy is recommended because of its high risk of rupture in the second trimester. We present a case of non-communicating rudimentary horn pregnancy that was terminated, and the rudimentary horn was resected.
Ruptured Rudimentary Horn Pregnancy of Unicornuate Uterus- A Case Report
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Mullerian anomalies were first classified in 1979 by Buttram and Gibbons and further revised by the American Society of Reproductive Medicine in 1988. Unicornuate uterus is a type 2 classification with unilateral hypoplasia or agenesis that can be further subclassified into communicating, noncommunicating, no cavity, and no horn. 1 The incidence of uterine congenital anomalies because of Mullerian defects in the normal fertile population is 3.2%. A unicornuate uterus accounts for 2.4%-13% of all Mullerian anomalies. 2 72-85% of the rudimentary horns are noncommunicating with the cavity. 3 Unicornuate uterus with rudimentary horn may be associated with gynaecological and obstetric complications like infertility, endometriosis, haematometra, urinary tract anomalies, abortions, and preterm deliveries. Rupture during pregnancy is the most dreaded complication which can be life threatening to the mother. We report a case of ruptured rudimentary horn pregnancy of 20 weeks gestation which was ultrasonographically diagnosed as intra-abdominal pregnancy and on laparotomy was managed by resection of the rudimentary horn. CASE REPORT A 21-year-old G2A1 with amenorrhoea of five months was referred from district head quater hospital with complains of pain abdomen for two days which gradually increased in intensity, was more in the lower abdomen and associated with vomiting and one episode of syncopal attack. She was married for 3 years and had a spontaneous first trimester abortion one year back. Her menstrual cycles were regular. On admission patient had mild pallor, no icterus, pulse rate was 96/min, blood pressure-100/60 mm of Hg and respiratory rate was 20/min. On abdominal examination there was generalised
Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the mullerian ducts and incomplete fusion with the contra lateral side. Pregnancy in the non-communicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Pregnancy occurs via trans peritoneal migration of sperm or zygote. Variable thicknesses of rudimentary horn musculature, poor dispensability of myometrium lead to rupture. This complication is usually seen in 2nd trimester resulting in shock and hemoperitoneum. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. Diagnosis of rudimentary horn pregnancy is difficult and can be missed by ultrasound. We report a case of ruptured rudimentary horn pregnancy at 17 weeks of gestation.
Pregnancy in Rudimentary Horn: A Case Report
Himalayan Journals, 2023
A unicornuate uterus with a rudimentary horn is a uterine anomaly resulting from the incomplete development of one of the Müllerian ducts and an incomplete fusion with the contralateral side. Pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. Usually the diagnosis is missed and may present as an emergency with haemoperitoneum. We described a case of a 26-year-old PGR who had been diagnosed with intrauterine foetal death at 19 weeks of pregnancy and was referred to Dr. RPGMC Tanda.
First Trimester Ultrasonographic Diagnosis of Unruptured Rudimentary Horn Pregnancies in Two Cases
Haseki Tıp Bülteni, 2016
Pregnancy in a woman with unicornuate uterus with non-communicating uterine horn is a considerably rare condition with an incidence of one in 100.000 cases. Fertilization occurs by transperitoneal migration of sperm and, uterine rupture is a considerably frequent complication of those pregnancies. Therefore, early diagnosis is of great importance due to the potential risk of maternal mortality. Herein, we present two cases of rudimentary horn pregnancy diagnosed by ultrasonography in the first trimester, and treated with laparoscopic approach. These two patients attended the hospital in the sixth and twelfth gestational weeks respectively, and the first case was misdiagnosed with tubal ectopic pregnancy in the emergency unit. After detailed transvaginal ultrasonographic examination, a gestational sac separate from the uterus and surrounded by myometrium was seen and the final diagnosis was the rudimentary horn pregnancy. The diagnosis was also confirmed after laparoscopy in both cases, and the patients underwent excision of the rudimentary horn.
Pregnancy in a Rudimentary Horn with a Live 19-Weeks Fetus: a Case Report
2019
Background: A unicornuate uterus with a rudimentary horn is a rare uterine anomaly occurring in 1 out of 100,000 to 140,000 pregnancies. The diagnosis of this complication is conventionally difficult and missed, which may cause uterine rupture leading to hemoperitoneum. The standard treatment is the surgical excision of the horn through laparotomy. The aim of this report was to introduce a case of pregnancy in a rudimentary horn of the uterus. Case report: We present a 31-year old nulliparous woman at 19 weeks of gestation with a live fetus in a rudimentary horn. The first ultrasound showed a bicornuate uterus at 13 weeks. The patient was referred to Mobini Hospital with abdominal and epigastric pain, nausea, and vomiting. Repeated blood tests, ultrasonography, and clinical signs raised the suspicion of a ruptured ectopic pregnancy. The diagnosis of a rudimentary horn pregnancy was made in the operative room. The rudimentary horn with the left tube was excised and the patient was discharged in good condition two days later. Conclusion: This case highlights the importance of following up of patients whose early ultrasound indicates a uterine anomaly. In addition, obstetricians and midwives must have a high level of clinical suspicion and pay careful attention to such complicated cases.
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.
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
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.