A 32 weeks twin pregnancy in a non-communicating rudimentary horn: Case report

Abstract

Introduction: Pregnancy in a rudimentary horn represents a serious implication of this rare uterine anomaly. In 90% of cases, rupture of the horn occurred in the second trimester. In this report, we present a rare case of intact twin pregnancy in a non-communicating rudimentary horn that reached 32 weeks of gestation. Case presentation: A 25 years old Caucasian woman pregnant for 32 weeks presented with shock, acute lower abdominal pain and considerable vaginal bleeding. The patient was shocked and the uterus was tender and tense. Trans-abdominal ultrasound scan revealed a twin intrauterine pregnancy with no cardiac activity in both fetuses, fetal biometry was equivalent to 32 weeks and there was a huge retroplacental hematoma. Urgent laparotomy was performed and a huge intact right sided rudimentary horn was identified. Vertical incision was done with extraction of the dead twins, and the horn was excised. Conclusion: Despite being rare, rudimentary horn pregnancy should be suspected regardless of the gestational age. Placental abruption should also be considered as an unusual presentation of this condition.