English

Abstract

INTRODUCTION: Pregnancy in a rudimentary horn of a unicornuate uterus is rare.1 An incidence of 1 in 76,000-150,000 pregnancies is reported in the literature.2,3 We present a case report of rupture of a 25 weeks pregnancy in the non-communicating rudimentary horn of a unicornuate uterus. Congenital malformations of the uterus, also known as Mullerian duct anomalies, are rare in general population (Approx. 1%). These abnormalities result from arrested development, abnormal formation or incomplete fusion of mesonephric ducts. Unicornuate uterus results from unilateral arrested mullerian duct development. Rarely unicornuate uterus may also have a rudimentary horn, more on the right than on the left side. The incidence of unicornuate uterus is estimated to be 1:250 and its occurrence with rudimentary horn is 1:100,000. Such anomalies are reported to result in increased rate of miscarriages, recurrent pregnancy losses, preterm labor, infertility and other obstetric complications. Conception in rudimentary horn arises either from a small communication with the uterine cavity (Communicating) or by Trans peritoneal migration of the fertilized ovum from the contra-lateral side (Non-communicating). The proportion of non-communicating rudimentary horns is 70-90%. The frequency of pregnancy in rudimentary horn is reported to be 1:76000. The clinical presentations vary from being asymptomatic to vague complaints of mild lower abdominal pain with gastrointestinal upset to its severest form of acute abdomen with hemorrhagic shock. The most significant threat of a rudimentary horn pregnancy is the risk of rupture because of poorly developed musculature. In view of the paucity of literature on rare observation of pregnancy in rudimentary horn of uterus, the case reported here is of crucial importance.