Abstract
Introduction: Mullerian malformations are a group of malformations that result from an alteration of embryonic development. Most cases are asymptomatic, however, in pregnant patients it has been associated with recurrent abortion or premature delivery. Case presentation: 12 + 2 weeks pregnant woman consulted for abdominal pain, vomiting and fever. During the study, a transvaginal ultrasound was performed, where two endometric cavities and a pregnancy in the right horn were observed. The evolution of the patient was torpid, reaching hypovolemic shock, resolved by an emergency laparotomy where the rupture of the right horn was found. Discussion: The bicornuate uterus is the consequence of a partial fusion of the paramesonephric ducts during the fetal development, resulting in two functional uterine horns. Patients with bicornuate uterus may be asymptomatic, a uterine rupture is a rare but potentially severe complication of the bicornuate uterus and is usually presented during first and second trimester. Conclusions: Pregnancy with Mullerian anomalies often has preterm delivery, IUGR and malpresentation, and even more severe complication as uterine ruptura, so, requires proper counselling and close monitoring during antenatal period.
Highlights
Mullerian malformations are a group of malformations that result from an alteration of embryonic development
In pregnant patients it has been associated with recurrent abortion or premature delivery
The bicornuate uterus is the consequence of a partial fusion of the paramesonephric ducts during the fetal development, resulting in two functional uterine horns
Summary
The prevalence of these malformations varies in the literature, differentiating between the general population (3% - 4%) and the infertile population (5% - 10%), reaching its highest prevalence in the population with fetal death in the first-second trimester or premature delivery (10% - 25%) [2]. Most of the cases in the Mullerian malformations are asymptomatic, they can cause gynecological symptoms such as pelvic pain, abnormal uterine bleeding, hematometer or hematocolpos, infection of the genital tract [3] In pregnant patients, it has been associated with recurrent abortion or premature delivery, intrauterine growth restriction, fetal deformities, placental insertion abnormalities, cervical insufficiency, rudimentary horn rupture [4]. Bicornuate uterus is associated with adversely reproductive outcomes and very rarely can lead to rupture uterus during the pregnancy
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