Minimally Invasive Management of a Second Trimester Miscarriage in a Patient with a Non-Communicating Uterine Horn

Abstract

<h3>Study Objective</h3> We present a rare case of an 18-week missed abortion in a patient with a previously undiagnosed non-communicating uterine horn. <h3>Design</h3> N/A. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> A patient with a history of suspected bicornuate uterus presented with missed abortion at 18 weeks gestation. <h3>Interventions</h3> Prior attempt at dilation and evacuation was unsuccessful and a diagnostic hysteroscopy confirmed no connection between the uterine cavity and the pregnancy. MRI imaging confirmed a unicornuate uterus with a non-communicating horn. Exploratory laparoscopy with hemi-hysterectomy and removal of uterine horn with fetus was performed. <h3>Measurements and Main Results</h3> N/A. <h3>Conclusion</h3> Timely diagnosis of pregnancy within an unruptured non-communicating horn is exceedingly rare. With adequate workup including proper imaging, surgical planning, and technical expertise, safe laparoscopic removal of both the rudimentary horn and fetus is possible and should be offered to spare the patient the morbidity of laparotomy.