Pregnancy in the Rudimentary Uterine Horn Case Report of an Unusual Presentation = عرض لحالة نادرة لحمل في قرن رحم غير مكتمل النمو

Qamariya Ambusaidi,Chitra Jha

doi:10.12816/0003349

Abstract

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. The standard treatment is the surgical excision of the horn. A gravida 2, para 1 patient presented at 23 weeks' gestation with fetal demise. Repeated failed attempts at induction of labour raised the suspicion of an abnormally located pregnancy which was confirmed by magnetic resonance imaging. She underwent a laparotomy with right rudimentary horn excision. The final diagnosis of a non-communicating rudimentary horn pregnancy was made intraoperatively and was confirmed by histopathology. This case highlights the importance of an early ultrasound in detecting uterine anomalies and the need for high clinical suspicion.

Highlights

Unilateral genito-urinary agenesis or hypoplasiaCases of unicornuate uterus with contralateral renal agenesis due to agenesis or hypoplasia of an entire urogential ridge
Pregnancy in a rudimentary uterine horn is a rare condition that can lead to a catastrophic outcome when it ruptures
The majority of cases are diagnosed late, after the rupture has occurred.The use of ultrasonography helps clinicians to diagnose uterine malformations earlier, which can be confirmed by a magnetic resonance image (MRI) or a laparoscopy

Summary

Unilateral genito-urinary agenesis or hypoplasia

Cases of unicornuate uterus with contralateral renal agenesis due to agenesis or hypoplasia of an entire urogential ridge. 2. Uterine duplicity (bicornuate or didelphys uterus) with a blind hemivagina (or unilateral cervico-vaginal atresia) and ipsilateral renal agenesis. Uterine duplicity (bicornuate or didelphys uterus) with a blind hemivagina (or unilateral cervico-vaginal atresia) and ipsilateral renal agenesis This includes the Herlyn-Werner-Wunderlich syndrome and there can be cases of resorption partial of the intervaginal septum

Isolated or common uterine or utero-vaginal anomalies

Findings

Discussion

Conclusion