Rupture of a Rudimentary Uterine Horn: A Case Report

Kouamé Arthur Didier,Koffi Soh Victor,Adjoby Cassou Roland,Diomandé Fatoumata Alice,Kouakou Firmin,Kakou Charles,Konan Joachim,Effoh N’Drin Dénis

doi:10.4236/ojog.2017.77076

Abstract

Pregnancy in an abnormal uterus is a high-risk situation in obstetrics. Uterus bicornis unicollis with a rudimentary horn is often discovered incidentally. The aim of this report is to warn obstetricians about recurrent abdominal pain in the second trimester of pregnancy without any cause identified. Pregnancy can proceed in the rudimentary horn. We presented a case of a rupture of the rudimentary horn which occurred at 25 weeks of amenorrhea in an unmarried 19-year-old primigravida. The rudimentary horn was removed after performing an emergency laparotomy for an intraperitoneal hemorrhage with signs of shock. This abnormality is often revealed by uterine rupture, which usually occurs in the second trimester of pregnancy. Conclusion: We emphasize the importance of early diagnosis of this uterine abnormality, before pregnancy if possible. Undiagnosed, this condition evolves towards uterine rupture during pregnancy and requires emergency surgery with excision of the rudimentary horn.

Highlights

The embryology of uterus bicornis with a rudimentary horn is a consequence of the failure of progression of one of the two Müllerian ducts between the sixth and ninth week of gestation
We presented a case of a rupture of the rudimentary horn which occurred at 25 weeks of amenorrhea in an unmarried 19-year-old primigravida
The rudimentary horn was removed after performing an emergency laparotomy for an intraperitoneal hemorrhage with signs of shock

Summary

Introduction

The embryology of uterus bicornis with a rudimentary horn is a consequence of the failure of progression of one of the two Müllerian ducts between the sixth and ninth week of gestation. This rudimentary horn may have a cavity with endometrial lining of the uterus, and can serve as a site of implantation during pregnancy [1] [2]. Pregnancy in a rudimentary horn usually results in its rupture which can lead to a life-threatening heavy bleeding.

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