Abstract
ObjectivesTo evaluate the presentation, assessment, treatment, and pregnancy outcomes of 22 women with a rudimentary uterine horn.MethodsWe reviewed the data regarding the outcomes of patients with a rudimentary horn pregnancy (RHP) who were managed at Peking Union Medical College Hospital over the last 30 years. Twenty-two pregnant patients with a rudimentary horn have been treated at our institute over the last 30 years. All patients with RHP were divided into two groups: Type A (n = 4), a rudimentary horn with a cavity that communicated with the uterus; and Type B (n = 7), a rudimentary horn with a cavity that did not communicate with the uterus. We classified all 22 patients into communicating group or noncommunicating group according to the anatomical connection of the rudimentary horn to the contralateral hemiuterus.ResultsThe mean gestational age of Type A patients (23.5 weeks) was significantly higher (P = 0.046) than that of Type B patients (10 weeks). The rudimentary uterine horn carried 4 of 5 (80%) pregnancies in the communicating group. Three case of rudimentary horn pregnancies ruptured before a gestational age of 12 weeks, and one abortion occurred after a gestational age of 12 weeks. In the noncommunicating group, 7 of 17 (41.2%) cases were RHPs, and 3 ruptured after a gestational age of 12 weeks.ConclusionsThe diagnosis and management of the rudimentary uterine horn continues to be challenging. Medical and radiological personnel must maintain a high degree of alertness to prevent the morbidity associated with this condition. In particular, patients with RHP (Type A), who have a higher chance being misdiagnosed before 12 gestational weeks, have a higher risk of potential complications. If pregnancy in the rudimentary horn is diagnosed, excision of the pregnant horn is recommended, regardless of the type of unicornuate uterus.
Highlights
The pregnancy outcomes of patients with rudimentary uterine horn have a higher chance being misdiagnosed before 12 gestational weeks, have a higher risk of potential complications
Mullerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and unicornuate uterus is observed in 0.4% of women[1,2,3]
Diagnosis before rupture is essential for the successful management and prevention of maternal morbidity and mortality
Summary
Mullerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and unicornuate uterus is observed in 0.4% of women[1,2,3]. An embryo can implant in a uterus with a rudimentary horn or in a unicornuate uterus These conditions are similar, their reproductive outcomes are completely different. The reproductive outcomes of women with unicornuate uteruses are poor; the associated live birth rate is only 29.2% and the prematurity rate is 44%[14, 15]. Women with this anomaly present spontaneous abortion rates of 24.3% in the first trimester and 9.7% in the second trimester[1]
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