Unicornuate Uterus With Pre Ruptured Rudimentary Horn Pregnancy At 15 Weeks Gestation: Case Report

Abstract

To describe the diagnosis and management of one case of pre rupture rudimentary horn pregnancy of unicornuate uterus in the early second trimester by clinical suspicion, sonography, and laparotomy. This paper presents a rare case in which a rudimentary horn pregnancy was suspected clinically at 15 weeks gestation with moderate to severe abdominal pain and diagnosed by sonographic criteria which revealed an empty uterine cavity with a pregnant uterine horn and confirmed by laparotomy. Which revealed a right unicornuate uterus and pre rupture a noncommunicating left rudimentary horn containing a gestational sac, fetus, and placental tissue. The patient underwent surgery, and the pre rupture rudimentary horn pregnancy with fallopian tube was resected and repair of the damaged uterine wall was made with no complications. The patient conceived spontaneously eight months after surgery and her antenatal care was regular without complications until 36 weeks gestation presented with mild left iliac fossa pain. Her vaginal examination revealed she is in labor; the patient prepared and operated the next day as elective cesarean section; the baby and the placenta were delivered without any difficulty. Rudimentary horn pregnancy is a dangerous kind of ectopic pregnancy and is considered as very rare condition which make difficulty in understanding the disease. Most of the clinicians instructed to be focus on prenatal ultrasound for an earlier diagnosis and management which results in a reduction in risk of maternal morbidity and mortality. Additionally, MRI can be used to confirm the diagnosis before an invasive procedure is undertaken.