Case Of Rudimentary Horn Pregnancy Research Articles

Left Sided Abdominal Ectopic Pregnancy with Placenta in Rudimentary Horn-Complicated With Acute Renal Failure: A Case Report

Though unicornuate uterus with rudimentary horn is a rare Mullerian duct malformation, it is marked with frequent undesired gynaecological and obstetrical complications. Rupture of gravid horn results in maternal and foetal morbidity and mortality. A case of rudimentary horn pregnancy at 15 ± 4 weeks was reported here, with acute renal failure in the postoperative period. The favorable maternal outcome was only ensured after extensive hemodialysis sessions apart from appropriate intensive care management.

A case of rudimentary horn pregnancy that was treated with laparoscopic surgery

A case of rudimentary horn pregnancy that was treated with laparoscopic surgery

A Case of Rudimentary Horn Pregnancy Diagnosed After Failed Attempts at Pregnancy Termination

: We present a case of rudimentary horn pregnancy in the 18th gestational week with fetal demise and treatment failure. After failure in pregnancy termination, the patient was admitted to a tertiary care hospital. Following laparatomy, a definitive diagnosis was confirmed. Laparotomy was performed to remove the rudimentary horn and ipsilateral fallopian tube. Overall, physicians should be cautious about the risk of uterine disorders in the event of several failures in terminating pregnancy.

First Trimester Ultrasonographic Diagnosis of Unruptured Rudimentary Horn Pregnancies in Two Cases

The Medical Bulletin of Haseki Training and Research Hospital, published by Galenos Publishing. Haseki T›p Bulteni, Galenos Yay›nevi taraf›ndan bas›lm›flt›r. Ad­dress­for­Cor­res­pon­den­ce/Ya­z›fl­ma­Ad­re­si:­Derya Akdag Cirik Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey Phone: +90 312 567 40 00/4330 E-mail: deryaakdag@yahoo.com Received/Gelifl­Tarihi:­01 February 2016 Ac­cep­ted/Ka­bul­Ta­ri­hi:­07 February 2016 Pregnancy in a woman with unicornuate uterus with non-communicating uterine horn is a considerably rare condition with an incidence of one in 100.000 cases. Fertilization occurs by transperitoneal migration of sperm and, uterine rupture is a considerably frequent complication of those pregnancies. Therefore, early diagnosis is of great importance due to the potential risk of maternal mortality. Herein, we present two cases of rudimentary horn pregnancy diagnosed by ultrasonography in the first trimester, and treated with laparoscopic approach. These two patients attended the hospital in the sixth and twelfth gestational weeks respectively, and the first case was misdiagnosed with tubal ectopic pregnancy in the emergency unit. After detailed transvaginal ultrasonographic examination, a gestational sac separate from the uterus and surrounded by myometrium was seen and the final diagnosis was the rudimentary horn pregnancy. The diagnosis was also confirmed after laparoscopy in both cases, and the patients underwent excision of the rudimentary horn.

Laparoscopic management of an 11-week rudimentary uterine horn pregnancy using extracorporeal Roeder knot to secure the dilated vascular pedicle

Pregnancy in a uterine rudimentary horn carries a high risk of uterine rupture with severe and potentially lethal intra-abdominal haemorrhage. There is now growing evidence that this condition can be safely managed by minimally invasive surgery. We report a case of an unruptured 11-week rudimentary horn pregnancy that was diagnosed and treated laparoscopically. We have performed a literature review using PubMed, Embase and Cochrane Database of Systematic Reviews to identify relevant cases and draw conclusions with regards to their management. We have collated 20 published cases of rudimentary horn pregnancies that were managed by laparoscopy. The surgical technique appears consistent among these cases with few variations. In advanced gestations, feticide may need to be performed. Morcellation has been shown to be possible without compromising patient safety from trophoblast spill. The possibility of uncommon presentations such as duplicated or absent ureter should be taken into account. Extracorporeal Roeder knot can be used safely to secure unusually dilated vascular pedicles. Overall, laparoscopy appears to be as safe as and potentially superior to laparotomy for the management of rudimentary horn pregnancies.

MRI诊断早期残角子宫妊娠1例

残角子宫妊娠由于发病率低、早期诊断困难，常导致子宫破裂大出血，甚至危及患者生命。早期诊断后及时行手术治疗是其治疗的关键。本文通过描述1例残角子宫妊娠的MRI表现，旨在探讨MRI在早期残角子宫妊娠中的诊断价值。Due to the low incidence and difficult in early diagnosis, rudimentary horn pregnancy often leads to massive hemorrhage caused by uterine rupture, and even endanger the lives of patients. Early diagnosis and timely operation is critical to its treatment. So in order to explore the diagnostic value of MRI in the early pregnancy of rudimentary horn, this paper describes the MRI manifestations of one case of rudimentary horn pregnancy.

MULLERIAN DUCT ANOMALIES;

Background: Müllerian duct anomalies (MDAs) occur with an incidence estimated to be 4.3%. A unicornuate uterus with orwithout a rudimentary horn; is a type of mullerian duct abnormality with a frequency of 0.4%. Rudimentary horn pregnancies are rare obstetriccomplication and may cause difficulty in diagnosis and subsequent management. Objective: To alert about Mullerian duct abnormalitiesespecially unicornuate uterus with or without rudimentary horn. Design: Case series. Setting: Study was conducted in the department ofGynecology and obstetrics unit1, Allied Hospital Faisalabad. Duration of study: Cases detected during September 2006-0ctober 2011.Subjects and methods: All admitted cases of MDA whether obstetric or gynecological were included. We calculated cases of unicornuateUterus with or without rudimentary horn, also included cases of rudimentary horn pregnancy with or without rupture. Results: There were120cases of MDA out of which 8 (6.6%) were of unicornuate uterus. Out of 8 unicornuate uteri, 7/8 (87.5%) were with rudimentary horn and1/8(12.5%) without rudimentary horn. Left rudimentary horn in 4/8 patient (50%), right in 3/8 (37.5%) without horn1/8 (12.5%).Out of 7 rudimentaryhorn 1/7 gynecologic and 6/7 were obstetric, 5/7 (71.42%) ruptured in second trimester, and1/7 (14.28%) term pregnancy. In 1/7 (14.28%) hornnot removed because tubal ligation was done. Unilateral renal agenesis was present in 3/8 patient (37.5 %). Ovaries were preserved in 3/7patients (66%). Conclusions: There must be high index of suspicion for Mullerian duct abnormalities especially rudimentary horn for achievinggood success in diagnosis and management.

Rudimentary Horn Pregnancy: Series of Four Cases and Review of the Literature

Abstract Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian abnormality that may cause many gynecologic and obstetric complications. Pregnancy in a rudimentary horn is very rare, with an estimated incidence of 1 in 100,000 to 1 in 140,000 pregnancies. The natural history of rudimentary horn pregnancy (RHP) is usually rupture of pregnant horn in the second or third trimester, resulting in life- threatening heavy bleeding. Materials and Methods: In this series, 4 cases of RHP are discussed. The first case presented after failure of induction with prostaglandins. Two cases presented with abdominal pain, whereas the fourth case presented in hypovolumic shock. Conclusions: This condition should be diagnosed before conception or at least before rupture, and rudimentary horn should be excised to prevent rupture in future pregnancy. Nonresponders of induced abortion should be investigated with a high index of suspicion. (J GYNECOL SURG 27:139)

Successful outcome in preeclamptic rudimentary horn pregnancy

Unicornuate uterus with rudimentary horn is an uncommon type of mullerian duct malformation associated with various gynecological and obstetrical complications. Rudimentary horn pregnancy is a rare entity and the majority have rupture of gravid horn leading to maternal and fetal morbidity and mortality. A case of rudimentary horn pregnancy at 32 weeks and 6 days with pregnancy induced hypertension is reported where proper management results in successful pregnancy outcome.

Failure of prostaglandin induction labor in a Müllerian abnormality

Rudimentary-horn pregnancy (RHP) is a rare condition which is usually presented as a rupture of the pregnant horn during the second or third trimester, resulting in life-threatening bleeding. The authors report two cases of RHP which were diagnosed at the time of labor induction following fetal death diagnosis. Although the failure of prostaglandin induction to initiate labor could suggest that an additional obstructive Müllerian uterine anomaly is present, a directed investigation of such anomaly is more acceptable in cases of antepartum fetal death or atypical mid-trimester abdominal pain. Therefore, a high index of suspicion combined with clinical and imagiological findings are important to establish a correct diagnosis of pre-rupture RHP.

An early diagnosis and successful local medical treatment of a rudimentary uterine horn pregnancy: a case report

A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly. The great majority of the rudimentary horns are of non-communicating type (72-85%). The incidence is estimated at 1 per 100000 to 140000 pregnancies. It has poor outcome and rupture usually occurs in the second trimester leading to maternal morbidity and/or fetal mortality. This is the first case of rudimentary horn pregnancy treated with local methotrexate administration. (excerpt)

Rudimentary Horn Pregnancy

Two cases of rudimentary horn pregnancy diagnosed in the first trimester by sonography and confirmed by magnetic resonance imaging (MRI) are reported. We suggest criteria for early, prerupture sonographic diagnosis of this rare condition. We report a case in which pregnancy in a rudimentary horn was suspected on routine sonographic examination. In the second case, sonographic examination at 11 weeks' gestation revealed a right unicornuate uterus and a noncommunicating left rudimentary horn containing a gestational sac. In both cases, MRI clearly confirmed the sonographic diagnosis, showing an empty cavity of the uterine body and a pregnant uterine horn without an endometrial communication to the uterine body. Both patients underwent surgery, and the pregnant rudimentary horns were resected with no complications. We suggest the following criteria for sonographic diagnosis of rudimentary horn pregnancy: (1) a pseudopattern of a asymmetrical bicornuate uterus, (2) absent visual continuity tissue surrounding the gestational sac and the uterine cervix, and (3) the presence of myometrial tissue surrounding the gestational sac. Typical hypervascularization of placenta accreta may support the diagnosis. Additionally, MRI can be used to confirm the diagnosis before an invasive procedure is undertaken.

Noncommunicating Rudimentary Horn Pregnancy

ABSTRACT An asymptomatic case of rudimentary horn pregnancy diagnosed by ultrasound is presented. This potentially lethal condition requires clinical suspicion, and ultrasound can be used to confir...

Problems of rudimentary horn pregnancy.

Five cases of rudimentary horn pregnancy are discussed. Two presented as acute ruptured ectopic pregnancy, whereas in 3 the pregnancy was advanced and intact with intrauterine death of the fetuses. The diagnostic difficulties are discussed and in centres where ultrasound facilities are not available, a high index of suspicion in nonresponders to oxytocin induction is emphasized.