Pregnancy In Horn Research Articles

Exteriorization of genital system of Awassi ewes with laparotomy in standing position

The study were undertaken on 16 Iraqi Awassi ewes, presented in the farm of college of veterinary medicine, Al- Fallujah University/ Fallujah, during the end of February to the half of the march, 2018. The age of the animals ranged between 2 to 4 years. All the ewes were examined by ultrasonography by specialist in order to be sure that the animals not pregnant with B- mode system. All the animals has been synchronized with vaginal sponges impregnated in 40 mg flurogestone acetate (intervet, B.V. Boxemeer, Holland). The animals were put in a standing position clipping and shaving of the left flank area then the site washed with antiseptic and disinfected with tincture iodine. The animals anesthetized locally using 2% xylocaine hydrochloride using 10 ml subcutaneously and intra muscular. left flank sharp dissection about 10-12 cm were made through the skin, muscle and peritoneum. Exteriorization of the uterus and ovaries were done to detect the pregnancy through a symmetry of uterine horns and the enlargement of pregnant horn or to detect the numbers of follicles and corpora lutea after that the peritoneum and the muscles were sutured with catgut no.1 with lock stich pattern. The skin was sutured with silk no.1 using horizontal mattress interrupted pattern. Systemic long acting tetracycline were applied I.M (200 mg/ ml: 100mg/kg B.W) for one day and another for 3 injection. Local antibiotic spray was applied to treat the surgical wounds for 7 days. The suture materials of the skin were removed after 7 days of the operation. The animals were examined daily for general health condition (temperature, heart rate, pulse rate, appetite). The wound also examined for presence of swelling, hematoma, pus or infection or hernia Positive results were considered when the animal in a good general health condition and the wound showed normal healing without presence of swelling, hematoma, pus or infection or hernia. This technique is simple, easily done, save time and cost as well as reduce the surgical trauma with few suture materials. The study was the first of its kind all over the world in exteriorization of genital organs in standing position in ewes.

Novel Management of Ectopic Pregnancy in a Noncommunicating Rudimentary Horn of a Unicornuate Uterus

Pregnancy in a rudimentary horn is a rarely encountered form of ectopic pregnancy and is often an emergent situation because of the risk of rupture of the horn. A 31-year-old gravida 3 para 1 woman with 7 to 8 weeks' gestational age was found to have a viable pregnancy in a rudimentary noncommunicating horn of a unicornuate uterus. She elected termination of the pregnancy via local intracardiac lidocaine and intra-amniotic methotrexate injections. Subsequent removal of the rudimentary horn was necessary to prevent recurrence. Because of the risk of rupture, the diagnosis and management of an ectopic pregnancy in a rudimentary horn can be emergent.

Ectopic pregnancy în rudimentary horn: early diagnosis and management

Pregnancy in rudimentary horn is a rare clinical entity with an incidence ranging from 1:76.000 to 1:140.000 preg­nan­cies. The symptomatology that accompanies pregnancy de­ve­loped in rudimentary horn is similar to that of ectopic preg­nan­cies or may evolve as a normal pregnancy. It is dif­ficult to diagnose in the first trimester of pregnancy when conservative treatment is possible, with minimal mor­bi­di­ty, frequently evolving until the second trimester when clinically manifests as a uterine rupture syndrome and it is accompanied by intraperitoneal hemorrhage and he­mor­rhagic shock. It is desirable that the diagnosis of these pregnancies to be established as early as possible in the first trimester of pregnancy and they will be terminated as soon as they have been diagnosed with certainty.

Ruptured Ectopic Pregnancy in Rudimentary Horn of Unicornuate Uterus

Ruptured Ectopic Pregnancy in Rudimentary Horn of Unicornuate Uterus

Pregnancy in Non-Communicating Rudimentary Horn of A Unicornuate Uterus.

Diagnosis and management of pre-rupture stage of the pregnant horn are difficult and usually missed on a routine ul- trasound scan. Also most cases are detected after rupture of pregnant horn. We presented a 28-year-oldG2 L1 woman with diagnosis of rudimentary horn pregnancy (RHP) at 14 weeks of gestation. We diagnosed her with a normal intrauterine pregnancy, whereas a pregnancy in a right-sided non-communicating rudimentary horn with massive he- moperitoneum was later discovered on laparotomy. RHP has a high risk of death for mother, so there must be a strong clinical suspicion for the diagnosis of RHP. Although there is a major advancement in field of diagnostic ultrasound and other imaging modalities, prenatal diagnosis has remained elusive and a laparotomy surgery is considered as a definitive diagnosis.

095 Comparison of expression of glucose, fructose, and cationic amino acid transporters in bovine caruncular and inter-caruncular tissue between the pregnant and non-pregnant uterine horn from days 16 to 50 of gestation

095 Comparison of expression of glucose, fructose, and cationic amino acid transporters in bovine caruncular and inter-caruncular tissue between the pregnant and non-pregnant uterine horn from days 16 to 50 of gestation

Ruptured noncommunicating rudimentary horn of unicornuate uterus at 12 weeks

Pregnancy in a rudimentary horn of a unicornuate uterus is rare but ruptured horn has a mortality rate of 5%. We report a case of 26-year-old G4P3 L3 with previous full-term vaginal deliveries, who presented at 12-week gestation with severe abdominal pain. Transvaginal ultrasound imaging was suggestive of ruptured right ectopic pregnancy and patient was taken up for emergency laparotomy. Intraoperatively, 2500 cc hemoperitoneum was present and ruptured right rudimentary horn in the posterolateral part was found, with fetus in the pouch of Douglas, the uterus was of unicornuate type. Excision of ruptured right rudimentary horn along with the right salpingectomy was done. Despite advances in imaging, in developing countries where the prerupture diagnosis is unlikely, a high index of suspicion is crucial in saving mother's life.

Histomorphometry of the placental vasculature and microcotyledons in Thoroughbred mares with chronic laminitis

The objective of this study was to assess the placental vasculature and microcotyledons in pregnant mares with chronic laminitis. Twenty-six pregnant mares were enrolled in the study, 13 had chronic laminitis (Laminitis Group) and 13 were healthy mares (Healthy Group). Arterial systolic pressure and heart rate were measured in the last 30 days of gestation. After foaling, the fetal membranes were grossly evaluated and samples were harvested for histopathologic examination. All mares had digitalized images taken from chorioallantois for histomorphometry analyses (software-NIH ImageJ). Images were assessed for: (i) arterioles from the allantoic region: total and lumen vascular diameter and vascular wall thickness; (ii) microcotiledonary and capillary area/field. Mares in the Laminitis Group showed hypertension, shorter gestational length, lower placental weight and lower birthweight (p < 0.05) foal in comparison with mares in the Healthy Group. Laminitis mares had a reduction of vascular lumen diameters in the uterine body and pregnant horn (p < 0.05), vascular wall thickening in the pregnant horn (p < 0.05) and smaller capillary area/field in the microcotyledons of uterine body and pregnant horn (p < 0.05). In conclusion, pregnant mares with chronic laminitis presented signs of hypertension syndrome, and vascular abnormalitities in placental vessels such as reduction in the vascular lumen and capillary area in the microcotyledones, and thickening of the vascular wall. Foals born from mares with chronic laminitis showed lower birth weight and shorter gestation lengths.

Successful outcome of multifetal pregnancy in a single horn of a bicornuate uterus: a case report

Successful outcome of multifetal pregnancy in a single horn of a bicornuate uterus: a case report

Asymptomatic Rupture of Term Non-communicating Rudimentary Horn of Uterus: A Case Report

A Rudimentary horn is a rare form of congenital uterine anomaly, resulting from an arrest in the development of one of the Mullerian ducts with inappropriate fusion with the other side. In most of the cases no direct communicating channel exists between the two parts of the uterus. Pregnancy in the rudimentary horn represents a rare form of ectopic gestation and is thought to result from transperitoneal migration of spermatozoa or the fertilized ovum. Most patients with rudimentary horn pregnancy present in second trimester with hemorrhagic shock due to rupture of horn. Diagnosis of the rudimentary horn may be done with magnetic resonance imaging or 3D, 4D ultrasonography but confirmation of diagnosis is usually surgical at laparoscopy or laparotomy. We report a case with provisional diagnosis of a case of primigravida with 40+ weeks pregnancy with transverse lie along with placenta praevia and intrauterine fetal death. But at laparotomy it revealed a ruptured pregnant non-communicating horn of uterus.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 53-55

The nitric oxide serum level and combined utero-placental thickness in buffalo (Bubalus bubalis) affected by pregnancy pathology

The present study aimed mainly to study the level of nitric oxide (NO) and combined thickness of the uterus and placenta (CTUP) in buffaloes affected by pregnancy pathology. Females (n = 104) were classified into three main groups: nonpregnant (n = 10), healthy pregnant (n = 54), and pathologically pregnant (n = 40). The healthy pregnant animals were subgrouped according to the stage of pregnancy to early stage (n = 15), mid stage (n = 15), late stage (n = 19), and full term (n = 5). The animals in which pregnancy was associated with placental pathology were subgrouped to uterine torsion (n = 27), hydroallantois (n = 5), and abortion (n = 8). Blood samples were collected from all animals to estimate the NO level using Griess reaction test. Combined thickness of the uterus and placenta was measured at the most caudal part of the pregnant horn using a rectal ultrasound probe. Placental tissue samples were collected from all pregnant animals just after delivery or abortion for histopathologic section. The results revealed that the level of NO was higher (P ≤ 0.05) in pregnant than in nonpregnant animals (6.89 ± 0.18 μM). Additionally, NO level was decreased significantly at full term (18.26 ± 0.27 μM) when compared to the other stages of pregnancy. Moreover, there was a decrease (P ≤ 0.05) in the level of NO in cases of uterine torsion (22.22 ± 0.46 μM) and hydroallantois (24.20 ± 0.07 μM) in comparison with the normal pregnant buffalo. The CTUP was significantly increased as pregnancy progressed. The CTUP in cases of uterine torsion (18.2 ± 3.3 mm) was higher (P < 0.05) than in healthy pregnant buffalo at the same stage of pregnancy. Additionally, CTUP significantly differed between different types of uterine torsion. There was no significant difference between CTUP in hydroallantois and abortion cases besides healthy pregnancy. Histopathologic examination revealed a great proliferation and hyperplasia of cytotrophoblastic cells only in uterine torsion and hydroallantois cases. In conclusion, NO level and CTUP can be used as indicators for pregnancy pathology that is usually associated with presence of cytotrophoblastic cells and placental insufficiency.

Misdiagnosed Case of a Rudimentary Horn Pregnancy

Objective: To emphasize the importance of knowledge of mullerian anomalies while evaluating a suspected case of pregnancy in a bicornuate uterus. Design: Case report Setting : Obstetric unit in a training and research hospital. Patient : A 25 year old primigravida woman with 26 weeks pregnancy in a non communicating rudimentary horn. Intervention: The exact diagnosis of ruptured non communicating rudimentary horn pregnancy was diagnosed after explorative laparotomy. Conclusion : Pregnancy in a non communicating rudimentary horn should always be considered as a differential diagnosis of a pregnancy in a bicornuate uterus. Lack of experience and knowledge may lead to incorrect diagnosis in such cases, and hence compromising maternal and fetal health.

Spontaneous Rupture Of Noncommunicating Rudimentary Horn Pregnancy Presenting As Medical Emergency

Pregnancy in a noncommunicating rudimentary horn of the uterus is extremely rare and usually terminates in rupture during first or second trimester of pregnancy.Diagnosis of such cases with prior vaginal delivery is difficult. It can be missed in routine ultrasonograms and in majority is detected after rupture. 30 year old P3L1S2 presented to the Emergency Medical Ward with an acute abdomen and shock. Surgical and gynaecological advice was seeked, a provisional diagnosis of ruptured ectopic pregnancy made as the patient gave history of over the counter consumption of abortion pills a month ago. At laprotomy a unicornuate uterus with ruptured noncommunicating rudimentary horn was seen with massive hemoperitoneum. The need for high index of suspicion is recognized in such cases.The incidence is estimated at 1 per 100000 to140000 pregnancies.There are no definitive clinical criteria to detect this life threatening condition specially when it mimics other medical and surgical emergencies.

Assessment of the accuracy of estimation of gestational age in cattle from placentome size using inverse regression

AIMS: To assess, in dairy cows between 60–160 days of gestation, whether the agreement between actual gestational age and that predicted by placentome size could be improved by using individual placentome measurements rather than a single average, and to identify how increasing the number of placentomes measured improved the prediction.METHODS: Data were obtained from 58 cows examined using transrectal ultrasonography every 10 days between 60–130 days, and every 15 days between 130–160 days of gestation. For each cow, four to six placentomes in each of the pregnant and non-pregnant horns were examined from the region of the uterus near to the cervix. A mixed-effects model, which included cow as a random effect, and a simple linear regression which ignored within-cow correlation, were fitted to the data. Inverse regression was used to compare the 95% prediction bands obtained for estimating gestational age using the means of three, five or eight placentome measurements.RESULTS: The fit of the mixed effects model was better than a simple linear regression (p<0.001) but the fitted lines from the two models were very similar. Using the simple regression model, for a mean placentome length of 15 mm estimated gestational age was 100 days, with 95% CI of 68–131 days for measurement of three placentomes, and 80–120 days for eight placentomes.CONCLUSIONS: The agreement between placentome size and gestational age was improved by increasing the number of placentomes measured. Direct comparison of these CI with those for other published fetal measures was not possible as similar prediction bands have not previously been calculated for fetal measures; however one study reported a residual SD which had been calculated using size measurements as the predictor variable and age as the response variable. Using these data 95% CI were calculated to be ±9 days for crown-rump length and ±25 days for uterine diameter. These are likely to be an underestimate of the true CI and do not take account of the increase in variance of the difference between predicted and actual gestational age as gestational age increases.CLINICAL RELEVANCE: Placentome measurement may be useful for estimating fetal age in late gestation. Further research is required to better establish the agreement between gestational age and the fetal measurements which are currently used to estimate fetal age.

Full-Term Pregnancy in a Non-communicating Rudimentary Horn: A Case Report

Unicornuate uterus with a rudimentary horn is a rare anomaly of the female genital system resulting from inco mplete development of one of the mullerian ducts. It might end in grave obstetrical and gynecological complications in the absence of early diagnosis and proper management. A rare case of a full-term pregnancy in a non-communicating rudimentary horn is presented in this paper. A 24-year-old pregnant woman carrying the preliminary diagnosis of placenta percreta was referred to our clinic by reason of vaginal bleeding at a gestational age of 38 weeks. She underwent emergency cesarean section in our clinic, which led to the finding that her condition was not placenta percreta, but a full-term pregnancy in a non-communicating rudimentary horn. The need for a high index of suspicion as well as the use of ultrasonography plays a key role in the early diagnosis of this rare condition. Rudimentary horn pregnancy must be suspected in patients referred with the preliminary diagnosis of placenta percreta.

A Case Report of Pregnancy in Rudimentary Horn

Pregnancy in rudimentary horn is rare occurrence with incidence of less than 1 in 150,000. Pregnant rudimentary horn can present with wide range of symptoms that may be similar to ectopic pregnancy or may remain silent with features of normal pregnancy. All pregnancies with rudimentary horn must be terminated as soon as diagnosed.

Near Term Rudimentary Horn Pregnancy with Term Intrauterine Pregnancy: A Case Presentation

Introduction: Unicornuate uterus accounts for 5 percent of all Mullerian anomalies.Rarely it could be a site for ectopic pregnancy, where natural course is rupture during second trimester, with a potentially life-threatening heavy bleeding. However, in about 10 percent of cases horn pregnancy will go to term or form a lithopedion. We describe an unexpected horn pregnancy reaching near term with live term intrauterine pregnancy, an unusual presentation. Case presentation: 25 years old Gravida III, Para II woman presented to our hospital with complaint of right upper quadrant swelling of 5 months duration. Thirteen months back, she was diagnosed to have IUFD with femoral length of 34 weeks and misoprostol used for induction of labor but failed. Patient went home and she came again with the above complaint. On examination, uterus was 26 weeks sized, positive fetal heartbeat. She has 20 cm × 20 cm firm, non-tender right upper quadrant mass. Ultrasound showed singleton intrauterine alive pregnancy of 26 weeks + 5 days and dead fetus of 34 weeks by femur length in the right abdominal cavity. Transverse lower uterine segment cesarean was done to effect 3800 gm male alive neonate. Resection of rudimentary horn and right salpingectomy was done. The horn was connected to the isthmic right wall of the uterus by a thin fibromuscular tissue and contained 2200 gm macerated fetus and placenta. No right ovary seen. The patient and neonate progressed well and were discharged. Conclusion: An ectopic pregnancy in a rudimentary horn is rare and carries severe maternal and fetal consequences; antenatal diagnosis is challenging. Therefore, high index of suspicion is recommended to prevent morbidity and mortality after failed induction. The life-threatening complication is rupture of the horn.

The Unchartered Waters of Obstetrics - Rupture of Noncommunicating Rudimentary Horn Pregnancy (Rnhp) in a Bicornuate Uterus

Background: Mullerian duct anomalies in female result from failure of complete development of one duct and incomplete fusion of other duct during embryonic life. Bicornuate uterus with rudimentary horn (BURH) is the rarest uterine anomaly. Pregnancy in rudimentary horn is even rarer, i.e. 1:1,40,000 pregnancies. Case description: A 24-year-old primigravida presented with acute pain abdomen and amenorrhoea for 16 weeks. She was severely pale and was in hypovolemic shock, with diffuse tenderness, guarding and rigidity of abdomen. Per vaginal examination revealed a bulky uterus with motion tenderness and full fornices. On laparotomy there was hemoperitoneum along with rupture of left horn of the bicornuate uterus. The placenta was inside the rudimentary horn, and the horn was non-communicating with the body of the uterus. It was excised completely. An abortus of 16 weeks size was lying within intact membranes, and was found free within the abdominal cavity. Conclusion: A second trimester pregnancy with features of ruptured ectopic should be screened for the associated uterine anomalies. Rupture of the rudimentary horn of the uterus is one of the important but rare causes of acute abdomen. A high index of suspicion is warranted in cases of advanced gestation presenting with acute abdomen, especially in developing countries like India, where the possibility of early detection before rupture is unlikely, culminating in maternal demise.

112 PRESENCE OF BACTERIA IN THE ENDOMETRIUM AND OVIDUCT OF COWS WITH PYOMETRA AS DETECTED BY FLUORESCENCE IN SITU HYBRIDIZATION

The objective of the study was to identify the location of the present bacteria in the uterus and oviducts of cows with pyometra. Pyometra is one of the postpartum infectious diseases in cattle that can result in infertility and thereby affect reproduction performance. Reproductive tracts (n = 21) were collected at a slaughterhouse in Denmark and send to The University of Copenhagen for examination and sampling. The uteri were included in the study when the following criteria were met: the cow was more than 21 days postpartum, the uterus was distended with pus, the cervix was closed, and a corpus luteum was present in one or both ovaries. A full thickness uterine tissue sample from the previous pregnant horn and both oviducts were sampled and then fixed in formalin. The tissues were trimmed, processed by routine methods, embedded in paraffin, sectioned at 3 microns, and prepared for fluorescence in situ hybridization using a probe targeting the 16S ribosomal RNA of the domain bacteria (i.e. targeting all bacteria regardless of species). Using fluorescence microscopy, the presence of bacteria within or on the surface of the endometrium and in the oviducts were noted. The endometrial biopsies from all cows (n = 21) contained bacteria, while 75% (16/21) of the cows had bacteria in one or both oviducts. The bacteria were located on the luminal surface and in the lamina propria in 38.1% (8/21) of the uterine biopsies. In the remaining 62% of the uterine biopsies, the bacteria were only located above the basal membrane. Regarding the oviduct biopsies, the bacteria were located on the luminal surface and in lamina propria in 9.5% (2/21) of the biopsies, whereas the bacteria were located only above the basal membrane in 90.5% of the biopsies. In conclusion, 1) bacteria are present in the uteri and oviducts of cows with pyometra and 2) the bacteria are primarily located on the luminal epithelia surface above the basal membrane. Further analyses will investigate which specific species of bacteria that are located in the lamina propria of the uterine and oviduct biopsies.

INTERSTITIAL PREGNANCY AFTER IPSILATERAL SALPINGECTOMY - CASE REPORT

Interstitial pregnancy is ectopic pregnancy which occurs within the intramural (interstitial) part of the uterine tube. The frequency of its occurrence is 3-4% of all ectopic pregnancies. It is also significant because of a long asymptomatic period and common ending with the rupture of the uterine horn as a serious complication. Mortality after this type of ectopic pregnancy is about 2,5%. This paper presents a case of a 29year-old patient hospitalized for suspected ectopic interstitial pregnancy in the left uterine horn. Her anamnesis showed the left tube pregnancy ended with salpingectomy after the rupture of the uterine tube. The patient was examined both clinically and by ultrasound, her s-HCG level was being monitored, and after an adequate preoperative preparation, she underwent a surgery. Surgical intervention consisted of the incision of pregnancy-altered uterine horn, curettage and evacuation of ovulary tissue, which saved the uterine horn. Timely diagnosis of interstitial pregnancy can prevent its possible serious complications. Acta Medica Medianae 2015;54(2):52-55.