Rudimentary Horn Of Unicornuate Uterus Research Articles

Single live 8 weeks ectopic pregnancy in rudimentary horn of unicornuate uterus

Female aged 26 years detected as single live pregnancy of 8 weeks in right tube. She was diagosed as right tubal ectopic and resent for confirmation of diagnosis to other Sonography centre as pregnancy grew upto 8 weeks with normal Foetal heart sound and if it was tubal would have ruptured earlier.

Acute maternal collapse in pregnancy with ruptured rudimentary horn of unicornuate uterus: A case report

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. It is associated with numerous obstetrics and gynecological problems such as Infertility, Endometriosis, Miscarriages, Malpresentations & Intrauterine growth restriction. Pregnancy in the non-communicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Pregnancy occurs via transperitoneal migration of sperm or zygote. Variable thickness of rudimentary horn musculature, poor distensibility of myometrium lead to rupture. This complication is usually seen in 2nd trimester resulting in shock and haemoperitoneum. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. It requires a high risk of suspicion. Materials and Methods: We report the case of 24yr primi gravida with 26 weeks of gestation presented with pain abdomen and sudden maternal collapse on arrival, suspected to be intra-abdominal pregnancy in ultrasound and on laparotomy found ruptured rudimentary horn of unicornuate uterus with fetus found intra-abdominally with massive hemoperitoneum. Conclusion: Pregnancies in rudimentary horn of unicornuate uterus are prone to intra uterine growth restriction and rupture in second trimester so a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during non-pregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.

Pregnancy in Non-communicating Rudimentary Horn of Unicornuate Uterus: A Case Report

A unicornuate uterus with a non-communicating rudimentary horn has always been a notorious uterine malformation threatening normal pregnancy continuation. Pregnancy in the rudimentary horn of the uterus is rare, but it plays an essential role in maternal morbidity and mortality. Early detection of rudimentary horn pregnancy is vital because poor musculature can lead to the dangerous complication of uterine rupture. When a Rudimentary horn pregnancy is diagnosed, surgical treatment to excision the horn with ipsilateral salpingectomy is recommended because of its high risk of rupture in the second trimester. We present a case of non-communicating rudimentary horn pregnancy that was terminated, and the rudimentary horn was resected.

Rudimentary Horn Pregnancy- A diagnostic dilemma

Abstract Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Half of them rupture, and 80% of the rupture occurs in first and second trimesters. Atrocious outcomes are reported. Horn pregnancy rarely reaches third trimester and when it does the diagnosis becomes more challenging. Ectopic in unicornuate rudimentary horn of uterus is difficult to diagnose even with best facilities available. Consequences are grave with slightest error of radiological and clinical judgment. Here we present case series of women who had rudimentary horn pregnancy and presented with varied clinical presentation, however they went undiagnosed even after radiological assessment and it lead to exaggerated maternal morbidity. The purpose is to spread awareness of all such rare cases where maternal and fetal wellbeing is jeopardized, and accentuates the significance of high index of suspicion in all such cases

Triaging of eccentric gestational sac in early pregnancy using two dimensional and three dimensional transvaginal ultrasound

AbstractObjectives: Interstitial ectopic pregnancy and pregnancy in arudimentary horn of a unicornuate uterus are rare forms of ectopic pregnancy but carry a high risk for maternal morbidityand mortality. Their diagnosis is challenging and can be misdiagnosed with less dangerous conditions; namely: angular pregnancy or pregnancy in one side of septate or bicornuate uterus.This study aimed to differentiate between these four situationsto allow early detection that will enhance the prognosis.Methods: This is a retrospective study, carried out on 26 patients referred to a private referral center for obstetric and gynecology sonography, in the period from November 2019 tillNovember 2020. All cases were referred due to unusual eccenteric location of the gestational sac. In each case we assessed3 variables using 2D -TVUS which were: relation to the endometrium , interstitial line sign and condition of the overlyingmyometrium. We assessed also 2 variables using 3D- TVUSwhich were: shape of the uterine cavity and the relation of thegestational sac to the uterotubal junction.Results: It was found that the gestational sac (GS) is withinthe endometrium in angular pregnancy and pregnancy in septate and bicornuate uterus while GS is outside the endometrial interface in interstitial ectopic pregnancy and pregnancy inrudimentary horn of unicornuate uterus. The interstitial linesign was +ve and the overlying myometrium was thin only ininterstitial ectopic pregnancy. Cavity was normal in angularand interstitial ectopic pregnancy but it has a Mullerian fusionanomaly in cases of pregnancy in rudimentary horn of a unicornuate uterus and cases with pregnancy in one side of a septateor bicornuate uterus. GS was lateral to the uterotubal junctionin interstitial ectopic pregnancy and pregnancy in rudimentaryhorn of unicornuate uterus but it was medial to it in the other 3situations.Conclusion: Our study described a simple triaging model basedon sonographic criteria for four pregnancy situations where thegestational sac appears eccenterically in the early 1st trimester.These four situations are namely; interstitial ectopic pregnancy,ectopic pregnancy in a rudimentary horn of a unicornuate uterus,angular pregnancy and pregnancy in one sideof a septate or bicornuate uterus. This modelwill be helpful for early accurate diagnosis toavoid false positive diagnosis that may lead tounnecessary intervention and false negativediagnosis that may lead to maternal morbidityor mortality.

A surprising presentation of a partial hydatidiform molar pregnancy in rudimentary horn of unicornuate uterus

A surprising presentation of a partial hydatidiform molar pregnancy in rudimentary horn of unicornuate uterus - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/j.ijogr.2019.087, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol Res

CHALLENGES OF DIFFERENTIAL DIAGNOSIS OF CONGENITAL UTERINE MALFORMATIONS


 
 
 A unicornuate uterus varies from 2.4 to 13% among Müllerian anomalies and most of them have rudimentary (functional) cavity. Patients with rudimentary horns that contain functional endometrium are at the risk of gynecological and obstetric complications such as ectopic pregnancy, hematometra, endometriosis and poor pregnancy outcomes. These reports describe two cases. One of them regards of a successful pregnancy in non- communicating rudimentary horn of unicornuate uterus and postpartum clinical manifestation of it and another one describes adenomyosis in rudimentary horn. In both cases were difficulties of differential diagnosis of uterus anomalies.
 
 

UNICORNUATE UTERUS WITH FUNCTIONAL RUDIMENTARY HORN: CLINICAL MANIFESTATIONS AND DIAGNOSTIC PROBLEMS (CLINICAL CASE)

A unicornuate uterus ranges from 1 in 1000 to 1 in 5400 women and 74-90% of them will have rudimentary uterine horn. Patients with non-communicating uterine horns that contain functional endometrium are at an increased risk of ectopic pregnancy, hematometra, hematosalpinx, endometriosis and poor pregnancy outcomes. This report describes a case of a successful pregnancy in non-communicating rudimentary horn of unicornuate uterus and postpartum clinical manifestation of it and difficulties of differential diagnosis of uterus anomalies.

Rupture of Non-communicating Rudimentary Horn of Unicornuate Uterus with Pregnancy

AbstractUnicornuate uterus with a non-communicating horn is a rare anomaly and even rarer pregnancy in its non-communicating horn. The incidence of pregnancy in the non-communicating horn is 1 in 76,000 to 1 in 150,000. Due to non-compliant uterine musculature in the non-communicating horn, it is prone to rupture in cases of pregnancy. The rupture occurs usually in the second trimester. We describe a case which presented with the rupture of non-communicating horn with live fetus inside it. The present case had a 22 week fetus floating in the peritoneal cavity following the rupture of non-communicating horn with normal other uterine horn.

Ruptured Ectopic Pregnancy in Rudimentary Horn of Unicornuate Uterus

Ruptured Ectopic Pregnancy in Rudimentary Horn of Unicornuate Uterus

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.

Rupture of Non-communicating Rudimentary Horn at 28 Weeks of Pregnancy in Previously Scarred Uterus: A Diagnosis in Disguise

Pregnancy in non-communicating rudimentary horn of unicornuate uterus is an uncommon form of ectopic pregnancy usually resulting in rupture during second trimester with grave consequences for the mother and fetus. We report a case of ruptured non-communicating rudimentary horn at 28 weeks of gestation in woman with previous Caesarean section in unicornuate uterus. She presented to emergency with pain abdomen since four days. Laparotomy was done and the rudimentary horn excised. Post-operative recovery was uneventful. High index of suspicion of uterine anomaly and its early diagnosis in cases of second trimester rupture is required to save this catastrophic event.

English

A 16-year-old woman was admitted to the emergency room due to severe lower abdominal pain. She had no surgical or obstetric history. Menarche had occurred 2 years ago. She suffered from dysmenorrhea and pelvic cyclic pain during menstruation. The three-dimensional computed tomography combined with ultrasonography revealed a rudimentary horn of unicornuate uterus. We performed a laparoscopic removal of this uterine anomaly without any complication in the post-operative period. Laparoscopy resulted in anatomical and reproductive outcome equivalent to those offered by a laparotomic approach, and minimally invasive surgery had additional advantages such as, better cosmetic results and postoperative period, which are important for very young patients.   Key words: Uterus, laparoscopy, Imaging three-dimensional, tomography x-ray computed.

Advanced pregnancy loss in the rudimentary horn of an undiagnosed unicornuate uterus

A case of advanced pregnancy loss in the rudimentary horn of a unicornuate uterus is presented herein. The unknown uterine malformation and advanced pregnancy resulted in the condition being incorrectly diagnosed on ultrasound. After a failed attempt at dilatation and curettage, a correct diagnosis was made and proper treatment was given during salvage laparotomy performed for arising complications (coagulopathy).

Adenomyosis in a noncommunicating rudimentary horn of unicornuate uterus - a diagnostic dilemma

The prevalence of congenital uterine malformations is about 0.5%.Unicornuate uterus is a rare anomaly of the female internal genitalia (2.5-13%) [ 1 ]. Partial development of one of the mullerian ducts may result in anomalies in various combinations whereby one of the horns may remain rudimentary with or without any communication with its fellow [ 1 ]. Complications related to this condition are related to its presentation during different phases of life of a woman. We present a case of adenomyosis in the noncommunicating laterally displaced rudimentary horn which gave us a primary impression of solid ovarian tumor.

RUPTURE OF RUDIMENTARY HORN OF UTERUS AT 16 WEEKS OF GESTATION

Rupture of gravid uterus is a rare but serious obstetric complication. Rupture in primigravida in firstor second trimester generally occurs in mullerian anomalies. A 24-year-old, primigravida, at 16 weeks gestationpresented with dull, lower abdominal pain, and tachycardia. She underwent D&C for the presumptive diagnosis ofmissed abortion few days’ back. Chronic ectopic pregnancy was diagnosed on the basis of history & examination, andher laparotomy was planned. Upon laparotomy, right-sided ruptured ectopic pregnancy in rudimentary horn ofunicornuate uterus was found & ruptured horn was excised. The patient had uneventful recovery.

Management of un-ruptured pregnancy in a rudimentary horn of unicornuate uterus at 14 weeks gestation

We present a case of missed miscarriage in an unsuspected non communicating rudimentary horn on a unicornuate uterus. The difficulties of the diagnosis and management of such congenital malformation are described.