scholarly journals Rudimentary Horn Pregnancy Diagnosed after Laparotomy

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Kurabachew Mengistu ◽  
Tufa Bobe ◽  
Gashaw Tilahun ◽  
Kibru Kifle ◽  
Dereje Geleta

Müllerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and a unicornuate uterus is observed in 0.4% of women. The uterus is normally formed during embryogenesis by the fusion of the two Müllerian ducts. If one of the ducts does not develop, only one Müllerian duct contributes to the uterine development. We report a case of Gravida II, abortion I referred from a primary hospital with a referral paper and sonography stating she had IUFD. She had regular antenatal care follow-up at the primary hospital and had 8 months of amenorrhea. Our ultrasound assessment confirmed the intrauterine fetal demise, but the rudimentary horn pregnancy was missed. Repeated attempts at the induction of labor were tried but unsuccessful. The diagnosis was confirmed at laparotomy. She underwent cesarean section with right intact rudimentary horn removal. A nonviable male fetus with birth weight of 1.2 kg was delivered. Women with this abnormality are asymptomatic and unaware of having a unicornuate uterus. Abdominal pain is the most common presenting symptom with the rudimentary horn, but communicating horn pregnancy is generally asymptomatic in early pregnancy. Early awareness of this rare clinical condition is so crucial especially in developing countries where the availability of new technologies is scarce to explore uterine abnormalities. The patient had uneventful postoperative recovery and was discharged after 3 postoperative days.

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Deepa V. Kanagal ◽  
Lokeshchandra C. Hanumanalu

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. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. Timely laparotomy, excision of the horn, and blood transfusion saved the patient.


Author(s):  
Suman Kumari ◽  
Pratiksha Gupta ◽  
Jyoti . ◽  
Pooja Sharma

A rudimentary horn with a unicornuate uterus results due to failure of the complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in non-communicating rudimentary horn of unicornuate uterus is a rare form of ectopic gestation and it carries grave consequences for mother and the fetus. The most dreaded complication is rupture during pregnancy which can be life threatening to the mother. The continuation of pregnancy is rare till 3rd trimester and usually ruptures in 2nd trimester. The primary strategy of the management is surgical excision of the rudimentary horn. Here is a case of 24year old, gravida1 with unruptured rudimentary horn pregnancy at gestational age 28 weeks diagnosed on table. IOL (induction of labour) was done with misoprostol for fetal demise and later cesarean section done in view of failed induction. Laparotomy was done and dead fetus with placenta delivered followed by excision of the rudimentary horn. The post-operative period was uneventful. This highlights the need   of an increased awareness of this condition especially in developing countries where most pregnancy are unbooked and uninvestigated as in present case.


1970 ◽  
Vol 2 (1) ◽  
pp. 59-62
Author(s):  
Suniti Rawal ◽  
Josie Baral ◽  
Meeta Singh ◽  
Samira Khan ◽  
Beemba Shakya ◽  
...  

A unicornuate uterus with functioning and non communicating rudimentary horn is a rare Mullerian abnormality, difficult to diagnose at times usually low in the list of differential diagnosis for pelvic pain and dysmenorrhea. A 22 years P1 presented with severe lower abdominal pain and dysmenorrhoea, following laparotomy that was done for endometriotic cyst of left ovary 7 months back. Radiographic studies revealed the haematometra in the rudimentary horn with normal uterus, right ovary and the tube. Laparotomy with drainage of haematometra and excision of septum along with the reconstruction of uterine cavity was performed thus anatomizing it with the cavity of the rudimentary horn. Both the intra and the post operative period were uneventful. She was discharged on OCP along with the advice to follow up regularly. She is asymptomatic till date. Key words: Endometriosis, haematometra, rudimentary horn doi:10.3126/njog.v2i1.1480 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 59 - 62 May -June 2007


2019 ◽  
Vol 52 (02) ◽  
pp. 246-249
Author(s):  
K. Preetha Rani ◽  
J. Satish Kumar ◽  
V. Singaravelu ◽  
Fernandes Deyonna

Abstract Background With increasing radicality of rectal cancer surgeries, the postoperative defects are becoming more complex. This demands an ideal reconstructive option with minimal morbidity to the patient. Although vertical rectus abdominis myocutaneous (VRAM) flap is the commonly used flap, gracilis myocutaneous flap is increasingly being performed to avoid morbidity associated with VRAM flap. Results We share our experience about two of our patients treated for rectal malignancy with pelvic exenteration who were reconstructed immediately with pedicled gracilis myocutaneous flap. Both the patients had an uneventful postoperative recovery period and were discharged on postoperative day 10. During follow-up period both patients had a healthy flap with no evidence of recurrence. No perineal hernias or gross dehiscence of skin closure occurred. Conclusion Gracilis myocutaneous flap has its own place with unique advantages adding to the armamentarium of reconstructive options for complex perineal defects, thereby avoiding the morbidity associated with VRAM flap. It stands as a reliable alternative in patients where VRAM cannot be used.


2021 ◽  
Vol 2 (1) ◽  
pp. 1-5
Author(s):  
Sule MB ◽  
◽  
Sa’idu SA ◽  
Ma’aji SM ◽  
Danfulani M ◽  
...  

Unicornuate uterus is a form of uterine anomalies which arise from failure of development and fusion of the Mullerian ducts, and accounts for about 2.4-13% of all Mullerian anomalies. This is a 30-year-old housewife referred for hysterosalpingography (HSG) on account of secondary infertility. The patient also had history of recurrent abortion in the first trimester. The HSG showed an ellipsoidal or Banana shaped uterus in the left lateral pelvic cavity with prominent left fallopian tube that showed peri-fimbrial spillage of contrast medium with non-demonstration of a communicating rudimentary horn. She also had a pelvic ultrasound that showed an empty uterus with a right hypoechoic solid area most likely the right rudimentary horn. We report the radiologic features of Unicornuate uterus due to its rare nature and peculiar presentation


Author(s):  
Arti Anand ◽  
Madhuri Chandra ◽  
Meeta Agarwal

Congenital malformations of the female genital tract occur in about 8-10% of all women. The unicornuate uterus is a result of partial or complete agenesis of one of the paired Mullerian ducts. It could be a true unicornuate uterus or along with a rudimentary horn, which may be functional. When the rudimentary functional horn is non-communicating, most patients become symptomatic after menarche or present with pregnancy related problems. Three clinical presentations of unicornuate uterus with non-communicating rudimentary horn encountered in last one year are described. The first case was of unruptured rudimentary horn pregnancy of 11-12 weeks. Second case had rudimentary horn removed as an adolescent due to intractable pain, but later main uterus harboured an uneventful pregnancy. Case three had two early abortions, followed by term caesarean section for fetal distress. With advent of ultrasonography and other imaging techniques, the diagnosis and management of unicornuate uterus and its variations is possible. The functional rudimentary horn if symptomatic must be removed along with ipsilateral tube. A unicornuate uterus is associated with obstetric problems and such women should be considered as high risk pregnancy.


Author(s):  
Jaydip Hindocha ◽  
Sneh Sonaiya

Unicornuate uterus with a rudimentary horn is an anomaly of the mullerian duct and is an extremely rare condition. This condition results when one of the paired mullerian ducts fails to fuse completely. Its incidence is estimated to be one in 76,000 pregnancies.Pregnancy in the rudimentary horn of the unicornuate uterus is difficult to diagnose on ultrasound and can be easily missed out. Hence the pregnancy usually gets detected after rupture when the mother presents with the complaint of severe abdominal pain. This is a case report of a 24 year old G2P1A0L1 female who presented to us with complaints of tenderness in the left iliac fossa and mild abdominal distention. Clinical examinations, radiological investigations, and exploratory laparotomy revealed a unicornuate uterus with an unruptured left rudimentary horn pregnancy at 14 weeks with mild hemoperitoneum. Following the exploratory laparotomy, excision of the left rudimentary horn and thorough peritoneal lavage was performed.


2019 ◽  
Vol 3 (1) ◽  

Introduction: A unicornuate uterus with a rudimentary horn is a uterine anomaly resulting from the incomplete development of one of the Müllerian ducts and an incomplete fusion with the contralateral side. Pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. It carries grave consequences for the mother and fetus as the diagnosis may be missed and subsequently result in an emergency due to spontaneous rupture of the enlarging rudimentary horn and massive intraabdominal bleeding. The standard treatment is the surgical excision of the rudimentary horn. The authors present a case of a rare recurrent rudimentary horn pregnancy that contained a viable pregnancy diagnosed in first trimester and managed with complete excision of the rudimentary horn along with the pregnancy in-situ.


2020 ◽  
Vol 12 (5) ◽  
pp. 167-170
Author(s):  
Aigerim Kvarantan ◽  
Gorazd Poje ◽  
Livije Kalogjera

Aims: Inadequate surgical frontal sinus drainage in chronic sinusitis cases refractory to conservative treatment results in a poor clinical response and is associated with recurrent frontal recess stenosis. Endonasal frontal sinus drainage procedures are classified according to Draf into three groups: DrafIIb enables unilateral orbit to septum drainage and the IIc is the extension of the IIb across the midline. The purpose of our report is to review chronic sinusitis cases treated at our Department using the standard (IIb) or modified (IIc) procedure and compare results. Methods: Patient- and surgery-related data were retrieved on patients operated between 2013 and 2016 for chronic frontal sinusitis using the standard/modified DrafIIb procedure.The modified IIb (i.e. IIc) procedure was performed so that both frontal sinus ostia were visualized by performing an intersinusseptectomy: the aim was to provide drainage to both frontal sinuses simultaneously. Results: In the observed period, 26 patients were treated: 12 using the modified DrafIIb (IIc) and 14 using the standard DrafIIb procedure. There were no significant differences between groups regarding age, sex, number of previous procedures or follow-up period. All patients had an uneventful postoperative recovery and there were no cases of re-stenosis observed in the DrafIIc group; there were seven cases of restenosis in the DrafIIb group.


Author(s):  
Liva Wijaya

Objective: To report the congenital abnormalities of müllerian duct and review its literature. Methods: Case report. Case: A sixteen years old unmarried woman came to our policlinic with chief complain of cyclical abdominal pain (VAS 6). She had regular menstruation. In other hospital, she had diagnosed as suffering from ovarian tumor. Our examination showed that the uterus was unicornuate with rudimentary horn. We did explorative laparotomy. We took out the left cornu and left salpingoophorectomy due to hematosalphing and endometrial cyst. The Visual analogue score after surgery was reduced until VAS 2. Conclusion: Congenital abnormalities of the müllerian ducts are relatively common. Comprehensive examination can diagnose this abnormality earlier, thus intervention can be given as soon as possible. [Indones J Obstet Gynecol 2013; 1-4: 215-8] Keywords: abnormalities müllerian ductus, endometriosis


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