scholarly journals Unicornuate uterus: case reports of heterogenous presentations challenging clinical diagnosis and management

2021 ◽  
Vol 10 (6) ◽  
pp. 2514
Author(s):  
Swati Trivedi ◽  
Santosh Khokher ◽  
Prasoon Rastogi ◽  
Vinod Kumar Dhaka
Keyword(s):  
Case Reports ◽  
Haemorrhagic Shock ◽  
Lower Abdomen ◽  
Pregnant Uterus ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Trimester Pregnancy ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Lateral Fusion

Unicornuate uterus is an anomaly arising from defective lateral fusion of incompletely developed mullerian duct or paramesonephric duct with the contralateral duct. Pregnancy in non-communicating rudimentary horn can result in I and II trimester pregnancy losses along with maternal morbidity and mortality. Here we describe three such cases of unicornuate uterus with non-communicating rudimentary horn pregnancy, who presented to our hospital with pain in lower abdomen. Two of them with II trimester pregnancy landed in haemorrhagic shock owing to rupture of pregnant horn, though were revived by immediate intervention. Third patient who came with a definitive diagnosis of I trimester rudimentary horn pregnancy was managed electively by hemi-hysterectomy. Rupture of pregnant uterus can occur in II trimester when associated with uterine anomaly. Early sonographic diagnosis has a major offering in workup, management and prevention of mother from grave life threatening consequences.

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

scholarly journals A rare case of unicornuate uterus with non communicating rudimentary horn containing functional endometrium

2018 ◽  
Vol 7 (12) ◽  
pp. 5182
Author(s):  
Priyanka Priyanka ◽  
Harbhajan Shergill ◽  
Romi Bansal ◽  
Mohini Aggarwal
Keyword(s):  
Severe Pain ◽  
Rare Case ◽  
Lower Abdomen ◽  
Rare Type ◽  
Mullerian Anomalies ◽  
Rudimentary Horn ◽  
Müllerian Anomalies ◽  
Unicornuate Uterus ◽  
Chief Complaints ◽  
Multiple Episodes

Unicornuate uterus with rudimentary horn is a rare type of anomaly. The incidence is approximately 1/100,000. Mullerian anomalies are associated with many obstetrical and gynecological complications. Non-communicating and functional rudimentary horn can cause severe pain in abdomen due to accumulation of the blood causing its distension. Authors report a case of 25 years old patient with unicornuate uterus with non-communicating rudimentary horn containing functional endometrium presenting with chief complaints of severe pain in lower abdomen associated with multiple episodes of vomiting.

scholarly journals A rare case of pregnancy in the rudimentary horn of unicornuate uterus (on table diagnosis): a case report

2019 ◽  
Vol 8 (3) ◽  
pp. 1190
Author(s):  
Suman Kumari ◽  
Pratiksha Gupta ◽  
Jyoti . ◽  
Pooja Sharma
Keyword(s):  
Surgical Excision ◽  
Contralateral Side ◽  
Incomplete Fusion ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Ectopic Gestation ◽  
Mullerian Ducts ◽  
Life Threatening ◽  
Failed Induction

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.

scholarly journals An unusual case of ruptured noncommunicating rudimentary horn pregnancy at 10 weeks

2020 ◽  
Vol 9 (2) ◽  
pp. 839
Author(s):  
Kiran Pande ◽  
Angela Yadav
Keyword(s):  
Maternal Morbidity ◽  
Unusual Case ◽  
Incomplete Fusion ◽  
Second Trimester ◽  
Catastrophic Event ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Maternal Morbidity And Mortality ◽  
Mullerian Ducts ◽  
High Index Of Suspicion

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 10 weeks 3 days in a woman. She had a routine USG before pregnancy in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So, a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality.

scholarly journals Ruptured Noncommunicating Rudimentary Horn Pregnancy at 19 Weeks with Previous Cesarean Delivery: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sita Thakur ◽  
Ajay Sood ◽  
Chanderdeep Sharma
Keyword(s):  
Cesarean Delivery ◽  
First Trimester ◽  
Incomplete Fusion ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Laparoscopic Excision ◽  
Maternal Morbidity And Mortality ◽  
Mullerian Ducts ◽  
High Index Of Suspicion ◽  
Previous Cesarean

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. 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 nonpregnant 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.

scholarly journals A Case of Ruptured Rudimentary Horn of Uterus during Pregnancy

2020 ◽  
Vol 32 (2) ◽  
pp. 121-123
Author(s):  
Ruman U ◽  
Khanam K ◽  
Akhter S ◽  
Karim R
Keyword(s):  
Abdominal Pain ◽  
Gestational Age ◽  
Hypovolemic Shock ◽  
Emergency Laparotomy ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Severe Haemorrhage ◽  
Life Threatening ◽  
History Of ◽  
Threatening Situation

Pregnancy in a rudimentary horn of an unicornuate uterus is a rare and life threatening situation for mother and fetus. Usually pregnancy continues upto approximately 18-20 weeks of gestational age. Then it usually ruptures and severe haemorrhage ensues. Emergency laparotomy is the treatment of choice. Here we report a case of 36 years woman with secondary subfertility who has history of taking ovulation inducing drug. She presented with 20 weeks amenorrhoea with severe abdominal pain and hypovolemic shock. Urgent laparotomy was done and the diagnosis was confirmed. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 121-123

scholarly journals Rupture of Non-communicating Rudimentary Horn Pregnancy at 15 Weeks with Previous Normal Pregnancies: A Case Report

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Sanyukta Rajbhandary ◽  
Anamika Das ◽  
Mausam Rai ◽  
Archana Kumari Sah
Keyword(s):  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Intrauterine Pregnancy ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Maternal Morbidity And Mortality ◽  
Important Diagnostic Tool ◽  
Mullerian Anomaly ◽  
Low Sensitivity ◽  
High Index Of Suspicion

Rudimentary horn is a mullerian anomaly that is a variant of unicornuate uterus. Rudimentary horn pregnancies are rare and associated with increased maternal morbidity and mortality. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with previous vaginal delivery is challenging. Although ultrasonography is an important diagnostic tool, it has low sensitivity in making diagnosis of ruptured rudimentary horn pregnancy. Therefore, clinicians should have high index of suspicion in such cases. We report a case of G3P2L2 at 15 weeks period of gestation referred to our centre as a case of intrauterine pregnancy with acute abdomen. She underwent emergency laparotomy and was found to have ruptured rudimentary horn intraoperatively. Excision of the ruptured rudimentary horn and ipsilateral salpingectomy was done and the patient had an uneventful postoperative recovery.

scholarly journals Ruptured Rudimentary Horn Pregnancy: Two Case Reports

2016 ◽  
Vol 29 (2) ◽  
pp. 116-119
Author(s):  
Irin Parveen Alam ◽  
Mahbuba ◽  
Quorrta Eynul Forhad
Keyword(s):  
Case Reports ◽  
Contralateral Side ◽  
Clinical Suspicion ◽  
High Index ◽  
Incomplete Fusion ◽  
Mullerian Duct ◽  
Rudimentary Horn ◽  
Complete Development ◽  
Unicornuate Uterus

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one Mullerian duct and incomplete fusion of the contralateral side. Pregnancy in rudimentary horn is rare and carries grave consequences to both mother and fetus. Here two case reports have been presented, both the cases were diagnosed after laparotomy. Diagnosis before rupture is challenging. So high index clinical suspicion and role of ultrasonography, resuscitation and laparotomy is necessary to prevent catastrophe.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(2) : 116-119

Sonographic diagnosis of uncomplicated first-trimester pregnancy in the rudimentary horn of a unicornuate uterus

2007 ◽  
Vol 36 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Kishor Taori ◽  
Bimal Kumar Saha ◽  
Deepal Shah ◽  
Narottam Khadaria ◽  
Vijay Jadhav ◽  
...  
Keyword(s):  
First Trimester ◽  
Sonographic Diagnosis ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

Unicornuate Uterus with NonCommunicating Non-Cavitated Rudimentary Uterine Horn: An Unusual Case with Adenomyosis Managed with Total Hysterectomy

2015 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Medical Treatment ◽  
Unusual Case ◽  
Uterine Bleeding ◽  
Uterine Horn ◽  
Rudimentary Horn ◽  
Total Hysterectomy ◽  
Unicornuate Uterus ◽  
Ultrasound Evaluation ◽  
Rudimentary Uterine Horn

A 45-year-old woman admitted to our hospital complaining of perimenopausal uterine bleeding not responding to medical treatment. Ultrasound evaluation revealed unicornuate uterus with adenomyosis and it was so difficult to see the distant small left rudimentary horn on ultrasound. The patient underwent laparotomy with total hysterectomy for both horns and was sent to pathologist that indicated adenomyosis and non-communicating non-cavitated left rudimentary horn.

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