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 Pregnancy in Noncommunicating Rudimentary Horn of Unicornuate Uterus: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Melese Gezahegn Tesemma
Keyword(s):  
Ectopic Pregnancy ◽  
Hypovolemic Shock ◽  
Emergency Laparotomy ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Ultrasound Evaluation ◽  
Compatible Blood ◽  
High Index Of Suspicion ◽  
Time Of Presentation ◽  
Rule Out

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. Both prerupture and postrupture diagnosis of ectopic pregnancy in the rudimentary horn of a unicornuate uterus is difficult. Here is a case of a 21-year-old gravida 5 para 3 abortion 1 mother presented with abdominal pain of 2 days duration following a falling accident. The patient was severely anemic and was in hypovolemic shock at the time of presentation. She had diffused lower abdominal tenderness with hemoperitonium. After clinical and ultrasound evaluation, emergency laparotomy was decided for preop diagnosis of ruptured cornual ectopic pregnancy to rule out uterine rupture at gestational age of 16 weeks. Intraoperatively, ruptured ectopic pregnancy in noncommunicating rudimentary horn was diagnosed. Resection of rudimentary horn and ipsilateral salpingectomy was done. She was transfused with 5 units of compatible blood. It is better to increase awareness about pregnancy occurring in this rare uterine anomaly, so as to have a high index of suspicion as early detection before it gets ruptured is difficult.

scholarly journals Ruptured Rudimentary Horn Pregnancy at 25 Weeks with Previous Vaginal Delivery: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Deepa V. Kanagal ◽  
Lokeshchandra C. Hanumanalu
Keyword(s):  
Vaginal Delivery ◽  
Contralateral Side ◽  
Incomplete Fusion ◽  
Second Trimester ◽  
Intrauterine Pregnancy ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Mullerian Ducts ◽  
High Index Of Suspicion

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.

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 Laparoscopic Approach of a Unicornuate Uterus with Noncommunicating Rudimentary Horns

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Lidia Rosi Medeiros ◽  
Daniela Dornelles Rosa ◽  
Fabio Rosa Silva ◽  
Bruno Rosa Silva ◽  
Maria Ines Rosa
Keyword(s):  
Pelvic Pain ◽  
Congenital Anomalies ◽  
Laparoscopic Approach ◽  
Incomplete Fusion ◽  
Arrested Development ◽  
Rudimentary Horn ◽  
Diagnosis And Management ◽  
Unicornuate Uterus ◽  
Mullerian Anomaly ◽  
Successful Approach

Background. Müllerian duct malformations delineate a miscellaneous group of congenital anomalies that result from arrested development, abnormal formation, or incomplete fusion of the mesonephric ducts. Case. This paper describes the diagnosis and management of a noncommunicating rudimentary horn complicated by severe pelvic pain and associated endometriosis. Conclusion. This condition was diagnosed by laparoscopy and hysteroscopy examination. Operative videolaparoscopy proved to be a successful approach for the treatment of this congenital Müllerian anomaly.

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
Keyword(s):  
New Technologies ◽  
Postoperative Recovery ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uneventful Postoperative Recovery ◽  
Mullerian Ducts ◽  
Primary Hospital ◽  
Ultrasound Assessment

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.

scholarly journals Ruptured Ectopic Pregnancy in Accessory Horn

2016 ◽  
Vol 2 (4) ◽  
pp. 70-72
Author(s):  
Suhasini Akash ◽  
B Sindhura ◽  
Sailakshmi LNU
Keyword(s):  
Ectopic Pregnancy ◽  
Preterm Labor ◽  
Intrauterine Growth Retardation ◽  
Postoperative Recovery ◽  
High Rate ◽  
Emergency Laparotomy ◽  
Type Ii ◽  
Second Trimester ◽  
Intrauterine Growth ◽  
Unicornuate Uterus

ABSTRACT Pregnancy in an accessory horn is rare. The incidence of uterine congenital anomalies: Müllerian defects in the normal fertile population are 3.2%. Incidence in pregnancy is 1 in 76,000 to 150,000 pregnancies. There are chances of high rate of spontaneous abortion, preterm labor, intrauterine growth retardation, intraperitoneal hemorrhage, and uterine rupture. Unicornuate uterus is a type II classification with unilateral hypoplasia or agenesis. It can be further classified into communicating, noncommunicating, without cavity, and unicornuate uterus. Mother and fetus are at grave risk due to rupture of horn in second trimester of pregnancy. We report a case of ruptured accessory horn pregnancy at gestation of 18 weeks. Emergency laparotomy was done and the accessory horn was excised. Patient's postoperative recovery was uneventful. How to cite this article Sindhura B, Sailakshmi, Akash S. Ruptured Ectopic Pregnancy in Accessory Horn. J Med Sci 2016;2(4):70-72.

scholarly journals MULLERIAN DUCT ANOMALIES;

2012 ◽  
Vol 19 (05) ◽  
pp. 723-729
Author(s):  
SARWAT ARA ◽  
TASNEEM ALI
Keyword(s):  
Renal Agenesis ◽  
Case Series ◽  
Mullerian Duct ◽  
Unilateral Renal Agenesis ◽  
Müllerian Duct ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Müllerian Duct Anomalies ◽  
Mullerian Duct Anomalies ◽  
High Index Of Suspicion

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.

scholarly journals A Case of Rare Mullerian Anomaly—Functional Rudimentary Uterine Horn: As an Unusual Cause of Unilateral Dysmenorrhea in Postmenarchal Adolescent Girl

2012 ◽  
Vol 4 (1) ◽  
pp. 56-58
Author(s):  
Rekha Choudhary ◽  
Suniti Verma ◽  
Asha Meena ◽  
Sitaram Gothwal
Keyword(s):  
South Asian ◽  
Adolescent Girl ◽  
Chronic Pelvic Pain ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Uterine Horn ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Rudimentary Uterine Horn ◽  
Mullerian Anomaly

ABSTRACT An 18-year-old girl presented with progressively increasing dysmenorrhea. A pelvic mass was suspected which on exploratory laparotomy was found to be a rudimentary horn (hematometra, hematosalpinx). We report a case of unicornuate uterus with functioning rudimentary horn to highlight that mullerian duct anomalies should be considered in the differential diagnosis of severe dysmenorrhea even in normally menstruating girls. Unicornuate uterus with a rudimentary horn is susceptible to many gynecologic and obstetric complications. Hematometra, chronic pelvic pain, endometriosis, infertility are some of the complaints in women with unicornuate uterus. How to cite this article Choudhary R, Verma S, Meena A, Gothwal S. A Case of Rare Mullerian Anomaly—Functional Rudimentary Uterine Horn: As an Unusual Cause of Unilateral Dysmenorrhea in Postmenarchal Adolescent Girl. J South Asian Feder Obst Gynae 2012;4(1):56-58.

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