unicornuate uterus
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2022 ◽  
Vol 9 (3) ◽  
pp. 8-11
Author(s):  
Pranay Kumar Madasi ◽  
Arshad Rajmohammed Shaikh

Abstract Background: Due to the high prevalence and possible impact on the reproductive health of the of woman, congenital uterine malformation of female genital tract is a challenge for the therapeutic decision-making process. The current study aimed to evaluate the morphological anomalies of the uterus as observed by modern investigation techniques. Methods: This cross-sectional observational study was done in Prathima Institute of Medical Sciences, Nagnoor, Karimnagar, Telangana state. Women who were infertile and anxious to conceive and women were subjected to 2D ultrasound Screening followed by Hysterosalpingography. Those women who were fertile and found to have uterine anomalies and needed reconfirmation of the provisional diagnosis were subjected to Hysterosalpingography. Results: Out of n=300 cases studied n=288 (96%) were with normal uterine anatomy and n=12 (4%) cases were detected with uterine malformations as seen by USG. N=5 (40.5%) had a Bicornuate Uterus. While uterus didelphys and unicornuate uterus were seen in n=2 (16.67%) each. Arcuate uterus, uterine septum, uterine Aplasia/Hypoplasia were seen in n=1(8.33%) women each respectively. Conclusion: Due to the psychological consequences associated with infertility, the effects of uterine anomalies on the life of women are very important. It is critical to know the exact nature of the anomaly, to plan for the most appropriate treatment modality. As most of these anomalies cannot be rectified by medical management, they need surgical correction. For optimal results, it is important to know the exact type of anomaly for surgical correction. The 2D USG can be recommended as the basic modality to evaluate uterine anomalies. HSG/MRI may be used to delineate detail of anomalies if initially detected by the 2D scan.


2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Xiao Chen ◽  
Chunhui Xiao ◽  
Xueling Zhang ◽  
Yu Liang ◽  
Xihui Zhu ◽  
...  

Unicornuate uterus has a low incidence,it is a congenital uterine developmental anomaly, it has many complications during pregnancy, and it is less common in pregnancy to term. This article retrospectively analyzes a case of unicornuate uterus with a full-term vaginal trial of labor and delivery with placental abruption resulting in neonatal asphyxia. We also present the typology of unicornuate uterus, diagnosis, and discuss the mode of delivery in the light of the literature, in order to raise awareness of this type of disease among medical professionals and reduce the occurrence of adverse pregnancy outcomes.


2021 ◽  
Vol 3 (3) ◽  
pp. 78-82
Author(s):  
Gülnaz Şahin ◽  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Erol Tavmergen

Objective: We aimed to evaluate the obstetric and neonatal outcomes of singleton pregnancies at risk for preterm birth (PTB) following assisted reproductive treatments and underwent cervical cerclage placement. Material and methods: A total of 42 women with singleton pregnancies following ART who underwent cerclage between 2009-2021 were included in this retrospective study.  Indications of the cerclage procedure, gestational age at cerclage placement and delivery, neonatal birthweight, and requirement for admission to the neonatal unit of newborns were evaluated. Results: Of those cerclage placement performed in women with a history of second-trimester loss (19%), women with suspected cervical insufficiency according to pre-pregnancy evaluation (52.4%), women with the unicornuate uterus (4.8%), women with cervical shortening/or suspicious changes on ultrasonography (11.9%), and women with detection of cervical dilatation/shortening beyond 20 weeks of gestation (11.9%). Of the total group, 7.1% resulted in late miscarriages, while the remaining 92.9% ended with a live birth with mean gestational age at delivery of 37.0±2.5 weeks. Of those live births, 92.3% (36/39) delivered at >34 weeks and %74.4 (29/39) delivered at term. Except one neonatal death due to extremely PTB at 26th weeks, all infants were discharged from the hospital with well condition. Conclusion: ART pregnancies are evaluated as a special group as having a higher PTB risk at baseline. Cerclage may be considered in broader indications for suspected cervical insufficiency in these pregnancies. There is need for further studies on the effectiveness of cerclage in these ART pregnancies with suspected cervical insufficiency based on different criterions used.


2021 ◽  
pp. 1-4
Author(s):  
Zuhdi Khalid Nagshabandi ◽  
Bindu Isaac ◽  
Inshia Begum

Congenital uterine anomalies are an uncommon type of female genital malformations caused by abnormal development of müllerian ducts during embryogenesis. Patients with an obstructive uterine anomaly have a higher risk of developing gynecological and obstetric complications that may present at menarche or later in life. We present a case of severe dysmenorrhea in a young teenager caused by obstructive hematometra in a noncommunicating horn of the unicornuate uterus. A differential diagnosis of a possible anomaly was made using 2-dimensional pelvic ultrasonography, which was later confirmed using MRI that revealed an anomalous uterine cavity with a single left-sided cornua communicating with the cervix and a distended right-sided rudimentary horn. She underwent a right salpingectomy with rudimentary horn excision, which was successfully managed laparoscopically. This case emphasizes the importance of physicians being cognizant in identifying patients with uterine anomaly to provide appropriate treatment and prevent adverse reproductive outcomes.


2021 ◽  
Vol 12 (5) ◽  
pp. 344-350
Author(s):  
Ahmad Badeghiesh ◽  
Angelos G Vilos ◽  
Haitham Baghlaf ◽  
Jana Abi Rafeh ◽  
Nabigah Alzawawi ◽  
...  

Objective: To investigate reproductive and neonatal outcomes in women with unicornuate uterus. Study design: Data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database were extracted from 2010 through 2014 to create a delivery cohort using ICD-9 codes. Code 752.33 was used to identify cases with unicornuate uterus and reproductive outcomes were compared to pregnancies without unicornuate uterus. A multivariate logistic regression model was used to adjust for statistically significant variables (P-value<0.05). Results: Among 3,850,226 deliveries during the study period, 802 women had unicornuate uterus. Patient with unicornuate uterus were more likely to be older (P<0.001), have thyroid disease (P<0.001), previous Caesarean section (P<0.001), and to have had in-vitro fertilization (IVF) (P<0.001). The risk of gestational diabetes, pregnancy induced hypertension, gestational hypertension and preeclampsia were significantly greater in the unicornuate uterus group relative to controls, after controlling for baseline risk factors; aOR 1.32 [95% CI 1.03–1.71], aOR 1.46 [95% CI 1.16–1.85], aOR 1.16 [95% CI 1.22-2.28] and aOR 1.70 [95% CI 1.24-2.32], respectively. Also, the rates of preterm delivery, preterm premature rupture of membranes and caesarean section were higher in the unicornuate uterus group compared to controls after controlling for confounding factors, aOR 3.83 (95% CI 3.19–4.6), aOR 5.11 (95% CI 3.73–7.14) and aOR 11.38 (95% CI 9.16–14.14) respectively. At birth, 11.1% and 2.6% of neonates were small for gestational age in the unicornuate uterus and the control groups, respectively, aOR 4.90, (95% CI 3.87-6.21). Conclusion: Women with unicornuate uterus are at higher risk for pregnancy complications, preterm delivery and having small for gestation age neonates. Women with known unicornuate uterus may benefit from increased surveillance to prevent and/or decrease maternal and neonate morbidity and mortality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Makiko Ueda ◽  
Kuniaki Ota ◽  
Toshifumi Takahashi ◽  
Satoshi Suzuki ◽  
Daisuke Suzuki ◽  
...  

Abstract Background Pregnancy in a rudimentary horn is an extremely rare type of ectopic pregnancy. A rudimentary uterine horn pregnancy is associated with a risk of spontaneous rupture and bleeding during surgery due to the increased uterine blood flow. Recent advances in imaging modalities have enabled laparoscopic surgery to be performed in cases without rupture in the early stages of pregnancy. However, there are few reports of successful pregnancies and deliveries after treatment of rudimentary horn pregnancies. We report the successful management of a case of non-communicating rudimentary horn pregnancy by local injection of methotrexate followed by complete laparoscopic excision along with a review of the literature. Case presentation The patient was a 29-year-old Japanese woman, gravida 2, nullipara. She was diagnosed with a left unicornuate uterus with a right non-communicating rudimentary horn on hysterosalpingography and magnetic resonance imaging. A gestational sac with a heartbeat was observed in the right rudimentary uterine horn at 6 weeks of gestation. A diagnosis of ectopic pregnancy in a non-communicating rudimentary horn was made. Color Doppler detected multiple blood flow signals around the gestational sac, which were clearly increased compared to the left unicornuate uterus. Her serum human chorionic gonadotropin level was 104,619 mIU/ml. A 100 mg methotrexate injection into the gestational sac was administered, and laparoscopic surgery was performed on day 48 after the methotrexate treatment. The right rudimentary horn and fallopian tube were successfully excised with minimal bleeding. A spontaneous normal pregnancy was established 6 months after the surgery. The pregnancy was uneventful, and a baby girl was born by elective cesarean section at 38w0d. Conclusion Combined local methotrexate injection and laparoscopic surgery are safe treatment options for patients with a unicornuate uterus with a non-communicating rudimentary horn pregnancy.


2021 ◽  
Vol 58 (S1) ◽  
pp. 49-49
Author(s):  
B. Bracco ◽  
L. De Braud ◽  
T. Tellum ◽  
J. Knez ◽  
D. Jurkovic

Author(s):  
Jose D Roman ◽  
Jose D Roman

The prevalence of congenital uterine anomalies has been reported as 6.7% in the general population. The unicornuate uterus accounts for 2.4-13% of all Mullerian anomalies and has a prevalence of 1:1000. A unicornuate uterus may be present alone or with a rudimentary horn and 75-90% of rudimentary horns are non-communicating. A pregnancy in the rudimentary horn may lead to uterine rupture, haemoperitoneum with a high risk of maternal mortality. The association of a unicornuate uterus with a non-communicating uterine horn to the VACTERL association of defects (vertebral anomalies, anorectal malformations, cardiovascular anomalies, tracheoesophageal fistula, esophageal atresia, renal anomalies and limb defects) has been described only twice in the literature. We report a patient who was born with an extra thumb and had a trachea-bronchial remnant with oesophageal stenosis that were both operated on earlier, and they were associated with a non-communicating rudimentary uterine horn. To the best of our knowledge, this is the third case reported in the literature of a VACTERL association to a unicornuate uterus with a non-communicating functional rudimentary horn. Given the high risk for the patient if pregnant an early diagnosis is paramount. This case highlights the importance of considering Mullerian defects in the young patient born with components of the VACTERL association.


2021 ◽  
pp. 8-9
Author(s):  
Keerthi Somi Reddy Gari ◽  
Y. Lakshmi Nalini ◽  
Sowjanya Sowjanya

Unicornuate uterus belongs to class U4 or Hemi-uterus classication according to the European society of human reproduction and embryology (ESHRE). The incidence of Hemi-uterus is 1-2 %. It is associated with fetal survival of 40%. Kyphoscoliosis is an abnormal curvature of the spine in both coronal and sagittal planes. Prevalence varies from 0.3% to 15.3%. We present a case of 27 years, unbooked primigravida with 34 weeks gestation with leaking per vagina and pain abdomen with breech presentation. She had short stature and kyphoscoliosis. During caesarean section she was found to have unicornuate uterus with absent left fallopian tube and ovary.


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