Non-communicating rudimentary horn of a unicornuate uterus: clinical spectrum and diagnostic challenges: a case series

Karubaki Utkalika; Diptimayee Mohapatra; Benudhar Hui

doi:10.18203/2320-1770.ijrcog20251989

Authors

Karubaki Utkalika Department of Obstetrics and Gynaecology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
Diptimayee Mohapatra Department of Obstetrics and Gynaecology, Surakhya Nursing Home, Odisha, India
Benudhar Hui Department of Obstetrics and Gynaecology, Surakhya Nursing Home, Odisha, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251989

Keywords:

Müllerian duct anomalies, Uterine diseases, Pregnancy, Ectopic, Hematometra, Diagnostic imaging

Abstract

Pregnancy or hematometra in a non-communicating rudimentary horn of a unicornuate uterus is a rare and potentially life-threatening condition, often misdiagnosed due to its atypical presentation and resemblance to other pelvic pathologies. We report three cases highlighting the varied presentations and diagnostic challenges associated with rudimentary horn anomalies: a 28-year-old woman presented with persistent lower abdominal pain and bleeding following a failed medical termination of pregnancy. Imaging revealed a 12-week live gestation in a non-communicating rudimentary horn; a 36-year-old woman with chronic dysmenorrhea and a suspected subserosal fibroid was intraoperatively diagnosed with a rudimentary horn; and a 45-year-old perimenopausal woman with irregular menstrual cycle and an adnexal mass was found to have hematometra within a non-communicating rudimentary horn. Early diagnosis of rudimentary horn anomalies remains challenging. A high index of suspicion and appropriate imaging (MRI/3D ultrasound) are essential for accurate diagnosis and timely surgical intervention to prevent complications.

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