Successful outcome in a perplexing case of Roberts uterus: a rare uterine anomaly, a rare case report with review of literature

Swati Singh, Renuka Malik, Pooja Gupta, Anjum Ara


Robert uterus is a rare Mullerian development anomaly with very few cases reports available. It presents with triad of morphologic features of - Blind hemi cavity with or without unilateral hematometra, contralateral unicornuate uterine cavity and normal uterine fundus with or without small external indentation. The major difficulty lies in making the diagnosis of Robert’s uterus. All the reported cases of Robert’s uterus have been managed differently according to patient’s complaints. A 25-year-old married female, resident of Agra presented to gynecology OPD of Dr RML Hospital and associated PGIMER in June 2013, with primary infertility and cyclical left sided dysmenorrhoea since menarche. Patient was consulting at her hometown Agra for 2 years and had an USG and MRI pelvis report of Feb. 2013 with her showing unicornuate uterus with rudimentary horn. Infertility investigations were done in our hospital. HSG report was of localized spill on right with left tubal block. Patient was posted for diagnostic hystero-laproscopy which was further followed by laprotomy, after which we could reach to a diagnosis of Robert uterus with non-communicating left cavity and with severe endometriosis. Patient needed a second hysteroscopy for lysis of septum and subsequently conceived with IVF. She delivered a healthy male baby of 2.65 kg by elective LSCS at 37 weeks with associated breech presentation with gestational hypertension with severe IHCP on 20 June 2019. Paediatric surgeons and gynecologists should be aware of this rare atypical obstructive Mullerian malformation and its management to avoid inappropriate management delays in these patients. A timely diagnosis and definite treatment have a great impact on future reproductive and endocrine function.


Hysteroscopic resection, Mullerian anomaly, Robert’s uterus, Septate uterus, Tomkins metroplasty, Unilateral dysmenorrhoea

Full Text:



Capito C, Sarnacki S. Menstrual retention in a Robert's uterus. J Pediatr Adolesc Gynecol. 2009;22(5):e104-6.

Benzineb N, Bellasfar M, Merchaoui J, Sfar R. Robert's uterus with menstrual retention in the blind cavity. J Gynaecol Obstet Biol Reprod. 1993;22(4):366-8.

Gupta N, Mittal S, Dadhwal V, Misra R. A unique congenital mullerian anomaly: Robert’s uterus. Arch Gynecol Obstet. 2007;276(6):641-3.

Benzineb N, Bellasfar M, Merchaoui J, Sfar R. Robert's uterus with menstrual retention in the blind cavity. J Gynecol Obstet Biol Repro. 1993;22(4):366-8.

Jayasinghe Y, Rane A, Stalewski H, Grover S. The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol. 2005;105:1456-67.

Acién P. Incidence of Müllerian defects in fertile and infertile women. Hum Reprod. 1997;12(7):1372-6.

Behr SC, Courtier JL, Qayyum A. Imaging of müllerian duct anomalies. Radiograph. 2012;32:E233-50.

Marcal L, Nothaft MA, Coelho F, Volpato R, Iyer R. Mullerian duct anomalies: MR imaging. Abdom Imaging. 2011;36(6):756-64.

Bermejo C, Ten MP, Cantarero R, Diaz D, Pérez Pedregosa J, Barrón E. Three-dimensional ultrasound in the diagnosis of Mullerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol. 2010;35(5):593-601.

Maddukuri SB, Karegowda LH, Prakashini K, Kantipudi S. Robert's uterus: a rare congenital müllerian duct anomaly causing haematometra. Case Reports. 2014;2014:bcr2014204489.

Chandra M, Pathak V. Pregnancy in non-communicating half of septate uterus. J Obstet Gynaecol India. 2012;62(Suppl 1):31.

Singhal S, Agarwal U, Sharma D, Sirohiwal D. Pregnancy in asymmetric blind hemi cavity of Robert's uterus--a previously unreported phenomenon. Eur J Obstet Gynecol Reprod Biol. 2003;107:93-5.

Ludwin A, Ludwin I, Bhagavath B, Lindheim SR. Pre-, intra-, and postoperative management of Robert's uterus. Fert Ster. 2018;110(4):778-9.

Li J, Yu W, Wang M, Feng LM. Hysteroscopic treatment of Robert's uterus with laparoscopy. J Obstet Gynaecol Res. 2015;41:1491-4.

Sardeshpande N, Chipalkatti P, Doctor J. Roberts uterus: a rare congenital anomaly. Int J Reprod Contracept Obstet Gynecol. 2017;6:5657-9.

Vural M, Yildiz S, Cece H, Camuzcuoglu H. Favourable pregnancy outcome after endometrectomy for a Robert's uterus. J Obstet Gynaecol. 2011;31(7):668-9.