Ruptured rudimentary horn pregnancy: a case report
Keywords:Ectopic pregnancy, Hemi-uterus, Ruptured rudimentary horn pregnancy, Unicornuate uterus
Uterine anomalies are congenital malformations arising due to embryological mal-development of mullerian ducts. The European society of Human Reproduction and Embryology (ESHRE) classifies these anomalies into 6 classes. Hemi-uterus is one such class of formation defect of mullerian duct with unilateral uterine development; the contralateral part could be either incompletely formed or absent. In a rare form of ectopic pregnancy, implantation can occur in the cavity of a rudimentary horn of the hemi-uterus. Authors report a case of 22-year G2P1L1 with 12 weeks gestation who presented with acute abdomen. Ultrasound showed hemoperitoneum with suspicion of ectopic pregnancy. Laparotomy confirmed the diagnosis of ruptured right rudimentary horn with fetus and placenta in the peritoneal cavity. Immediate laparotomy and excision of the horn with transfusion of blood and blood products saved the patient in the nick of time.
Grimbizis GF, Gordts S, Sard ADS, Brucker S, Angelis CD. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. J Human Reprod Gynecol Surg. 2013;28(8):2032-44.
Development of female reproductive organs and related disorders. In: Kumar S, Padubidri VG, Daftary SN (Eds). Howkins and Bourne SHAW’S textbook of gyanecology. 17th Edition. Gurgaon, Haryana, India: Relix India private limited; Copyright; 2018.
Ambusaidi Q, Jha C. Pregnancy in the rudimentary uterine horn: Case report of an unusual presentation. Sultan Qaboos Univ Med J. 2014;14(1):e134-e138.
Dhar, Hansa. Ruptured rudimentary horn at 22 weeks. Nigerian Med J. 2012;53(3):175-7.
Jain R, Gami N, Puri M, Trivedi SS. A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. J Hum Reprod Sci. 2010;3:113-5.
Chowdhury S, Chowdhury T, Azim E. Pregnancy in a non-communicating rudimentary horn of uterus: a clinical case report. Bangladesh Med J. 2010;39(1):47-8.
Goverdhan NA, Patankar A. Ruptured ectopic pregnancy in rudimentary horn. Int J Reprod Contracept Obstet Gynecol. 2016;5:1247-50.
Tsafrir A, Rojansky N, Sela HY, Gomori JM, Nadjari M. Rudimentary horn pregnancy: First‐trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging. J Ultrasound Med. 2005;24(2):219-23.