An Unexpected Near Term Pregnancy in a Rudimentary Uterine Horn

Abstract

Unicornuate uterus occurs due to a complete or partial nondevelopment of one Mullerian duct; sometimes it is associated with a rudimentary horn, which can communicate or not with uterine cavity or contain functional endometrium. Pregnancy in a rudimentary horn is rare and the outcome almost always unfavorable, usually ending in rupture during the first or second trimester with significant morbidity and mortality. Despite the availability and advances on imagiologic procedures, recognition of this ectopic pregnancy is frequently made at laparotomy after abdominal pain and collapse. The authors describe a case of a primigravida with 34 weeks of gestation admitted with a preeclampsia with severity criteria. A cesarean for fetal malpresentation was done and, unexpectedly, a rudimentary horn pregnancy was found with a live newborn. In the literature, few reports of a horn pregnancy reaching the viability with a live newborn are described, enhancing the clinical importance of this case. A review of literature concerning the epidemics, clinical presentation, and appropriate management of uterine horn pregnancies is made.

Rupture of a Rudimentary Uterine Horn: A Case Report

“…Pregnancy in a rudimentary horn usually results in its rupture which can lead to a life-threatening heavy bleeding. That is an extremely rare condition 10-fold less common than abdominal pregnancy [3]. We describe a How to cite this paper: Didier, K.A., Roland, A.C., Joachim, K., Dénis, E.N., Charles, K., Alice, D.F., Victor, K.S.…”

Term Pregnancy with a Live Fetus in Non-communicating Rudimentary Horn with Placenta Percreta

“…Abnormalities of embryogenesis of mullerian duct system resulting in congenital anomalies of female genital tract are relatively common [1]. The prevalence of congenital uterine anomalies in the general population is 6.7 % [2].…”

“…Unicornuate uterus accounts for 5 % of all mullerian anomalies. Unicornuate uterus is thought to occur in general population at a rate of 1:4,020 [1]. Unicornuate uterus is a type II mullerian anomaly according to the American Fertility Society classification system [1,4] that occurs due to a complete or partial failure of development of one mullerian duct and incomplete fusion with contralateral side [1].…”

“…Unicornuate uterus is a type II mullerian anomaly according to the American Fertility Society classification system [1,4] that occurs due to a complete or partial failure of development of one mullerian duct and incomplete fusion with contralateral side [1]. The failed mullerian duct fusion leads to the formation of an isolated hemiuterus without a contralateral structure (in complete failure) to various degrees of a rudimentary horn (in partial failure) [1]. This rudimentary horn is subclassified into communicating or non-communicating with uterine cavity and a horn with no cavity [1].…”

“…The failed mullerian duct fusion leads to the formation of an isolated hemiuterus without a contralateral structure (in complete failure) to various degrees of a rudimentary horn (in partial failure) [1]. This rudimentary horn is subclassified into communicating or non-communicating with uterine cavity and a horn with no cavity [1]. In about 84 % of these cases, a contralateral rudimentary horn exists, almost always of a non-communicating type [1,5].…”