Hand-assisted Laparoscopic Management of a Midtrimester Rudimentary Horn Pregnancy with Placenta Increta: A Case Report and Literature Review

Contreras, Karenrose; Rothenberg, Jeffrey M.; Kominiarek, Michelle A.; Raff, G.J.

doi:10.1016/j.jmig.2008.06.008

Cited by 20 publications

(16 citation statements)

References 12 publications

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“…Unlike abdominal pregnancies, rudimentary horn pregnancies have a thin ring of myometrium that fits the placenta into the confines of the uterine horn, making it more identifiable [8].…”

Section: Discussionmentioning

confidence: 99%

“…This causes inadequate decidualization, thus leading to placenta accreta. The underdevelopment and poor distensibility of the myometrium and the propensity for abnormal placentation both contribute to the risk of uterine rupture in these cases [8].…”

Section: Discussionmentioning

confidence: 99%

“…These instruments provided for a relatively bloodless surgery despite the increased vascularity of the pregnant uterine horns [8,11]. Edelman et al used a morcellator, which required less operative time and eliminated the need for a posterior colpotomy or a larger suprapubic incision [12].…”

Section: Discussionmentioning

confidence: 99%

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Rupture of Non-Communicating Rudimentary Pregnant Uterine Horn in a Pseudo-Unicornuate Uterus with Placenta Increta at 27 Weeks of Amenorrhea

Hassani¹

2014

JGO

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Pregnancy in a non-communicating rudimentary horn is an extremely rare usually resulting in rupture during second trimester of pregnancy. The standard treatment is excision of the pregnancy and rudimentary horn. We report a case of ruptured non-communicating rudimentary horn at 27 weeks in a woman with previous vaginal delivery. She presented to emergency with acute abdominal pain and massive hemoperitoneum. Excision of the rudimentary horn was done at laparotomy and the patient had an uneventful recovery.

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“…Unlike abdominal pregnancies, rudimentary horn pregnancies have a thin ring of myometrium that fits the placenta into the confines of the uterine horn, making it more identifiable [8].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Rupture of Non-Communicating Rudimentary Pregnant Uterine Horn in a Pseudo-Unicornuate Uterus with Placenta Increta at 27 Weeks of Amenorrhea

Hassani¹

2014

JGO

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“…Lennox et al brought their specimen to the skin in an EndoCatch™ bag, then morcellated the tissues and extracted them with Beirer forceps [12]. Contreras et al performed laparoscopic amnioreduction for a 19-week RHP and used a hand-assist port through a 4-cm suprapubic incision to extract the specimen without morcellation [21]. Kadan and Romano placed their excised horn in an Endo bag, incised it and suctioned its contents laparoscopically; they then extended their right lateral incision slightly for extraction [18].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of an 11-week rudimentary uterine horn pregnancy using extracorporeal Roeder knot to secure the dilated vascular pedicle

2014

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Pregnancy in a uterine rudimentary horn carries a high risk of uterine rupture with severe and potentially lethal intra-abdominal haemorrhage. There is now growing evidence that this condition can be safely managed by minimally invasive surgery. We report a case of an unruptured 11-week rudimentary horn pregnancy that was diagnosed and treated laparoscopically. We have performed a literature review using PubMed, Embase and Cochrane Database of Systematic Reviews to identify relevant cases and draw conclusions with regards to their management. We have collated 20 published cases of rudimentary horn pregnancies that were managed by laparoscopy. The surgical technique appears consistent among these cases with few variations. In advanced gestations, feticide may need to be performed. Morcellation has been shown to be possible without compromising patient safety from trophoblast spill. The possibility of uncommon presentations such as duplicated or absent ureter should be taken into account. Extracorporeal Roeder knot can be used safely to secure unusually dilated vascular pedicles. Overall, laparoscopy appears to be as safe as and potentially superior to laparotomy for the management of rudimentary horn pregnancies.

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“…Women with uterine malformations have a higher risk of obstetric complications, including preterm labor (3). Prior knowledge of this condition would thus be valuable, but the sensitivity of ultrasound for diagnosing rudimentary horn pregnancies is only 29% (4). There are a few reports of rudimentary horn pregnancies proceeding to term, but immediate surgery is the standard treatment when the diagnosis is made.…”

mentioning

confidence: 99%

Second trimester pregnancy in a rudimentary uterine horn

Lauritsen¹,

Larsen²,

Johansen³

2010

Acta Obstet Gynecol Scand

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Hand-assisted Laparoscopic Management of a Midtrimester Rudimentary Horn Pregnancy with Placenta Increta: A Case Report and Literature Review

Cited by 20 publications

References 12 publications

Rupture of Non-Communicating Rudimentary Pregnant Uterine Horn in a Pseudo-Unicornuate Uterus with Placenta Increta at 27 Weeks of Amenorrhea

Rupture of Non-Communicating Rudimentary Pregnant Uterine Horn in a Pseudo-Unicornuate Uterus with Placenta Increta at 27 Weeks of Amenorrhea

Laparoscopic management of an 11-week rudimentary uterine horn pregnancy using extracorporeal Roeder knot to secure the dilated vascular pedicle

Second trimester pregnancy in a rudimentary uterine horn

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