Pre-rupture diagnosis and management of rudimentary horn pregnancy in the first trimester

Kriplani, Alka; Relan, Supriya; Mittal, Suneeta; Buckshee, K

doi:10.1016/0028-2243(95)80024-m

Cited by 30 publications

(18 citation statements)

References 5 publications

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“…A gestational sac surrounded by myometrium by the side of a normal empty uterus and non-communication of gestational sac with the endometrial cavity and the cervix differentiates it from pregnancy in one of the horns of a bicornuate uterus. 6,8,10 MRI and CT scan are also gaining popularity for diagnosing uterine malformations. Both clinically and radiologically the diagnosis is more accurate in the early first trimester when the two horns are separate in the pelvis.…”

Section: Discussionmentioning

confidence: 99%

A study of complications in case of unicornuate uterus with rudimentary horn

Kamal¹,

Roy²

2017

Int J Reprod Contracept Obstet Gynecol

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Background: To analyse gynecological and reproductive morbidities associated with unicornuate uterus with noncommunicating rudimentary horn.Methods: This is a retrospective study of 20 cases of unicornuate uterus with noncommunicating rudimentary horn found on laparotomy in a duration of 5 years (Oct 2011-Oct 2016).Results: Out of 20 patients, two teenagers presented with dysmenorrhoea and pain abdomen and had haematometra in the noncommunicating rudimentary horn which was excised. Eight had pregnancy in the noncommunicating rudimentary horn of which all presented after rupture and five were admitted in a state of shock. Ten patients had pregnancy in the hemiuterus with complications inherent to the condition.Conclusions: Unicornuate uterus with noncommunicating rudimentary horn is associated with poorest outcomes among all uterine anomalies and a high index of suspicion is needed to diagnose this condition and thus to save the woman from catastrophic complications.

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Section: Discussionmentioning

confidence: 99%

A study of complications in case of unicornuate uterus with rudimentary horn

Kamal¹,

Roy²

2017

Int J Reprod Contracept Obstet Gynecol

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“…Ultrasound can confirm RHP by revealing pregnancy circumscribed by a variable thickness of myometrium. This myometrial thickness is not seen in tubal ectopic pregnancy (10). Three dimensional ultrasound can be of special help in detecting mullerian anomalies.…”

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confidence: 82%

Rudimentary Horn Pregnancy: A Rare First Trimester Acute Presentation

P¹,

Brajendra²,

Pallav³

2015

IJWHR

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Introduction: Rudimentary horn pregnancy (RHP), an entity with a diagnostic dilemma is known to rupture most commonly in second trimester, sometimes in early third trimester. This case of ectopic rudimentary horn (RH) presented acutely in the first trimester. Case Presentation: A 30 years old G 3 P 2 L 2 with previous two vaginal deliveries presented with acute abdominal pain and features of hemorrhagic shock at 8 weeks 5 days gestational age. With clinical diagnosis of ruptured ectopic pregnancy, the patient immediately underwent laparotomy, which revealed hemoperitoneum with a unicornuate uterus along with ruptured RHP. RH excision with ipsilateral salpingectomy and right tubal ligation was done and the maternal life salvaged. Conclusion: High index of suspicion based on clinical history and examination complemented with diagnostic radiological modalities can help in prenatal and pre-rupture diagnosis of RHP, hence its prompt treatment to alleviate scope of any emergency situation and the disastrous consequences leading to maternal morbidity and mortality.

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“…There are only few case reports on prerupture diagnosis of rudimentary horn ectopic. 11,12 Tsafrir et al suggested the ultrasound criteria for diagnosis of rudimentary horn pregnancy: (1) pseudo pattern of an asymmetrical bicornuate uterus, (2) absent visual continuity between the cervical canal and the lumen of the pregnant horn, and (3) the presence of myometrial tissue surrounding the gestational sac. Presence of hyper vascularization typical to placenta accrete may additionally support the diagnosis of rudimentary horn pregnancy.…”

Section: Discussionmentioning

confidence: 99%