Pregnancy termination via laparotomy in a woman with bicornuate uterus

Lazenby, Gweneth B.; Huang, Christopher T.F.; Rahall, Ann M.; Fogelson, Nicholas S.

doi:10.1016/j.contraception.2006.10.007

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Medical termination of pregnancy is preferred choice in mullerian duct anomaly, but in our case laprotomy was done as USG diagnosed it as ectopic pregnancy. 4 CONCLUSION Some mullerian anomalies are easily diagnosed, but others have unusual presentation that make diagnosis and therapy difficult. A good knowledge of basic embryology is important for understanding the pathogenesis and clinical features of anomalies.…”

Section: Discussionmentioning

confidence: 99%

Dilemma in diagnosis of pregnancy in didelphys uterus: a original case report

Sagar,

Dogra

2024

Int J Reprod Contracept Obstet Gynecol

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Uterine didelphys is a congenital defect of female genital system that arises from abnormal embryological development of mullerian ducts. A 30-year-old female G4P3L3A0 at 9 weeks POG with uneventful previous three normal term delivery presented to gynae OPD of JPCH for medical termination of pregnancy and tubal ligation. On per speculum examination, cervix was found to be healthy and on per vaginal examination the uterus was parous size. Right adnexa were free and non-tender but left adnexal mass 4´4 cm felt which was non tender. USG findings was suggestive of live left ectopic pregnancy of 8wks with no free fluid. Patient underwent laparotomy. Per-op findings-two separate uterus with right fallopian tube attached to right uterus and left fallopian tube attached to left uterus. Left uterus was enlarged to 8 weeks. Right uterus was normal in size. Both right and left ovaries were normal. Patient wanted MTP with ligation, suction and evacuation were performed. B/L tubal ligation was done by modified Pomeroy’s method. The postoperative period was uneventful and on day -8 stitch was removed.

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Section: Discussionmentioning

confidence: 99%

Dilemma in diagnosis of pregnancy in didelphys uterus: a original case report

Sagar,

Dogra

2024

Int J Reprod Contracept Obstet Gynecol

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“…Causes of failed abortion include poor technique, cervical stenosis, marked uterine anteversion or retroversion, endometrial distortion, uterine fibroids, very early gestational age, and uterine anomaly [7]. There are several reports on failed surgical termination in patients with uterine anomalies, including bicornuate uteri [8], non-communicating rudimentary horn [9,10], and septate uteri [7,11]. Failed surgical abortion was also reported in women with Robert's uterus, a rare variant of septate uterus consisting of a non-communicating hemicavity or a contralateral unicornuate uterine cavity in a single uterine body with a normal fundus [12].…”

Section: Discussionmentioning

confidence: 99%

Operative hysteroscopy-assisted pregnancy termination after failed surgical abortion in missed abortion of woman with complete septate uterus

et al. 2020

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First trimester surgical abortion is an effective and safe procedure. Although its failure is uncommon, congenital uterine anomaly may be considered as one of the etiologic factors in such cases. Here, we report a rare case of surgical abortion failure that was successfully managed by operative hysteroscopy-assisted dilatation and evacuation (D&E) under ultrasound guidance in a woman with complete uterine septum. The patient was referred to Severance Hospital after two consecutive surgical abortion failures even under ultrasound guidance. A missed abortion in a leftsided hemicavity of septate uterus was noted on ultrasonography. Ultrasound-guided D&E was unsuccessful because the curette could not reach the uterine cavity with the gestational sac. Operative hysteroscopy revealed insufficient communication with the left-sided cavity just above the cervical internal os of the uterine septum. After widening the communication, ultrasound-guided D&E was successfully performed.

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“…When diagnosed in the nonemergent setting, pregnancy in a rudimentary uterine horn should be considered ectopic and managed as an abnormal pregnancy due to the high risk of uterine rupture as well as other maternal complications [4]. Hysterotomy to evacuate a fetus in an anomalous uterus should be considered for advanced gestations and when alternative approaches fail [3, 9]. …”

Section: Discussionmentioning

confidence: 99%

Management of Second Trimester Fetal Demise in a Noncommunicating Uterine Horn

Hillman

Chin

Mody

2015

Case Reports in Obstetrics and Gynecology

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Müllerian anomalies are uncommon but when present they can increase the risk of obstetrical complications. Anomalies such as bicornuate and unicornuate uterus can also increase the surgical risks of pregnancy termination. The diagnostic approach and surgical management must be individualized for each patient so that the termination procedure is safe and preserves fertility. We present a case of a patient with a 17-week pregnancy with fetal demise in a noncommunicating right uterine horn. Laparotomy and hysterotomy were required for evacuation of the fetus. The use of appropriate imaging studies to diagnose suspected uterine anomalies and a flexible and individualized operative strategy are essential for reducing complications associated with the termination of abnormal or unintended pregnancies in women with Müllerian anomalies.

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Pregnancy termination via laparotomy in a woman with bicornuate uterus

Cited by 7 publications

References 5 publications

Dilemma in diagnosis of pregnancy in didelphys uterus: a original case report

Dilemma in diagnosis of pregnancy in didelphys uterus: a original case report

Operative hysteroscopy-assisted pregnancy termination after failed surgical abortion in missed abortion of woman with complete septate uterus

Management of Second Trimester Fetal Demise in a Noncommunicating Uterine Horn

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