Rare case of live birth in a ruptured rudimentary horn pregnancy

Kawthalkar, Anjali; Gawande, Madhuri; Jain, Sudha; Joshi, Sulabha; Ghike, Sunita; Bhalerao, Anuja

doi:10.1111/j.1447-0756.2010.01497.x

Cited by 12 publications

(5 citation statements)

References 8 publications

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“…Gonçalves et al 10 reported a case where incidentally while taking the patient for caesarean due to malpresentation at 34 weeks, a live fetus was found in non-communicating rudimentary horn. Kawthalkar et al 11 also reported a case with a good neonatal outcome in a case of pregnancy in rudimentary horn. Another important differential to be kept in mind is cornual ectopic pregnancy.…”

Section: Discussionmentioning

confidence: 94%

Torsion and rupture of a non-communicating rudimentary horn in a 17-week gestation in a 16-year-old girl: lessons learnt

Kumar¹,

Das

Pandey

et al. 2018

BMJ Case Reports

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A unicornuate uterus with non-communicating rudimentary horn has always been notorious and poses threat to continuation of pregnancy with dismal consequences. We are reporting an interesting case of uterine malformation with a 90° rotation of uterine axis which ultimately ruptured during termination of pregnancy. The rarity in our case was not only conception in non-communicating horn but also the complete twisting of axis which made the pregnant horn come in front of the non-gravid unicornuate uterus, mimicking normal pregnancy. The most important lesson learnt is that if induction does not lead to cervical changes and uterine contractions, one must consider atypical presentations of an anomalous uterus as a possible differential before proceeding further.

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Section: Discussionmentioning

confidence: 94%

Torsion and rupture of a non-communicating rudimentary horn in a 17-week gestation in a 16-year-old girl: lessons learnt

Kumar¹,

Das

Pandey

et al. 2018

BMJ Case Reports

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“…4 In the literature, most cases are associated with labor procedures performed using agents for late termination. 5,6 Reports in which uterine rupture occurred spontaneously in the early trimesters are quite rare, 4 and the reported causes include uterine placenta percreta with or without a scarred uterus, 4,7,8 rudimentary horn pregnancy, 9,10 coronal resection because of previous ectopic pregnancy, 11,12 intrauterine anomaly, 13 and other conditions. [14][15][16][17] In this case, the placenta was attached to the posterior uterine wall, far from the previous incision.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2014

Am J Perinatol Rep

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A 31-year-old, gravida 4, para 2, woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of appendectomy during childhood and a right ovarian cystectomy at 24 years of age. Her obstetrical history began with a full-term spontaneous vaginal delivery followed by conization because of cervical cancer at 28 years of age. Her second pregnancy ended in a missed abortion at 7 weeks' gestation with dilation and curettage treatment. In her previous pregnancy at 30 years of age, she received a historyindicated Shirodkar cerclage at 15 weeks' gestation. The cerclage was removed electively at 36 weeks' gestation. Six days after the release, she was admitted for unexpected massive bleeding because of cervical laceration at the 9 o'clock position before labor, and an emergency transverse cesarean delivery was performed under a diagnosis of abruption. Fourteen months after the cesarean section, she became pregnant again.On admission, her general condition was quite stable. Her vital signs were as follows: pulse, 80 bpm; blood pressure, 108/70 mm Hg; and body temperature, 36.6°C. On abdominal examination, she reported pain in the entire abdomen; the pain was strongest around the right hypochondriac region with rebound tenderness. Bowel sounds were audible but weak. Pelvic examination showed normal secretions, no Keywords ► uterine rupture ► Shirodkar cerclage ► cesarean ► conization ► second trimester Abstract A pregnant woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of cesarean delivery for abruption after the removal of a Shirodkar cerclage that was placed because of cervical shortening caused by conization. She became pregnant again 14 months later. Ultrasonography revealed no significant findings, and a single intrauterine pregnancy with positive fetal heart activity was confirmed. An intestinal obstruction was suspected because abdominal radiography showed multiple air-fluid levels in the colon. Over the 3 hours following admission, her symptoms gradually worsened, and plain abdominal computed tomography (CT) showed a large hemorrhage in the abdominal cavity, but the uterine wall appeared intact at this time. Subsequently, dynamic CT revealed discontinuity of the uterine muscle layer. During laparotomy, uterine rupture with complete opening of the uterine wall at the site of the previous transverse scar was identified. A dead fetus was located within the amniotic sac in a blood-filled abdominal cavity. She received a total of 10 units of packed red blood cells and 6 units of fresh frozen plasma for the resuscitation. She was discharged on the eighth postoperative day without any complications.

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“…Cases of pregnancy progressing to third trimester and resulting in a live birth after caesarean section have also been documented. Pregnancy continued till term as abdominal after ruptured rudimentary horn of a unicornuate uterus and the placenta was attached in part to the myometrium of the horn deriving the blood supply for the live fetus 6–8. A very unusual case of twin pregnancy in a unicornuate uterus with one fetus in the non-communicating rudimentary horn has been reported where the outcome was successful birth of twins by caesarean section 4…”

Section: Discussionmentioning

confidence: 99%

Ruptured rudimentary horn at 22 weeks

Dhar

2012

Niger Med J

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Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in a non-communicating rudimentary horn is very difficult to diagnose before it ruptures. A case of undiagnosed rudimentary horn pregnancy at 22 weeks presented to Nizwa regional referral hospital in shock with features of acute abdomen. Chances of rupture in first or second trimester are increased with catastrophic haemorrhage leading to increased maternal and perinatal morbidity and mortality. Management of such cases is a challenge till today due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management is life saving in such cases.

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Rare case of live birth in a ruptured rudimentary horn pregnancy

Cited by 12 publications

References 8 publications

Torsion and rupture of a non-communicating rudimentary horn in a 17-week gestation in a 16-year-old girl: lessons learnt

Torsion and rupture of a non-communicating rudimentary horn in a 17-week gestation in a 16-year-old girl: lessons learnt

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Ruptured rudimentary horn at 22 weeks

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