Rudimentary horn pregnancy — ten years of experience

Abstract

Objectives:This study aimed to evaluate data on early diagnosis and therapeutic management of rudimentary horn pregnancy (RHP). Material and methods:Patients diagnosed with RHP at a tertiary center between for two periods of 2008-2012 and 2013-2018 were analysed retrospectively. We obtained information of patients from hospital electronic archive registration system. Data on demographic characteristics, clinical presentation, gestational age at presentation, presenting symptoms, diagnostic methods, and therapeutic management were noted and analysed by descriptive statistical method. Demographic datas, the complaint of patient's admission to hospital, history of cesarean section, preliminary diagnosis and intraoperative diagnosis were compared between periods of 2008-2012 and 2013-2018.Results: A total of 14 RHP patients were included. Eight (57.1%) of these patients were diagnosed between 2008-2012 (Group 1), whereas six patients (42.9%) were diagnosed between 2013-2018 (Group 2). Rudimentary horn was non-communicating in 13 patients (92.8%). Communicated form was observed in 1 patient in group 1. RHP was diagnosed on the left side in nine patients (64.2%). Six of these patients were observed in group 1 and 3 were in group 2. The pre-rupture diagnosis was made in 10 (71.4%) patients. Six (100%) of 10 patients were in group 2. In addition, in group 1, four patients (50%) experienced intraoperative RHP rupture. RHP was diagnosed before rupture in 2 (33.3%) patients in group 2. Conclusions:It is an indication of advanced ultrasonographic technology as well as increased carefulness on the physician side and raised alertness on the patient side that today both RHP and preoperative rupture of RHP are less frequent. Still, further awareness is required among physicians of the necessity of excision of a rudimentary horn that is detected at the time of C-section.

Successful Management of a Noncommunicating Rudimentary Uterine Horn Pregnancy by Laparoscopic Surgery

“…This lack of knowledge may lead to the high possibility of a life-threatening condition, namely, rudimentary uterine horn rupture. [ 5 11 57 ] On the other hand, when a prompt and accurate diagnosis is achieved, NCRHP can be treated less invasively by laparoscopic surgeries. [ 10 83 84 85 ] Since laparoscopic techniques have progressed considerably in the last few decades, especially in developed countries, the treatment methods have dramatically changed.…”

“…Finally, 72 reports were selected for our analysis. [ 7 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 ] Most of the articles were case reports, and we found 103 cases published from January 2000 to November 2020. Two reviewers (W.I.…”

“…[ 5 10 ] To treat these cases, emergency laparotomy is performed. Apart from detecting hypovolemic shock,[ 11 12 13 14 15 16 17 ] patients frequently have abdominal pain,[ 7 11 13 14 15 16 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 ] but some reports have indicated that only 8% of rudimentary horn pregnancies (RHPs) are diagnosed before the symptoms appear. [ 44 ] Sufficient knowledge seems necessary to detect NCRHP during early obstetric screening.…”

“…[ 56 ] However, a large review, which collected RHPs in the 20 th century, found that in 6.5% of all RHP cases, patients could obtain live newborn babies. [ 5 ] In addition, in the 21 st century, there are some cases in which patients could achieve live newborn babies by cesarean section,[ 11 23 26 35 44 57 58 59 60 61 62 63 64 ] although those situations may be extremely rare in the current developed countries. Thus, various situations should be considered when encountering NCRHP because its management would be affected by the different levels of obstetric medical care and diagnostic tools derived from individual countries, communities, or institutions.…”

Co-Existence of a Rudimentary Non-Communicating Horn with a Unicornuate Uterus in Association with 2 Components of the VACTERL Association: A Case Report

“…However, as endometriosis may be present in 20-40% cases and this is a very common condition, the diagnosis may be delayed [19]. A dedicated ultrasonography exam may be valuable in these circumstances to confirm the presence of a rudimentary horn and the extent of the functioning endometrium, but recently Magnetic Resonance Imaging has become crucial in the evaluation of Mullerian anomalies allowing for the simultaneous assessment of the anatomy, type of attachment between the rudimentary horn and the unicornuate uterus, and the study of the urinary tract as Mullerian anomalies are associated with renal anomalies in 40.5% cases and with one-sided renal agenesis in 28% [20][21][22][23].…”