Pregnancy in a Ruptured Non-communicating Rudimentary Horn: A Case Report

Authors

  • Fauzia Akhund Aga Khan University
  • Huma Syed Hussain Aga Khan University
  • Salman Haq Aga Khan University
  • Warda Maqsood Aga Khan University
  • Iffat Ahmed Aga Khan University

DOI:

https://doi.org/10.36283/PJMD13-3/025

Keywords:

Rudimentary horn, Mullerian duct anomaly

Abstract

The rudimentary horn is a Müllerian duct anomaly. In instances of pregnancy within a non-communicating rudimentary horn, timely diagnosis is imperative to prevent life-threatening complications. Ultrasound only demonstrates 26-33% sensitivity, leading to misdiagnoses for tubal, intrauterine, or abdominal pregnancies. We present a case of a 20-year-old female, gravida 2 para 1 (G2P1), who conceived spontaneously while experiencing constant mild lower abdominal pain throughout the earlier stages of pregnancy. Pregnancy in non-communicating rudimentary horns advanced to twenty weeks of gestation. The diagnosis was made when the horn ruptured, resulting in hemoperitoneum and hemodynamic instability. An emergency exploratory laparotomy was performed, uncovering a complete rupture of the pregnant rudimentary horn, leading to hemi-hysterectomy and removal of the left fallopian tube. The rudimentary horn was completely ruptured and lacked direct communication with the right unicornuate uterus cavity. The diagnostic and management challenges associated with rudimentary uterine horn highlight the need for heightened vigilance to prevent associated morbidity.

Keywords: Pregnancy, Rudimentary, Uterus; Müllerian anomaly.

Author Biographies

  • Fauzia Akhund, Aga Khan University

    Obstetrics and Gynecology Department

  • Huma Syed Hussain, Aga Khan University

    Paediatrics and Child Health Department

  • Salman Haq, Aga Khan University

    Biological and Basic Sciences Department

  • Warda Maqsood, Aga Khan University

    Obstetrics and Gynecology Department

  • Iffat Ahmed, Aga Khan University

    Obstetrics and Gynecology Department

References

Arvindar, Sen S, Bilwal B. Spectrum of rudimentary horn pregnancy: a case series. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023;12(8):2524-2529. DOI: 10.18203/2320-1770.ijrcog20232303

Ma YC, Law KS. Pregnancy in a Non-Communicating Rudimentary Horn of Unicornuate Uterus. Diagnostics (Basel). 2022;12(3). DOI: 10.3390/diagnostics12030759

Zhang Y, Pang Y, Zhang X, Zhao Z, Liu P. Full-term pregnancy in a rudimentary horn with a live fetus: A case report. Medicine (Baltimore). 2020;99(34):e21604. doi:10.1097/MD.0000000000021604

Sarikaya S, Aybay MN. Uterine rupture of a patient with rudimentary horn pregnancy at 26th gestational weeks. Int J Surg Case Rep. 2022; 94:107003. DOI: 10.1016/j.ijscr.2022.107003

Ueda M, Ota K, Takahashi T, Suzuki S, Suzuki D, Kyozuka H, et al. Successful pregnancy and term delivery after treatment of unicornuate uterus with non-communicating rudimentary horn pregnancy with local methotrexate injection followed by laparoscopic resection: a case report and literature review. BMC Pregnancy Childbirth. 2021;21(1):715. DOI: 10.1186/s12884-021-04195-5

Houmaid H, Hilali A. Rupture of Rudimentary Horn Pregnancy at 16 Weeks of Gestation. Case Rep Obstet Gynecol. 2021; 2021:8829053. doi:10.1155/2021/8829053

Walker C, Collins L, Pham A, George J, Johnson S. Avoiding the fatal misdiagnosis of pregnancy in a noncommunicating rudimentary horn using 3D transvaginal ultrasound. J Clin Ultrasound. 2020;48(9):553-556. DOI: 10.1002/jcu.22836

Bidiga S, Henry K, Augustino O, Mujuni F, Matovelo D, Ndaboine E, et al. Rudimentary horn pregnancy, a differential diagnosis of an intraabdominal pregnancy: a case report. J Med Case Rep. 2023;17(1):210. DOI: 10.1186/s13256-023-03882-5

Rodrigues A, Neves AR, Castro MG, Branco M, Geraldes F, Aguas F. Successful management of a rudimentary uterine horn ectopic pregnancy by combining methotrexate and surgery: A case report. Case Rep Womens Health. 2019;24:e00158. DOI: 10.1016/j.crwh.2019.e00158

Li X, Peng P, Liu X, et al. The pregnancy outcomes of patients with rudimentary uterine horn: A 30-year experience. PLoS One. 2019;14(1):e0210788. doi:10.1371/journal.pone.0210788

Monacci F, Lanfredini N, Zandri S, Strigini F, Luchi C, Giannini A, et al. Diagnosis and laparoscopic management of a 5-week ectopic pregnancy in a rudimentary uterine horn: A case report. Case Rep Womens Health. 2019;21:e00088. DOI: 10.1016/j.crwh.2018.e00088

Candiani M, Ciappina N, Fedele F, Bergamini V, Ferdinando Ruffolo A, Parazzini F. Laparoscopic Removal of Nonseparated Cavitated Horn in Unicornuate Uterus: Surgical Aspects and Long-Term follow-up. Int J Fertil Steril. 2023;17(2):145-150. DOI: 10.22074/ijfs.2022.543827.1231

Sonmezer M, Taskin S, Atabekoglu C, Gungor M, Unlu C. Laparoscopic management of rudimentary uterine horn pregnancy: case report and literature review. JSLS. 2006;10(3):396-399.

Downloads

Published

2024-08-01

How to Cite

1.
Akhund F, Hussain HS, Haq S, Maqsood W, Ahmed I. Pregnancy in a Ruptured Non-communicating Rudimentary Horn: A Case Report. PJMD [Internet]. 2024 Aug. 1 [cited 2024 Oct. 6];13(3):179-82. Available from: https://ojs.zu.edu.pk/pjmd/article/view/2636

Similar Articles

11-20 of 20

You may also start an advanced similarity search for this article.