Rudimentary horn is a mullerian anomaly that is a variant of unicornuate uterus. Rudimentary horn pregnancies are rare and associated with increased maternal morbidity and mortality. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with previous vaginal delivery is challenging. Although ultrasonography is an important diagnostic tool, it has low sensitivity in making diagnosis of ruptured rudimentary horn pregnancy. Therefore, clinicians should have high index of suspicion in such cases. We report a case of G3P2L2 at 15 weeks period of gestation referred to our centre as a case of intrauterine pregnancy with acute abdomen. She underwent emergency laparotomy and was found to have ruptured rudimentary horn intraoperatively. Excision of the ruptured rudimentary horn and ipsilateral salpingectomy was done and the patient had an uneventful postoperative recovery.
Introduction: Birth defect refers to any abnormality of physical structure or form or function of prenatal origin, whether genetic or not, which is present at birth. Congenital birth defect is one of the causes of perinatal morbidity and mortality especially in developed countries. Studies of congenital birth defects are useful to establish baseline data, document changes over time and identify clues to etiology. This study was aimed to determine the overall prevalence of newborns with congenital birth defects, outcomes of those babies at birth, modes of delivery as well as various organ systems involved. Methods: It is a short term observational study conducted in the Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan from July, 2016 to December, 2016 after ethical approval. All the intramural deliveries after 22 weeks of gestation in six months were looked for gross congenital birth defects soon after birth through meticulous examination. Antenatal sonographic documentation of fetal anomalies was noted and correlated after birth. The birth defects were categorized according to the ICD10 th Revision of birth defects. Results: During the study duration, there was a total of 6,496 births out of which 26 babies had birth defects. All the babies were delivered to mothers of age less than 35 years with no history of parental consanguinity. 11 (42.3%) babies were born to mothers with no folic acid supplementation and three (11.5%) babies had ambiguous sex. Most of them (22; 84.6%) were alive at birth and majority of them born vaginally (19; 73.0%) and had normal birth weight (18; 69.2%). Majority of them had defects detected incidentally after delivery (19; 73.0%) and were non-lethal. The most common birth defect was related to central nervous system (12; 46.15%). Conclusions: In this study, the prevalence of congenital birth defects was 0.4%. Majority of the birth defects (73.0%) were detected after delivery. Most of the babies with defects (84.6%) were alive at birth and non-lethal. The most common birth defects were related to central nervous system (46.15%). Hence, preconceptional counselling and folic acid supplementation are recommended for prevention, termination for lethal defects and surgical repairs of non-lethal defects for viable newborns after delivery.
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