Bicornuate uterus and obstetrical complications repeated: what’s solution for a better obstetrical prognosis into a developing country of Africa?

Abstract

Author report one case of bicornuate uterus and pregnancy in a patient who had a preterm delivery in her medical history. The support for the pregnancy was a cerclage of the cervix, bi-monthly prenatal consultation, a systematic work stoppage. The removal of cerclage was conducted at 37 weeks of amenorrhea. Childbirth is done vaginally. We didn’t realize restorative surgery of the uterus before pregnancy or after. The aim of our clinical case was to clarify the therapeutic possibilities in an African developing country. Moreover, the formation of an expert team for surgery of uterine malformations should be considered in our work environment.

Site of pregnancy obstetrician’s dilemma

“…Bicornuate uterus is known to be associated with several obstetric complications; some of them include recurrent pregnancy loss, foetal malpresentation, intrauterine growth restriction, preterm labour and increased need for operative intervention including caesarean section. [7][8][9] We retrospectively analysed our patient and it is possible that at the time of her caesarean section the pregnancy was in the right horn of the uterus and due to the physiological hypertrophy of the gravid horn, the left horn along with the left fallopian tube being underdeveloped was not apparent to the operating surgeon, thereby mislabelling the patient as Class II D ASRM, Unicornuate Uterus without rudimentary horn. This case highlights the importance of a detailed abdominal and pelvic exploration in case of an incidentally detected Mullerian anomaly during caesarean section in order to correctly classify the anomaly which may have a bearing on the future Gynaecological and obstetric outcome of patients.…”