Congenital Uterine Anomalies and Uterine Rupture

Abstract

Congenital uterine anomalies are more common than previously recognized. While many women will have no symptoms or problems, some women with congenital uterine anomalies have increased risks of adverse outcomes during pregnancy. This article presents a case study of a woman with a congenital uterine anomaly leading to spontaneous rupture of her unscarred uterus remote from term. The most common types of congenital uterine anomalies and their associated reproductive risks are reviewed. Evaluation of congenital uterine anomalies and management alternatives are discussed.

Diagnosis and Management of Congenital Uterine Anomalies in Pregnancy

“…31 One case report describes a 19-year-old woman with diagnosis of didelphys uterus made at 10 weeks' gestation, who presented at 19 weeks' gestation with spontaneous rupture of the left uterine horn, placenta percreta, and her previable fetus floating in her abdominal cavity. 32 A similar case is reported after an induction of labor with misoprostol at 18 weeks for anhydramnios. The patient developed severe pain and was noted to have free abdominal fluid on bedside ultrasound.…”

Pregnancy in Non-Communicating Unicornuate Uterus: Diagnosis Difficulty and Outcomes – a Case Report

“…However, the diagnosis is unlikely before the anomaly causes reproductive problems, and the diagnosis is usually made as an incidental finding during a routine prenatal ultrasound. 8 The first line diagnostic modality to investigate pelvic pathologies is transvaginal ultrasonography. 8 Yet, due to its sensitivity, the ultrasound detects less than three fourths of the cases, and this detection declines as the pregnancy advances.…”

“…8 The first line diagnostic modality to investigate pelvic pathologies is transvaginal ultrasonography. 8 Yet, due to its sensitivity, the ultrasound detects less than three fourths of the cases, and this detection declines as the pregnancy advances. 9 According to Goel et al 6 , only 5% of the reported cases of rudimentary horn pregnancies were diagnosed preoperatively.…”

“…The MRI has become the gold standard for the evaluation of congenital uterine anomalies. 8 When pregnancy occurs, characteristics such as the variable thickness of the rudimentary horn musculature, a dysfunctional endometrium, and poor distensibility of the myometrium lead to the life-threatening condition usually observed during the second trimester of gestation: rupture of the rudimentary horn. 6 In a study conducted by Goel et al 8 between April of 1994 and March of 2004 with 18 patients diagnosed by laparotomy with unicornuate uteri with non-communicating rudimentary horns, 7 patients had pregnancies in the noncommunicating rudimentary horns, and, 5 presented in a state of shock due to rudimentary horn rupture.…”

Rotura uterina: uma revisão de literatura

“…A maioria das parteiras nunca verá uma RU espontânea, mas verá as mulheres que lutam com as sequelas de anomalias congênitas uterinas. As parteiras e outros prestadores de cuidados de saúde das mulheres devem ter o conhecimento e a capacidade de ajudar a orientar essas mulheres através do processo de diagnóstico, ajudá-los a lidar com as implicações para a maternidade, fornecer recursos à medida que consideram opções de tratamento e apoiá-los emocional e psicologicamente à medida que eles vêm com anomalia congênita 31 . Uma visão mais global da pelve materna, busca de sinais secundários e documentação da localização fetal dentro do útero é necessária para evitar erros de diagnóstico e atraso na intervenção cirúrgica.…”