Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis

Abstract

Management of pregnancy in a rudimentary uterine horn continues to be a challenge to this day. Maintaining a higher degree of alertness, especially in high risk groups by emergency staff is required to prevent the morbidity, as they may present with acute uterine rupture in pregnancy.

Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report

“…The failed müllerian duct leads to the formation of an isolated hemiuterus without a contralateral structure (complete failure) or with varying stages of a rudimentary horn (partial failure) 19,20 . The rudimentary uterus may often be contained in an inguinal hernial sac.…”

Rupture of Non-communicating Rudimentary Horn at 28 Weeks of Pregnancy in Previously Scarred Uterus: A Diagnosis in Disguise

“…Most cases are diagnosed on laparotomies after uterine rupture at premature gestational age resulting in high neonatal mortality [7] and high maternal morbidity due to massive blood loss from thick and vascular uterine wall [4]. Uterine rupture associated with rudimentary horn was first reported in 1669 by Mauriceau [8].…”

A case of pregnancy in the rudimentary horn of unicornuate uterus

“…Most of the cases have poor fetal outcome as large number of cases present with fetal demise or rupture uterus at 2nd trimester of pregnancy. 8,9 Maternal mortality is low (0.5%).…”

“…2,8,9 The prerupture diagnosis of pregnancy in rudimentary horn can drastically reduce maternal mortality and a high index of clinical suspicion is required in such case. 3 A pre pregnancy history of severe dysmenorrhea may be a clue in this regard.…”

“…But the sensitivity of ultrasound to detect prerupture rudimentary horn pregnancy is very poor (30%) probably because of rarity of the diagnosis and non-familiarity of the radiologists about this potentially lethal condition. 8,9 Tsafrir et al suggested the following criteria for diagnosing a pregnancy in the rudimentary horn:…”