OC139: Rudimentary horn pregnancy: early sonographic diagnosis confirmed by Magnetic Resonance Imaging

Tsafrir, Avi; Rojansky, Nathan; Sela, Hen Y.; Gomori, Moshe; Nadjari, M.

doi:10.1002/uog.348

Cited by 58 publications

(94 citation statements)

References 3 publications

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“…There have even been reports of first trimester prerupture diagnosis of rudimentary horn pregnancy. 5 In the case of Madam CA, the diagnosis was not suspected on ultrasound scan therefore induction of labour was attempted. Even when the diagnosis was suspected clinically, other methods of confirmation such as CT scan and MRI could not be used because they were not readily available.…”

Section: Discussionmentioning

confidence: 99%

“…5 • Pseudopattern of an asymmetrical bicornuate uterus, • Absent visual continuity between the cervical canal and the lumen of the pregnant horn, and • The presence of myometrial tissue surrounding the gestational sac.…”

Section: Discussionmentioning

confidence: 99%

“…When the rudimentary horn pregnancy is small and facilities exist, it may be possible to resect it laparoscopically. 5 Others have described the administration of methotrexate for termination of an early pregnancy in a rudimentary horn followed by elective laparoscopic resection. 6 …”

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confidence: 99%

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Pregnancy in non-communicating rudimentary horn

Deora

Chawla

Shetty

2017

Int J Reprod Contracept Obstet Gynecol

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A 25-year old G3P2L2 presented to casuality of OBG Dept, Ummaid Hospital, Jodhpur with5 months amenorrhea and bleeding per vaginum for last 5 days associated with abdominal pain. On per abdomen examination, a mass arising from pelvis corresponding to the size of a 16 weeks pregnancy was seen. A repeat ultrasound was performed in our hospital and the findings were - normally visualised uterus with a gestational sac with thin myometrium rim seen on right side with single dead fetus of gestational age 14 weeks 3 days, pregnancy in rudimentary horn, bicornuate uterus with pregnancy in right horn. Patient was counselled and prepared for laparotomy which was performed under general anesthesia. Intra -operative findings were normal sized uterus, right sided rudimentary horn pregnancy was seen. Both tubes and ovaries were normal. Hence, right sided rudimentary horn excision along with ipsilateral salpingo – oophorectomy was planned and done by clamping and cutting. Hemostasis was achieved. There was no communication between the rudimentary horn and the main uterus. The estimated blood loss was 200ml.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pregnancy in non-communicating rudimentary horn

Deora

Chawla

Shetty

2017

Int J Reprod Contracept Obstet Gynecol

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“…Because there are not strict diagnostic criteria for this rare disease and the experience of the clinician is very important. Tsafrir et al defined some diagnostic criteria for the rudimentary horn pregnancies (9) . These are 1-(1) a pseudopattern of a asymmetrical bicornuate uterus, (2) absent visual continuity tissue surrounding the gestational sac and the uterine cervix, and (3) the presence of myometrial tissue surrounding the gestational sac.…”

Section: Discussionmentioning

confidence: 99%

Early diagnosis of rudimentary horn pregnancy and its excision by laparoscopy: Case Report

Ergenoğlu¹,

Yeniel²,

Yıldırım³

et al. 2012

J Turk Soc Obstet Gynecol

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“…There have even been reports of first trimester prerupture diagnosis of rudimentary horn pregnancy. 4 In the case of Madam CA, the diagnosis was not suspected on ultrasound scan therefore induction of labour was attempted. Even when the diagnosis was suspected clinically, other methods of confirmation such as CT scan and MRI could not be used because they were not readily available.…”

Section: 3mentioning

confidence: 99%

Rudimentary horn pregnancy: Pre-rupture diagnosis and management

Buntugu

Ntumy²,

Ameh³

et al. 2009

Ghana Medical Journal

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SUMMARYRudimentary horn pregnancy is a rare obstetric entity and the diagnosis and management may pose some problems especially in a low-resource center. We report our experience in diagnosing and managing a case of fetal death in a rudimentary horn.Keywords: rudimentary horn, pre-rupture, pregnancy, tourniquet CASE REPORTMadam CA was a 28 years old gravida 6 para 5. She presented to Korle Bu Teaching hospital with a complaint of vaginal bleeding of two days duration. She did not remember the exact date of her last menstrual period but she believed she was six months pregnant. The vaginal bleeding was associated with lower abdominal pain. She had not booked for antenatal care in this pregnancy. All her previous deliveries were spontaneous vaginal deliveries at term.On examination, she looked well with a pulse rate of 88 beats per minute and a blood pressure of 130/70mmHg. There was a mass arising from the pelvis corresponding to the size of a 16-week pregnancy. The surface was smooth, mildly tender and not mobile. The cervix was firm, 2.5cm long, posterior and the os was closed. There were no adnexal masses felt and the mass was not displaced to either side. There was no active vaginal bleeding. A speculum examination did not reveal any cervical or vaginal pathology. A clinical impression of threatened abortion was formed.A transabdominal ultrasound scan was performed and the findings were as follows: single intrauterine pregnancy, no fetal heart activity, reduced liquor volume, femur length 2.2cm and gestation age 16weeks. Her haemoglobin was 11.2g/dl, platelet count was 320 x 10 9 /L, and the clotting profile was normal.Labour was induced with 200mcg of misoprostol in the posterior vaginal fornix, 6 hourly for a total of four doses. This was however, unsuccessful on two different occasions, 48 hours apart. There were no complications associated with the attempts at induction of labour. Based on the two failed attempts at induction of labour, extrauterine pregnancy was suspected. A repeat transabdominal ultrasound scan could not conclusively confirm or rule out an extrauterine pregnancy. Transvaginal ultrasound scan, MRI and CT scan were not readily available for further investigation of the patient. A size 18 Foley catheter was passed into the uterine cavity and the balloon inflated with 10mls of normal saline. The bladder was also filled with about 250mls of normal saline. Trans-abdominal ultrasound scan examination was then repeated. On this occasion, the fetus was seen to be outside the uterine cavity and the diagnosis of extrauterine pregnancy was confirmed. Madam CA was counselled and prepared for laparotomy which was performed under general anaesthesia.

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OC139: Rudimentary horn pregnancy: early sonographic diagnosis confirmed by Magnetic Resonance Imaging

Abstract: Oral communication abstracts OC138The pre-operative assessment (including MRI) And surgical approach to uterine abnormalities A. Cutner UCLH, UK

Cited by 58 publications

References 3 publications

Pregnancy in non-communicating rudimentary horn

Pregnancy in non-communicating rudimentary horn

Early diagnosis of rudimentary horn pregnancy and its excision by laparoscopy: Case Report

Rudimentary horn pregnancy: Pre-rupture diagnosis and management

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