Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: Prerupture diagnosis and management

Lai, Yu-Ju; Lin, Chih‐Kung; Hou, Wen-Chien; Hwang, Kwei-Shuai; Yu, Mu-Hsien; Su, Her-Young

doi:10.1016/j.tjog.2016.06.009

Cited by 23 publications

(41 citation statements)

References 9 publications

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“…Pregnancy in a non-communicating rudimentary horn is believed to develop from transperitoneal sperm migration. This is a rare condition but may result in life-threating complications such as rupture, intra-abdominal bleeding and hemorrhagic shock [17]. In the present study, 2 patients (14.3%) presented to our clinic in a shock state.…”

Section: Discussionmentioning

confidence: 54%

Rudimentary horn pregnancy — ten years of experience

et al. 2020

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Objectives:This study aimed to evaluate data on early diagnosis and therapeutic management of rudimentary horn pregnancy (RHP). Material and methods:Patients diagnosed with RHP at a tertiary center between for two periods of 2008-2012 and 2013-2018 were analysed retrospectively. We obtained information of patients from hospital electronic archive registration system. Data on demographic characteristics, clinical presentation, gestational age at presentation, presenting symptoms, diagnostic methods, and therapeutic management were noted and analysed by descriptive statistical method. Demographic datas, the complaint of patient's admission to hospital, history of cesarean section, preliminary diagnosis and intraoperative diagnosis were compared between periods of 2008-2012 and 2013-2018.Results: A total of 14 RHP patients were included. Eight (57.1%) of these patients were diagnosed between 2008-2012 (Group 1), whereas six patients (42.9%) were diagnosed between 2013-2018 (Group 2). Rudimentary horn was non-communicating in 13 patients (92.8%). Communicated form was observed in 1 patient in group 1. RHP was diagnosed on the left side in nine patients (64.2%). Six of these patients were observed in group 1 and 3 were in group 2. The pre-rupture diagnosis was made in 10 (71.4%) patients. Six (100%) of 10 patients were in group 2. In addition, in group 1, four patients (50%) experienced intraoperative RHP rupture. RHP was diagnosed before rupture in 2 (33.3%) patients in group 2. Conclusions:It is an indication of advanced ultrasonographic technology as well as increased carefulness on the physician side and raised alertness on the patient side that today both RHP and preoperative rupture of RHP are less frequent. Still, further awareness is required among physicians of the necessity of excision of a rudimentary horn that is detected at the time of C-section.

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Section: Discussionmentioning

confidence: 54%

Rudimentary horn pregnancy — ten years of experience

et al. 2020

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“…As a result very few (10%) of these pregnancies reach full term out of which only 2% of the fetuses can survive [10]. Although antenatal diagnosis of pregnancy in rudimentary horn is still tricky, advanced first trimester scanning may provide a clue for early diagnosis [4,9]. But only few cases of rudimentary horn pregnancy were diagnosed in early trimester prior to rupture so far [8,11].…”

Section: Discussionmentioning

confidence: 99%

“…us a high index of suspicion is needed as in the majority of cases it is detected a er it gets ruptured [3,6]. Ectopic pregnancy in the rudimentary horn of unicornuate uterus is associated with life threatening complications, one of which is uterine rupture with a 50% risk [4,5]. Here, I report a case of ectopic pregnancy in the rudimentary horn of a unicornuate uterus at gestational age of 16 weeks.…”

Section: Introductionmentioning

confidence: 97%

“…e incidence of pregnancy occurring in a rudimentary horn of the unicornuate uterus is very rare ranging from 1 in 75,000 to 150,000 pregnancies. Usually the diagnosis is di cult and sometimes missed as the majority of the cases present on emergency with hemoperitonium [2,4,5]. About 85% of rudimentary uterine horns are noncommunicating in type [1,5].…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in Noncommunicating Rudimentary Horn of Unicornuate Uterus: A Case Report and Review of the Literature

Tesemma

2019

Case Reports in Obstetrics and Gynecology

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Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Both prerupture and postrupture diagnosis of ectopic pregnancy in the rudimentary horn of a unicornuate uterus is difficult. Here is a case of a 21-year-old gravida 5 para 3 abortion 1 mother presented with abdominal pain of 2 days duration following a falling accident. The patient was severely anemic and was in hypovolemic shock at the time of presentation. She had diffused lower abdominal tenderness with hemoperitonium. After clinical and ultrasound evaluation, emergency laparotomy was decided for preop diagnosis of ruptured cornual ectopic pregnancy to rule out uterine rupture at gestational age of 16 weeks. Intraoperatively, ruptured ectopic pregnancy in noncommunicating rudimentary horn was diagnosed. Resection of rudimentary horn and ipsilateral salpingectomy was done. She was transfused with 5 units of compatible blood. It is better to increase awareness about pregnancy occurring in this rare uterine anomaly, so as to have a high index of suspicion as early detection before it gets ruptured is difficult.

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“…While studies have reported rudimentary horn pregnancies, as well as tubal and cornual ectopic pregnancies occurring in both communicating and non-communicating horns,7 there is little published literature about ectopic pregnancies in the undescended ovary or tube in patients with an isolated unicornuate uterus. These ectopic pregnancies are associated with severe maternal morbidity and even mortality 8.…”

Section: Discussionmentioning

confidence: 99%

A rare case of an ectopic pregnancy in the rudimentary tube of a patient with an isolated unicornuate uterus

Gnanasambanthan

Uchil

2017

BMJ Case Reports

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Uterine anomalies are relatively uncommon and go undiagnosed in many cases. Ectopic pregnancies have been reported in such patients, although rarely, in the non-communicating rudimentary horns of unicornuate uteri. However, the case presented is of an ectopic pregnancy in the rudimentary fallopian tube related to an undescended ovary in a patient with an isolated unicornuate uterus, a phenomenon which is extremely rare.

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Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: Prerupture diagnosis and management

Abstract: Diagnosis and management of rudimentary horn pregnancy remain a challenge. We should be alert to prenatal ultrasound with the intention of making an earlier diagnosis, thereby resulting in decreased maternal morbidity and mortality.

Cited by 23 publications

References 9 publications

Rudimentary horn pregnancy — ten years of experience

Rudimentary horn pregnancy — ten years of experience

Pregnancy in Noncommunicating Rudimentary Horn of Unicornuate Uterus: A Case Report and Review of the Literature

A rare case of an ectopic pregnancy in the rudimentary tube of a patient with an isolated unicornuate uterus

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