Successful twin pregnancy in a unicornuate uterus with one fetus in the non-communicating rudimentary horn

Nanda, Smiti; Dahiya, Kiran; Sharma, Nidhi; Aggarwal, Deepika; Sighal, Savita Rani; Sangwan, Neetu

doi:10.1007/s00404-009-1028-x

Cited by 19 publications

(19 citation statements)

References 7 publications

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“…Even though Nanda et al [11] described a successful twin pregnancy in a unicornuate uterus with one fetus in the non-communicating rudimentary horn, many other cases of ruptured non-communicating rudimentary horn pregnancies have been described [12,13]. …”

Section: Discussionmentioning

confidence: 99%

Pregnancy in a unicornuate uterus: a case report

Caserta¹,

Mallozzi²,

Meldolesi

et al. 2014

J Med Case Reports

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IntroductionA unicornuate uterus accounts for 2.4 to 13% of all Müllerian anomalies. A unicornuate uterus with a non-communicating rudimentary horn may be associated with gynecological and obstetric complications such as infertility, endometriosis, hematometra, urinary tract anomalies, abortions, and preterm deliveries. It has a poor reproductive outcome and pregnancy management is still unclear.Case presentationWe report a case of a 26-year-old Caucasian woman presenting with a unicornuate uterus with a non-communicating rudimentary horn. The diagnosis of the anomaly was based on two-dimensional and three-dimensional sonography. The excision of her symptomatic rudimentary horn and her ipsilateral fallopian tube was performed laparoscopically. The growth of the fetus was normal. At 20 weeks’ pregnancy, her cervix started shortening and a tocolytic therapy was started. A cesarean delivery was successfully performed at 39 weeks and 4 days’ gestation.ConclusionsAlthough the reproductive outcome of women with unicornuate uterus is poor, a successful pregnancy is possible. Routine excision of the rudimentary horn should be undertaken during non-pregnant state laparoscopically, and it would be necessary to screen such pregnancies for the development of intrauterine growth retardation with serial ultrasound assessments of the estimated fetal weight and the cervix length.

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Section: Discussionmentioning

confidence: 99%

Pregnancy in a unicornuate uterus: a case report

Caserta¹,

Mallozzi²,

Meldolesi

et al. 2014

J Med Case Reports

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“…Although there is no identifiable trend regarding the ruptures, approximately 80% are expected to occur before the third trimester. The maternal mortality rate is volatile—between 6% and 23% 4. We were able to find only two live twin and very few live singleton births reported in the literature 5.…”

Section: Introductionmentioning

confidence: 64%

“…The American Fertility Society designates a unicornuate uterus, which is usually accompanied by a non–communicating rudimentary horn, as a class II uterine anomaly 4. Non–communicating rudimentary–horn pregnancies resulting from the migration of sperm to the peritoneum from the unicornuate side of uterus have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Life–threateningly heavy bleeding and abortion are the anticipated outcomes of rudimentary horn pregnancies 2,3. According to the literature, the newborn survival rate is between 0% and 13% in pregnancies in the rudimentary horn,4 with only one third of such gestations reaching term or beyond. Slightly more than 50% of the pregnancies ended with a rupture of the pregnant uterine horn.…”

Section: Introductionmentioning

confidence: 99%

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Unicornuate Uterus with a Rudimentary Horn Diagnosed at Scheduled Third Cesarean Section

et al. 2017

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A unicornuate uterus with a rudimentary horn is an anomaly caused by defective fusion of the Müllerian duct, estimated to occur in one in 76,000 pregnancies. Life threateningly heavy bleeding is a highly expected clinical consequence of such pregnancies. According to the known literature, only two living twins and few living singleton pregnancies have been reported up to now. Here we report on an incidentally diagnosed unicornuate uterus with a communicating rudimentary horn, found during a cesarean section of a gravida 3, parity 2 (G3 P2) patient. This case is rather unique since the patient has had three full term pregnancies and three cesarean sections without significant fetal compromise. This delivery and the existing literature showed us that extensive uterine correction surgeries need not be automatically proposed when a unicornuate uterus is diagnosed in the preconception period. Such deliveries indicate that women with this uterine anomaly may have the potential to carry pregnancies to full term.

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“…Abdominal pregnancies reaching term after rupture of RH, with its placenta deriving fetal blood supply from RH myometrium, have been described in the literature where the pregnancy outcome was a live fetus by cesarean section (6)(7)(8). There has been a report of a successful birth of twins by cesarean section, where one of the fetuses was in the non-communicating RH (9). What is unusual in our case is that, despite the functional endometrium in the RH, the patient had no symptoms of dysmenorrhea, hematometra, or pelvic endometriosis.…”

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confidence: 99%

Rudimentary Horn Pregnancy: A Rare First Trimester Acute Presentation

P¹,

Brajendra²,

Pallav³

2015

IJWHR

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Introduction: Rudimentary horn pregnancy (RHP), an entity with a diagnostic dilemma is known to rupture most commonly in second trimester, sometimes in early third trimester. This case of ectopic rudimentary horn (RH) presented acutely in the first trimester. Case Presentation: A 30 years old G 3 P 2 L 2 with previous two vaginal deliveries presented with acute abdominal pain and features of hemorrhagic shock at 8 weeks 5 days gestational age. With clinical diagnosis of ruptured ectopic pregnancy, the patient immediately underwent laparotomy, which revealed hemoperitoneum with a unicornuate uterus along with ruptured RHP. RH excision with ipsilateral salpingectomy and right tubal ligation was done and the maternal life salvaged. Conclusion: High index of suspicion based on clinical history and examination complemented with diagnostic radiological modalities can help in prenatal and pre-rupture diagnosis of RHP, hence its prompt treatment to alleviate scope of any emergency situation and the disastrous consequences leading to maternal morbidity and mortality.

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Successful twin pregnancy in a unicornuate uterus with one fetus in the non-communicating rudimentary horn

Cited by 19 publications

References 7 publications

Pregnancy in a unicornuate uterus: a case report

Pregnancy in a unicornuate uterus: a case report

Unicornuate Uterus with a Rudimentary Horn Diagnosed at Scheduled Third Cesarean Section

Rudimentary Horn Pregnancy: A Rare First Trimester Acute Presentation

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