Unicornuate uterus with an obstructed rudimentary horn: A report of two cases with an imaging perspective

Congenital uterine anomalies (CUAs) or Müllerian duct anomalies are rare and can be either complete failure or partial failure in the development of the Mullerian duct, and they have a probability to result in a condition known as the unicornuate uterus. Partial development of one of the horns results in a rudimentary horn, which may be communicating consisting of category II A or noncommunicating consisting of category II B. This report illustrates a rare case of a 23-year-old female, unmarried, nulligravida, who presented to the outpatient department with chief complaints of acute abdominal pain and dysmenorrhea associated with an average menstrual flow. Pelvic ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of a left unicornuate uterus with communicating right rudimentary horn associated with hematometra and hematosalpinx. As a treatment option, the surgical intervention mainly involved laparoscopic excision of the rudimentary horn and right salpingectomy that was performed by aspiration of blood from the rudimentary horn of around 25cc. Then, the right hydrosalpinx was removed, followed by right salpingectomy and excision of the rudimentary horn to reduce the risk of ectopic pregnancy having an incidence of 10% for which laparoscopic or robotic-assisted removal is preferable and practicable for young girls, compared with the open procedure. The patient adhered well to the surgical intervention.

Section: Discussionmentioning

confidence: 99%

A Case Report on Communicating Left Unicornuate Uterus and Right Rudimentary Horn With Hematometra and Hematosalpinx

Suryawanshi¹,

Dwidmuthe²

2023

“…Reproductive issues in women with Mullerian duct malformations include a greater prevalence of infertility, frequent spontaneous abortions in the first trimester, fetal malposition, and preterm labor. Imaging serves to diagnose and identify defects that can be corrected surgically, and the surgical strategy may change depending on the imaging results [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

A Unique Case of Unicornuate Uterus With a Non-communicating Rudimentary Horn and Hematometra

Ladke¹,

Ambhore²,

Dhok³

et al. 2022

Congenital uterine anomalies are a rare type of malformation involving female genitalia caused by abnormal development of the Mullerian duct system. Patients having an obstructive type of uterine anomalies are very much likely to develop obstetric and gynecological complications usually at the age of menarche or later in the course of life. In this case report, we present a case of a young female patient having severe dysmenorrhea which is caused by obstructive hematometra in the rudimentary horn which is not communicating with the uterine cavity. Ultrasonography (USG) was used to make a differential diagnosis of a probable congenital abnormality, which was subsequently validated by magnetic resonance imaging (MRI), which revealed a uterine cavity having a single cornu on the left side seen to be connecting with the cervix and a dilated rudimentary horn on the right side. The patient underwent the excision of the rudimentary horn laparoscopically. This case emphasizes the importance of identifying patients having anomalies involving the uterus to provide appropriate treatment to the patient and to prevent adverse outcomes for her reproductive potential.

“…The unicornuate uterus, characterized by a single uterine horn, poses unique challenges due to its asymmetry and potential association with a rudimentary contralateral horn. The rudimentary horn, often underdeveloped and nonfunctional, can harbor various obstetric complications, making timely recognition and proper management essential for optimal maternal and fetal outcomes [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Unicornuate Uterus and Rudimentary Horn: An Unusual Cause of Recurrent Fetal Malpresentation Identified During a Scheduled Cesarean Delivery

Muneeba,

Acharya,

Mohammad

et al. 2023

This case report presents a unique clinical scenario involving a 32-year-old woman with a unicornuate uterus and a rudimentary horn, leading to recurrent fetal malpresentation. The patient, gravida 3, para 1, presented at 36 weeks of gestational age with contractions and vaginal bleeding. Clinical evaluation revealed a breech presentation and nonreassuring fetal heart tracings. An emergency cesarean section was performed, during which a unicornuate uterus with a rudimentary horn was identified and fused to the main uterine cavity on the left posterior aspect. The rudimentary horn bore a functional left tube and ovary. The surgical procedure was successful, resulting in the delivery of a healthy baby girl. This case underscores the importance of meticulous preoperative assessment, multidisciplinary collaboration, and informed consent in managing complex uterine anomalies to ensure optimal maternal and fetal outcomes.