Unicornuate Uterus With Pre Ruptured Rudimentary Horn Pregnancy At 15 Weeks Gestation: Case Report

Abstract

To describe the diagnosis and management of one case of pre rupture rudimentary horn pregnancy of
unicornuate uterus in the early second trimester by clinical suspicion, sonography, and laparotomy.
This paper presents a rare case in which a rudimentary horn pregnancy was suspected clinically at
15 weeks gestation with moderate to severe abdominal pain and diagnosed by sonographic criteria
which revealed an empty uterine cavity with a pregnant uterine horn and confirmed by laparotomy.
Which revealed a right unicornuate uterus and pre rupture a noncommunicating left rudimentary horn
containing a gestational sac, fetus, and placental tissue. The patient underwent surgery, and the pre
rupture rudimentary horn pregnancy with fallopian tube was resected and repair of the damaged uterine
wall was made with no complications. The patient conceived spontaneously eight months after surgery
and her antenatal care was regular without complications until 36 weeks gestation presented with mild
left iliac fossa pain. Her vaginal examination revealed she is in labor; the patient prepared and operated
the next day as elective cesarean section; the baby and the placenta were delivered without any difficulty.
Rudimentary horn pregnancy is a dangerous kind of ectopic pregnancy and is considered as very rare
condition which make difficulty in understanding the disease. Most of the clinicians instructed to be
focus on prenatal ultrasound for an earlier diagnosis and management which results in a reduction in
risk of maternal morbidity and mortality. Additionally, MRI can be used to confirm the diagnosis before
an invasive procedure is undertaken.