Ruptured Noncommunicating Rudimentary Horn Pregnancy at 19 W
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Introduction
Unicornuate uterus with a rudimentary horn is a rare mullerian anomaly that has a high incidence of obstetric complications that include ectopic pregnancy in the rudimentary horn. Pregnancy in noncommunicating rudimentary horn is possible by trans-peritoneal migration of sperm or fertilized ovum. It occurs in approximately 1 of every 76,000 pregnancies. The risk of uterine rupture is 50–90%, with most ruptures (approximately 80%) occurring by the end of the second trimester. We report a case of second trimester rupture of noncommunicating rudimentary horn which was missed on routine malformation scan.

Case Report
A 26-year-old woman gravida 1, para 1 came to emergency with severe lower pain abdomen and vomiting since last two hours. She was 18 weeks pregnant and her routine malformation scan done one week back was normal. Her previous delivery was by Cesarean section for transverse lie. She denied history of dysmenorrhoea or of pain earlier in previous pregnancy. The patient had no significant medical or surgical history. No records of previous cesarean section were available....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483705/
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Dr. C●●●●●●●t K●●r
Dr. C●●●●●●●t K●●r Obstetrics and Gynaecology
Congratulations on handling the case so well. Two points come to mind. The previous C' s ... doctor shd have explained the risk to life the horn could cause, and the doc probably must have done it ,so at least the pt is aware of what can happen, though we always think it will only happen to someone else. secondly, maybe it WB d b good practice to do a laparoscopic exam. in every case diagnosed as unicornuate uterus on ultrasound, or maybe do an MRI of pelvis and the kidneys. please comment.... Read more
Apr 13, 2017Like