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Medline ® Abstract for Reference 43

of 'Clinical manifestations and diagnosis of congenital anomalies of the uterus'

Rupture of noncommunicating rudimentary uterine horn pregnancy.
Daskalakis G, Pilalis A, Lykeridou K, Antsaklis A
Obstet Gynecol. 2002;100(5 Pt 2):1108.
BACKGROUND: We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.
CASE: A 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. Hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. Hysteroscopy and laparoscopy were recommended but declined. She presented again 2 months later at 7 weeks' gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after an emergency laparotomy at 20 weeks because of the sudden onset of abdominal pain and signs of shock.
CONCLUSION: Although a rudimentary horn pregnancy had been suspected before the laparotomy, the patient presented as a clinical emergency. This report, like others, indicates that prompt diagnosis and immediate removal of the rudimentary horn is lifesaving.
First Department of Obstetrics and Gynaecology, Alexandra Hospital, University of Athens, Athens, Greece.