An incidental finding of a unicornuate uterus with non-communicating rudimentary horn in a 30-year-old female with recurrent abortion

2021 ◽  
Vol 2 (1) ◽  
pp. 1-5
Author(s):  
Sule MB ◽  
◽  
Sa’idu SA ◽  
Ma’aji SM ◽  
Danfulani M ◽  
...  
Keyword(s):  
Incidental Finding ◽  
First Trimester ◽  
Pelvic Cavity ◽  
Recurrent Abortion ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uterine Anomalies ◽  
Mullerian Ducts ◽  
Left Fallopian Tube ◽  
The Right

Unicornuate uterus is a form of uterine anomalies which arise from failure of development and fusion of the Mullerian ducts, and accounts for about 2.4-13% of all Mullerian anomalies. This is a 30-year-old housewife referred for hysterosalpingography (HSG) on account of secondary infertility. The patient also had history of recurrent abortion in the first trimester. The HSG showed an ellipsoidal or Banana shaped uterus in the left lateral pelvic cavity with prominent left fallopian tube that showed peri-fimbrial spillage of contrast medium with non-demonstration of a communicating rudimentary horn. She also had a pelvic ultrasound that showed an empty uterus with a right hypoechoic solid area most likely the right rudimentary horn. We report the radiologic features of Unicornuate uterus due to its rare nature and peculiar presentation

scholarly journals Hemiuterus with functional non-communicating horn in a young female

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
M. Venkatesh ◽  
Sandeep Singh Awal
Keyword(s):  
Female Genital Tract ◽  
Young Female ◽  
Human Reproduction ◽  
Obstetric Outcomes ◽  
Pelvic Cavity ◽  
Correct Identification ◽  
Pelvic Mri ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
The Right

Abstract Background Mullerian duct anomalies are a broad spectrum of congenital anomalies of the female genital tract presenting with variable symptoms like infertility, amenorrhoea, dysmenorrhea, pelvic endometriosis, and poor obstetric outcomes. Unicornuate uterus or hemiuterus occurs as a result of abnormal formation or failure of formation of the contralateral part. Case presentation We present a rare case report of hemiuterus with functional non-communicating horn along with hematometra in a 15-year-old female who presented with severe dysmenorrhoea since her menarche. Pelvic Ultrasonography demonstrated inconclusive findings of a heterogenous lesion in the right pelvic cavity adjacent to the uterus. Further, pelvic MRI revealed a hemiuterus on the left side with a normal endometrial cavity and a well-defined functional non-communicating horn on right side. The diagnosis of European Society of Human Reproduction (ESHRE) Classification U4a uterine anomaly (left hemiuterus with functional non-communicating horn on right side) was established. Conclusions ESHRE Class U4a comprises of hemiuterus with a functional rudimentary horn. This is considered clinically significant as it may lead to further complications, such as hematometra or ectopic pregnancy in the rudimentary horn. Hence, the correct identification of this entity is essential as laparoscopic removal is the current recommended management.

scholarly journals Timely Identification of Pregnancy in Noncommunicating Horn of Unicornuate Uterus by Three-Dimensional Transvaginal Ultrasonography

2018 ◽  
Vol 8 ◽  
pp. 39
Author(s):  
Aarti Deenadayal Tolani ◽  
Kadambari ◽  
Anupama Deenadayal ◽  
Suhasini Donthi ◽  
Indira Rani Yellenki ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Transvaginal Ultrasonography ◽  
Fertility Treatment ◽  
High Morbidity ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uterine Anomalies ◽  
3D Tv ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Pregnancy in the rudimentary horn of a unicornuate uterus is uncommon and needs to be diagnosed at early stages to avoid uterine rupture to avert the high morbidity and mortality. In this case report, we discussed the advantage of three-dimensional transvaginal ultrasonography (3D TV-USG) in assessing the early pregnancy in the noncommunicating rudimentary horn of uterus. A 23-year-old woman approached us for routine pregnancy scan. The location of 5-week pregnancy was confirmed in the right noncommunicating horn of a unicornuate uterus by 3D TV-USG. She has undergone laparohysteroscopy, and excision of a gravid rudimentary horn was done. After an interval of 6 months, the patient received fertility treatment and conceived consequently. Although magnetic resonance imaging (MRI) is an excellent way of diagnosing uterine anomalies, the procedure is expensive, time-consuming, and not widely available. 3D USG is less expensive and more readily accessible for early diagnosis of uterine anomalies, particularly in health-care centers where MRI is not readily available or affordable.

scholarly journals A Rare Case of Recurrent Non-Communicating Rudimentary Horn Pregnancy

2019 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Standard Treatment ◽  
Surgical Excision ◽  
First Trimester ◽  
Contralateral Side ◽  
Incomplete Fusion ◽  
Complete Excision ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Mullerian Ducts

Introduction: A unicornuate uterus with a rudimentary horn is a uterine anomaly resulting from the incomplete development of one of the Müllerian ducts and an incomplete fusion with the contralateral side. Pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. It carries grave consequences for the mother and fetus as the diagnosis may be missed and subsequently result in an emergency due to spontaneous rupture of the enlarging rudimentary horn and massive intraabdominal bleeding. The standard treatment is the surgical excision of the rudimentary horn. The authors present a case of a rare recurrent rudimentary horn pregnancy that contained a viable pregnancy diagnosed in first trimester and managed with complete excision of the rudimentary horn along with the pregnancy in-situ.

scholarly journals Ruptured Noncommunicating Rudimentary Horn Pregnancy at 19 Weeks with Previous Cesarean Delivery: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sita Thakur ◽  
Ajay Sood ◽  
Chanderdeep Sharma
Keyword(s):  
Cesarean Delivery ◽  
First Trimester ◽  
Incomplete Fusion ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Laparoscopic Excision ◽  
Maternal Morbidity And Mortality ◽  
Mullerian Ducts ◽  
High Index Of Suspicion ◽  
Previous Cesarean

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.

scholarly journals Unicornuate Uterus with Rudimentary Horn as a Rare Etiology of Secondary Dysmenorrhea: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Zuhdi Khalid Nagshabandi ◽  
Bindu Isaac ◽  
Inshia Begum
Keyword(s):  
Uterine Cavity ◽  
Abnormal Development ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Appropriate Treatment ◽  
Pelvic Ultrasonography ◽  
Uterine Anomalies ◽  
Uterine Anomaly ◽  
Mullerian Ducts ◽  
Secondary Dysmenorrhea

Congenital uterine anomalies are an uncommon type of female genital malformations caused by abnormal development of müllerian ducts during embryogenesis. Patients with an obstructive uterine anomaly have a higher risk of developing gynecological and obstetric complications that may present at menarche or later in life. We present a case of severe dysmenorrhea in a young teenager caused by obstructive hematometra in a noncommunicating horn of the unicornuate uterus. A differential diagnosis of a possible anomaly was made using 2-dimensional pelvic ultrasonography, which was later confirmed using MRI that revealed an anomalous uterine cavity with a single left-sided cornua communicating with the cervix and a distended right-sided rudimentary horn. She underwent a right salpingectomy with rudimentary horn excision, which was successfully managed laparoscopically. This case emphasizes the importance of physicians being cognizant in identifying patients with uterine anomaly to provide appropriate treatment and prevent adverse reproductive outcomes.

scholarly journals Ruptured Rudimentary Horn Pregnancy at 25 Weeks with Previous Vaginal Delivery: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Deepa V. Kanagal ◽  
Lokeshchandra C. Hanumanalu
Keyword(s):  
Vaginal Delivery ◽  
Contralateral Side ◽  
Incomplete Fusion ◽  
Second Trimester ◽  
Intrauterine Pregnancy ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Mullerian Ducts ◽  
High Index Of Suspicion

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. Timely laparotomy, excision of the horn, and blood transfusion saved the patient.

scholarly journals A case report on ruptured rudimentary horn ectopic pregnancy

2021 ◽  
Vol 10 (6) ◽  
pp. 2504
Author(s):  
Milan R. Shingala ◽  
Bhavesh B. Airao
Keyword(s):  
Ectopic Pregnancy ◽  
Rare Condition ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Incomplete Fusion ◽  
Lateral Side ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Wide Range ◽  
Laparoscopic Excision

Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. This malformation results from the defective fusion of the duct with the contra-lateral side. This rudimentary horn may or may not have functional cavity. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. IT is a rare condition that can lead to a catastrophic outcome when it rupture. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. Pregnant rudimentary horn can present with wide range of symptoms that may be similar to ectopic pregnancy or may remain silent with features of normal pregnancy.1-2 We report a case of ruptured non-communicating rudimentary horn at 19 weeks in pregnant lady. In our opinion, routine excision of rudimentary horn should be undertaken during non-pregnant state laparoscopically. However, those women who refuse should be adequately counselled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.

scholarly journals Ruptured rudimentary horn pregnancy: a case report

2020 ◽  
Vol 9 (3) ◽  
pp. 1271
Author(s):  
Gopika Venugopal ◽  
Soumya Patil ◽  
Nandish S. Manoli ◽  
Pratap T. ◽  
Hemapriya . ◽  
...  
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
European Society ◽  
Congenital Malformations ◽  
Human Reproduction ◽  
Blood Products ◽  
Rare Form ◽  
Rudimentary Horn ◽  
Uterine Anomalies ◽  
Mullerian Ducts

Uterine anomalies are congenital malformations arising due to embryological mal-development of mullerian ducts. The European society of Human Reproduction and Embryology (ESHRE) classifies these anomalies into 6 classes. Hemi-uterus is one such class of formation defect of mullerian duct with unilateral uterine development; the contralateral part could be either incompletely formed or absent. In a rare form of ectopic pregnancy, implantation can occur in the cavity of a rudimentary horn of the hemi-uterus. Authors report a case of 22-year G2P1L1 with 12 weeks gestation who presented with acute abdomen. Ultrasound showed hemoperitoneum with suspicion of ectopic pregnancy. Laparotomy confirmed the diagnosis of ruptured right rudimentary horn with fetus and placenta in the peritoneal cavity. Immediate laparotomy and excision of the horn with transfusion of blood and blood products saved the patient in the nick of time.

scholarly journals Rudimentary Horn Pregnancy Diagnosed after Laparotomy

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Kurabachew Mengistu ◽  
Tufa Bobe ◽  
Gashaw Tilahun ◽  
Kibru Kifle ◽  
Dereje Geleta
Keyword(s):  
New Technologies ◽  
Postoperative Recovery ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uneventful Postoperative Recovery ◽  
Mullerian Ducts ◽  
Primary Hospital ◽  
Ultrasound Assessment

Müllerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and a unicornuate uterus is observed in 0.4% of women. The uterus is normally formed during embryogenesis by the fusion of the two Müllerian ducts. If one of the ducts does not develop, only one Müllerian duct contributes to the uterine development. We report a case of Gravida II, abortion I referred from a primary hospital with a referral paper and sonography stating she had IUFD. She had regular antenatal care follow-up at the primary hospital and had 8 months of amenorrhea. Our ultrasound assessment confirmed the intrauterine fetal demise, but the rudimentary horn pregnancy was missed. Repeated attempts at the induction of labor were tried but unsuccessful. The diagnosis was confirmed at laparotomy. She underwent cesarean section with right intact rudimentary horn removal. A nonviable male fetus with birth weight of 1.2 kg was delivered. Women with this abnormality are asymptomatic and unaware of having a unicornuate uterus. Abdominal pain is the most common presenting symptom with the rudimentary horn, but communicating horn pregnancy is generally asymptomatic in early pregnancy. Early awareness of this rare clinical condition is so crucial especially in developing countries where the availability of new technologies is scarce to explore uterine abnormalities. The patient had uneventful postoperative recovery and was discharged after 3 postoperative days.

scholarly journals Retained second twin secondary to an undiagnosed bicornuate uterus in a poorly supervised labour: A case report

2020 ◽  
pp. 201010582094890
Author(s):  
Joseph Tochukwu Enebe ◽  
Chidimma Akudo Omeke ◽  
Emeka Kevin Chukwubuike
Keyword(s):  
Congenital Anomalies ◽  
Iliac Fossa ◽  
Uneventful Recovery ◽  
Left Iliac Fossa ◽  
Bicornuate Uterus ◽  
Uterine Anomalies ◽  
Mullerian Ducts ◽  
Abdominal Examination ◽  
The Right ◽  
Second Twin

Congenital anomalies of the uterus may result from maldevelopment, abnormal fusion or failure of recanalisation of the paramesonephric (Müllerian) ducts. They are uncommon and are associated with various fertility and pregnancy outcomes. Uterine anomalies have been associated with infertility and pregnancy-related complications. Some cases of successful pregnancies among women with a bicornuate uterus have been reported. However, successful twin pregnancy in a bicornuate uterus is very rare. We report the case of a 24-year-old primigravida who presented with a retained second twin secondary to an undiagnosed bicornuate uterus. An abdominal examination revealed an enlarged abdomen with the uterus tilted to the right and also a palpable firm mass on the left iliac fossa. The retained foetus was presenting cephalic, and the foetal heart rate was 118 bpm. A diagnosis of a retained second twin secondary to a suspected uterine anomaly and suspected foetal distress was made. An emergency caesarean section revealed two horns of the uterus, each having a fallopian tube, an ovary and a cervix. Both cervices opened into one vagina. A 3.0 kg live male baby was successfully delivered through a transverse incision on the lower segment of the right horn of the uterus. The client had an uneventful recovery and was discharged home together with her babies after 4 days. In conclusion, congenital anomalies of the uterus should be considered in cases of a retained second twin. A prompt and accurate diagnosis followed by appropriate management will go a long way in ensuring a good outcome, as was had in this case.

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