Rupture of noncommunicating rudimentary uterine horn pregnancy.
BACKGROUND
We present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.


METHODS
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.


CONCLUSIONS
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.
Daskalakis
George
G
First Department of Obstetrics and Gynaecology, Alexandra Hospital, University of Athens, Athens, Greece.
Pilalis
Athanasios
A
Lykeridou
Katerina
K
Antsaklis
Aris
A
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007813:Laparotomy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011261:Pregnancy Trimester, First; D012422:Rupture, Spontaneous; D012771:Shock, Hemorrhagic / Q000209:etiology; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging