title: Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis.
abstract: BACKGROUND
  Pregnancy in rudimentary horn of uterus, a form of ectopic gestation, is associated with significant rates of morbidity and mortality. Despite the recent advances in the ultrasonography, diagnosis of cornual pregnancy still remains elusive; with confirmatory diagnosis usually made during laparotomy. The aim of the present study is to analyze the obstetric implications and the diagnostic dilemma of rudimentary horn pregnancy.
  
  
  METHODS
  Records of women diagnosed with ectopic pregnancy in the rudimentary horn, during the years 2004 to 2008, managed in a referral hospital in northern India; were reviewed for their diagnostic difficulties and the associated morbidity.
  
  
  RESULTS
  During the four year study period, rudimentary horn pregnancies accounted for 12 pregnancies. Non communicating horn accounted for 75% of the cases. The mean age of women at presentation was 26 +/- 5.11 years and the period of gestation at diagnosis varied between 10 and 34 weeks. Preruputure diagnosis was possible only in two cases and sensitivity of ultrasonographic diagnosis was 33.3%. Laprotomy with excision of rudimentary horn and salpingectomy was done in all cases. Multiple blood transfusions were required in 83.3% of women.
  
  
  CONCLUSIONS
  Management of pregnancy in a rudimentary uterine horn continues to be a challenge to this day. Maintaining a higher degree of alertness, especially in high risk groups by emergency staff is required to prevent the morbidity, as they may present with acute uterine rupture in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drseemachopra@yahoo.com
authors.forename: Seema
authors.initials: S
authors.lastname: Chopra
authors.forename: Anish
authors.initials: A
authors.lastname: Keepanasseril
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Rohilla
authors.forename: Rashmi
authors.initials: R
authors.lastname: Bagga
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Kalra
authors.forename: Vanita
authors.initials: V
authors.lastname: Jain
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography; D014599:Uterus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D055815:Young Adult