Pregnancy in a Ruptured Non-communicating Rudimentary Horn: A Case Report

Abstract

The rudimentary horn is a Müllerian duct anomaly. In instances of pregnancy within a non-communicating rudimentary horn, timely diagnosis is imperative to prevent life-threatening complications. Ultrasound only demonstrates 26-33% sensitivity, leading to misdiagnoses for tubal, intrauterine, or abdominal pregnancies. We present a case of a 20-year-old female, gravida 2 para 1 (G2P1), who conceived spontaneously while experiencing constant mild lower abdominal pain throughout the earlier stages of pregnancy. Pregnancy in non-communicating rudimentary horns advanced to twenty weeks of gestation. The diagnosis was made when the horn ruptured, resulting in hemoperitoneum and hemodynamic instability. An emergency exploratory laparotomy was performed, uncovering a complete rupture of the pregnant rudimentary horn, leading to hemi-hysterectomy and removal of the left fallopian tube. The rudimentary horn was completely ruptured and lacked direct communication with the right unicornuate uterus cavity. The diagnostic and management challenges associated with rudimentary uterine horn highlight the need for heightened vigilance to prevent associated morbidity. Keywords: Pregnancy, Rudimentary, Uterus; Müllerian anomaly.

Keywords

• Rudimentary horn
• Mullerian duct anomaly