Pregnancy in a Rudimentary Horn with a Live 19-Weeks Fetus: a Case Report

Background: A unicornuate uterus with a rudimentary horn is a rare uterine anomaly occurring in 1 out of 100,000 to 140,000 pregnancies. The diagnosis of this complication is conventionally difficult and missed, which may cause uterine rupture leading to hemoperitoneum. The standard treatment is the surgical excision of the horn through laparotomy. The aim of this report was to introduce a case of pregnancy in a rudimentary horn of the uterus. Case report: We present a 31-year old nulliparous woman at 19 weeks of gestation with a live fetus in a rudimentary horn. The first ultrasound showed a bicornuate uterus at 13 weeks. The patient was referred to Mobini Hospital with abdominal and epigastric pain, nausea, and vomiting. Repeated blood tests, ultrasonography, and clinical signs raised the suspicion of a ruptured ectopic pregnancy. The diagnosis of a rudimentary horn pregnancy was made in the operative room. The rudimentary horn with the left tube was excised and the patient was discharged in good condition two days later. Conclusion: This case highlights the importance of following up of patients whose early ultrasound indicates a uterine anomaly. In addition, obstetricians and midwives must have a high level of clinical suspicion and pay careful attention to such complicated cases.