Failure of prostaglandin induction labor in a Müllerian abnormality

Rudimentary-horn pregnancy (RHP) is a rare condition which is usually presented as a rupture of the pregnant horn during the second or third trimester, resulting in life-threatening bleeding. The authors report two cases of RHP which were diagnosed at the time of labor induction following fetal death diagnosis. Although the failure of prostaglandin induction to initiate labor could suggest that an additional obstructive Müllerian uterine anomaly is present, a directed investigation of such anomaly is more acceptable in cases of antepartum fetal death or atypical mid-trimester abdominal pain. Therefore, a high index of suspicion combined with clinical and imagiological findings are important to establish a correct diagnosis of pre-rupture RHP.