Post term pregnancy in a non-communicating rudimentary horn of a unicornuate uterus

Pregnancy in a rudimentary horn of a unicornuate uterus is rare in obstetrics and when it occurs, it seldom progresses to term as ruptures frequently occur before the third trimester.

A 29 year old female, presented at 42 weeks 5 days complaining of absent foetal movements, with results of a self-prescribed ultrasound scan showing an "abdominal pregnancy with foetal demise". She was haemodynamically stable and there were no foetal heart tones. At laparotomy, a non-communicating rudimentary horn pregnancy (RHP) was discovered. The right horn and tube were resected, with delivery of a post term female stillbirth. There were no postoperative complications.

Rudimentary horn pregnancies are difficult to diagnose when advanced; especially in low-resource settings with suboptimal antenatal care. Maternal and foetal outcomes in RHPs are usually poor; RHPs should therefore be suspected in pregnancies with atypical ultrasonographic features and more investigations done to confirm the diagnosis in order to reduce the associated morbidity and mortality.