Ruptured rudimentary horn pregnancy in a unicornuate uterus

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Surgical Emergencies

Background:

• Ruptured rudimentary horn pregnancy is a rare but life-threatening obstetric emergency.
• It often mimics a ruptured tubal ectopic pregnancy, posing diagnostic challenges.
• Previous Cesarean sections can obscure uterine anomalies, complicating diagnosis.

Purpose of the Study:

• To highlight the diagnostic challenges of ruptured rudimentary horn pregnancy in a patient with a prior Cesarean section.
• To emphasize the importance of considering uterine anomalies in pregnant patients presenting with acute abdomen and shock.
• To underscore the critical role of intraoperative findings and patient communication.

Main Methods:

• Case report presentation.
• Clinical presentation review including severe abdominal pain and hypotension at 15 weeks gestation.
• Diagnostic imaging via ultrasonography.
• Surgical intervention through exploratory laparotomy.

Main Results:

• Ultrasonography revealed extrauterine fetal demise, uterine rupture features, and massive hemoperitoneum.
• Exploratory laparotomy confirmed a unicornuate uterus with a ruptured left-sided non-communicating horn.
• The patient presented with symptoms mimicking ectopic pregnancy due to an undiagnosed uterine anomaly.

Conclusions:

• Undiagnosed unicornuate uterus with a ruptured rudimentary horn presents a significant diagnostic and management challenge in pregnancy.
• Prompt surgical intervention is vital for managing acute abdomen and shock in such cases.
• Thorough documentation and communication of findings are essential for patient care and future management.