Rudimentary uterine horn pregnancy which could be diagnosed and treated before  rupture

MATSUOKA Toshihide, MINAMI Sawako, OTANI Tsutomu, YAGI Shigetaka, YATA Chie, BOUSHI Eiji, TANIMOTO Satoshi, UMESAKI Naohiko

doi:10.11437/sanpunosinpo.62.7

Pregnancy in a rudimentary uterine horn is an extremely rare and serious condition associated with uterine rapture and increased maternal morbidity. We reported a case of rudimentary uterine horn pregnancy which could be diagnosed and managed before rupture. A 23-year-old primigravida woman was suspected as an ectopic pregnancy and referred to our hospital at 12 weeks of pregnancy. Using transvaginal sonography (TV-USG) we observed thick endometrium without gestational sac in her uterus and large tumor on the left side of the uterus. We found large gestational sac with live fetus of 12 weeks of pregnancy in the tumor. The wall of the tumor was 1.37cm thick and showed the same density as a myometrium. Magnetic resonance imaging (MRI) revealed no communication between endometrium and gestational sac. She was diagnosed as rudimentary uterine horn pregnancy and laparotomy was performed at 13 weeks of pregnancy. We found the 8cm tumor and numerous convoluted vessels were observed on the surface of the tumor. We removed rudimentary uterine horn including the fetus and repaired with two layers. During operation we did not detect the communication between uterine cavity and the tumor using dye infusion from the uterine cervix.Using TV-USG and MRI we diagnosed rudimentary uterine horn pregnancy before rupture and successfully managed. [Adv Obstet Gynecol, 62 (1) : 7-10, 2010 (H22.2)]

Rudimentary uterine horn pregnancy which could be diagnosed and treated before rupture

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