Ruptured noncommunicating rudimentary horn of unicornuate uterus at 12 weeks

Abstract

Pregnancy in a rudimentary horn of a unicornuate uterus is rare but ruptured horn has a mortality rate of 5%. We report a case of 26-year-old G4P3 L3 with previous full-term vaginal deliveries, who presented at 12-week gestation with severe abdominal pain. Transvaginal ultrasound imaging was suggestive of ruptured right ectopic pregnancy and patient was taken up for emergency laparotomy. Intraoperatively, 2500 cc hemoperitoneum was present and ruptured right rudimentary horn in the posterolateral part was found, with fetus in the pouch of Douglas, the uterus was of unicornuate type. Excision of ruptured right rudimentary horn along with the right salpingectomy was done. Despite advances in imaging, in developing countries where the prerupture diagnosis is unlikely, a high index of suspicion is crucial in saving mother's life.