Pregnancy in a blind hemi-cavity of Robert’s uterus with ipsilateral renal agenesis: a case report and literature review

Abstract

Robert’s uterus is an asymmetric septate uterus with a noncommunicating cavity and is a rare Müllerian anomaly. We present a rare case of pregnancy in a blind cavity and the first report of ipsilateral renal agenesis. A 23-year-old primigravida woman presented to our hospital at 7 weeks and 3 days of gestation after an abortion had failed. Three-dimensional ultrasound and magnetic resonance imaging showed pregnancy in a blind hemi-cavity of Robert’s uterus with an ipsilateral renal anomaly. Surgery was performed by hysteroscopy with laparoscopic and ultrasound guidance. The pregnancy was removed and the asymmetric septum was resected. A single normal uterine cavity with bilateral tubal ostium remained. The treatment was considered to be satisfactory. Menstruation ceased to be painful and the uterus was not scarred. Robert’s uterus can be well evaluated by an experienced ultrasound physician and magnetic resonance imaging. Such patients may have renal agenesis and the urinary system must be simultaneously evaluated. Pregnancy in a blind hemi-cavity is extremely rare and easily ignored by gynecologists and sonographers. Timely and accurate diagnosis of this condition is essential to obtain minimally invasive treatment.