Advertisement

Archives of Gynecology and Obstetrics

, Volume 287, Issue 4, pp 687–695 | Cite as

Rudimentary horn pregnancy: a 10-year experience and review of literature

  • Sujata Siwatch
  • Reeti Mehra
  • Dilpreet Kaur Pandher
  • Anju Huria
General Gynecology

Abstract

Rudimentary horn pregnancy is rare, but can cause considerable morbidity and mortality. We discuss five cases presented to our hospital in the last 10 years and systematically review the 10-year literature of rudimentary horn pregnancies diagnosed antenatally pre-rupture.

Objectives of the review

The aim of the review was to find radiologic investigations/criteria to diagnose rudimentary horn pregnancy antenatally pre-rupture.

Search methods

A systematic literature review was carried out in Pubmed search for rudimentary horn pregnancies. The radiologic findings of the cases diagnosed before rupture were analyzed.

Results

Ultrasound is the most commonly used technique, though MRI seems to delineate details better. Non-continuity of the lumen of the cervix with the pregnant uterine horn is an important imaging finding. High clinical suspicion and radiologic skill for diagnosis are emphasized.

Conclusions

The review presents the existing imaging criteria to diagnose rudimentary horn pregnancy and suggests future research to enhance the limited evidence.

Keywords

Rudimentary horn pregnancy Ectopic pregnancy Mullerian duct abnormality 

Notes

Conflict of interest

None.

References

  1. 1.
    Reichman D, Laufer MR, Robinson BK (2009) Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril 91(5):1886–1894PubMedCrossRefGoogle Scholar
  2. 2.
    Nahum GG (2002) Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases. J Reprod Med 47(2):151–163PubMedGoogle Scholar
  3. 3.
    Jayasinghe Y, Rane A, Stalewski H, Grover S (2005) The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol 105(6):1456–1467PubMedCrossRefGoogle Scholar
  4. 4.
    Nahum GG, Stanislaw H, McMahon C (2004) Preventing ectopic pregnancies: how often does transperitoneal transmigration of sperm occur in effecting human pregnancy? BJOG 111(7):706–714PubMedCrossRefGoogle Scholar
  5. 5.
    O’Leary JL, O’Leary JA (1963) Rudimentary horn pregnancy. Obstet Gynecol 22:371–375PubMedGoogle Scholar
  6. 6.
    McCarthy E (1999) A case report and review of pregnancies in rudimentary noncommunicating uterine horns. Aust N Z J Obstet Gynaecol 39(2):188–190PubMedCrossRefGoogle Scholar
  7. 7.
    Goel P, Saha PK, Mehra R, Huria A (2007) Unruptured postdated pregnancy with a live fetus in a noncommunicating rudimentary horn. Indian J Med Sci 61(1):23–27PubMedCrossRefGoogle Scholar
  8. 8.
    Jain R, Gami N, Puri M, Trivedi S (2010) A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. J Hum Reprod Sci 3(2):113–115PubMedCrossRefGoogle Scholar
  9. 9.
    Fitzmaurice LE, Ehsanipoor RM, Porto M (2010) Rudimentary horn pregnancy with herniation into the main uterine cavity. Am J Obstet Gynecol 202(3):e5–e6PubMedCrossRefGoogle Scholar
  10. 10.
    Abreu R, Barros S, Jardim O, Morais C (2010) Failure of prostaglandin induction labor in a Müllerian abnormality. Arch Gynecol Obstet 282(2):143–147PubMedCrossRefGoogle Scholar
  11. 11.
    Chopra S, Keepanasseril A, Rohilla M, Bagga R, Kalra J, Jain V (2009) Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis. Arch Gynecol Obstet 280(6):907–910PubMedCrossRefGoogle Scholar
  12. 12.
    Buntugu K, Ntumy M, Ameh E, Obed S (2008) Rudimentary horn pregnancy: pre-rupture diagnosis and management. Ghana Med J 42(2):92–94PubMedGoogle Scholar
  13. 13.
    Contreras KR, Rothenberg JM, Kominiarek MA, Raff GJ (2008) Hand-assisted laparoscopic management of a midtrimester rudimentary horn pregnancy with placenta increta: a case report and literature review. J Minim Invasive Gynecol 15(5):644–648PubMedCrossRefGoogle Scholar
  14. 14.
    Kadan Y, Romano S (2008) Rudimentary horn pregnancy diagnosed by ultrasound and treated by laparoscopy—a case report and review of the literature. J Minim Invasive Gynecol 15(5):527–530PubMedCrossRefGoogle Scholar
  15. 15.
    Henriet E, Roman H, Zanati J, Lebreton B, Sabourin JC, Loic M (2008) Pregnant noncommunicating rudimentary uterine horn with placenta percreta. JSLS 12(1):101–103PubMedGoogle Scholar
  16. 16.
    Taori K, Saha BK, Shah D, Khadaria N, Jadhav V, Jawale R (2008) Sonographic diagnosis of uncomplicated first-trimester pregnancy in the rudimentary horn of a unicornuate uterus. J Clin Ultrasound 36(1):45–47PubMedCrossRefGoogle Scholar
  17. 17.
    Park JK, Dominguez CE (2007) Combined medical and surgical management of rudimentary uterine horn pregnancy. JSLS 11(1):119–122PubMedGoogle Scholar
  18. 18.
    Chopra S, Suri V, Aggarwal N (2007) Rudimentary horn pregnancy: prerupture diagnosis and management. Indian J Med Sci 61(1):28–29PubMedCrossRefGoogle Scholar
  19. 19.
    Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D (2007) Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol 30(5):765–770PubMedCrossRefGoogle Scholar
  20. 20.
    Sevtap HK, Aral AM, Sertac B (2007) An early diagnosis and successful local medical treatment of a rudimentary uterine horn pregnancy: a case report. Arch Gynecol Obstet 275(4):297–298PubMedCrossRefGoogle Scholar
  21. 21.
    Cash RL, Rahmani R, Herer ER (2006) First trimester screening aids in the diagnosis and management of an ectopic pregnancy in a noncommunicating uterine horn. J Clin Ultrasound 34(9):446–449PubMedCrossRefGoogle Scholar
  22. 22.
    Sönmezer M, Taskin S, Atabekoğlu C, Güngör M, Unlü C (2006) Laparoscopic management of rudimentary uterine horn pregnancy: case report and literature review. JSLS 10(3):396–399PubMedGoogle Scholar
  23. 23.
    Tsafrir A, Rojansky N, Sela HY, Gomori JM, Nadjari M (2005) Rudimentary horn pregnancy: first-trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging. J Ultrasound Med 24(2):219–223PubMedGoogle Scholar
  24. 24.
    Hemlatha AL, Divya P, Bharathi M, Parshwanath HA (2005) Ectopic pregnancy unusually occuring in rudimentary uterine horn—report of two cases. Indian J Pathol Microbiol 48(2):245–247PubMedGoogle Scholar
  25. 25.
    Shinohara A, Yamada A, Imai A (2005) Rupture of noncommunicating rudimentary uterine horn at 27 weeks’ gestation with neonatal and maternal survival. Int J Gynaecol Obstet 88(3):316–317PubMedCrossRefGoogle Scholar
  26. 26.
    Cutner A, Saridogan E, Hart R, Pandya P, Creighton S (2004) Laparoscopic management of pregnancies occurring in non-communicating accessory uterine horns. Eur J Obstet Gynecol Reprod Biol 113(1):106–109PubMedCrossRefGoogle Scholar
  27. 27.
    Ozeren S, Caliskan E, Corakci A, Ozkan S, Demirci A (2004) Magnetic resonance imaging and angiography for the prerupture diagnosis of rudimentary uterine horn pregnancy. Acta Radiol 45(8):878–881PubMedCrossRefGoogle Scholar
  28. 28.
    Sutkin G, Jazayeri A (2003) Diagnosis of a rudimentary uterine horn in pregnancy. J Ultrasound Med 22(9):985–988PubMedGoogle Scholar
  29. 29.
    Edelman AB, Jensen JT, Lee DM, Nichols MD (2003) Successful medical abortion of a pregnancy within a noncommunicating rudimentary uterine horn. Am J Obstet Gynecol 189(3):886–887PubMedCrossRefGoogle Scholar
  30. 30.
    Vo CV, Dinh TV, Hankins GD (2003) Value of ultrasound in the early diagnosis of prerupture uterine horn pregnancy. A case report. J Reprod Med 48(6):471–473PubMedGoogle Scholar
  31. 31.
    Daskalakis G, Pilalis A, Lykeridou K, Antsaklis A (2002) Rupture of noncommunicating rudimentary uterine horn pregnancy. Obstet Gynecol 100(5 Pt 2):1108–1110PubMedCrossRefGoogle Scholar
  32. 32.
    Adolph AJ, Gilliland GB (2002) Fertility following laparoscopic removal of rudimentary horn with an ectopic pregnancy. J Obstet Gynaecol Can 24(7):575–576PubMedGoogle Scholar
  33. 33.
    Smolders D, Deckers F, Pouillon M, Vanderheyden T, Vanderheyden J, De Schepper A (2002) Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus. Eur Radiol 12(1):121–124PubMedCrossRefGoogle Scholar
  34. 34.
    Kukreti M, Singhal VP, Kukreti R, Prakash A (2004) Pregnancy in a rupturing non-communicating rudimentary horn masquerading as epigastric pain. Aust N Z J Obstet Gynaecol 44(5):470–472PubMedCrossRefGoogle Scholar
  35. 35.
    Rana A, Gurung G, Rawal S, Bista KD, Adhukari S, Ghimire RK (2008) Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy. J Obstet Gynaecol Res 34(2):247–251PubMedCrossRefGoogle Scholar
  36. 36.
    Emembolu JO (1989) Rudimentary horn pregnancy associated with pre-eclampsia. Int J Gynaecol Obstet 30(4):367–370Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Sujata Siwatch
    • 1
    • 2
  • Reeti Mehra
    • 1
  • Dilpreet Kaur Pandher
    • 1
  • Anju Huria
    • 1
  1. 1.Department of Obstetrics and GynaecologyGovernment Medical College and HospitalChandigarhIndia
  2. 2.Department of Obstetrics and GynaecologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia

Personalised recommendations