Bicornuate Uterus with Third Trimester Fetal Demise in a Non-Communicating Rudimentary Uterine Horn: A Case Report
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Background Bicornuate uterus is a rare congenital uterine anomaly that occurs due to incomplete fusion of the mullerian ducts during fetal development, resulting in a single cervix and two uterine horns with partial to complete separation with or without communication between the cavities. Pregnancy in a rudimentary non-communicating uterine horn of a bicornuate uterus is an even rare occurrence, usually due to transperitoneal migration of sperms or zygote, and it is often associated with fetal demise and uterine rupture. We report a case of a bicornuate uterus unicollis with a third-trimester fetal demise in a non-communicating rudimentary uterine horn with focus on diagnosis, investigations and management in a low resource setting. s2001 Case Presentation The patient was a 24-year-old Ugandan, gravida 2 para 0+1 at 29 weeks of gestation who presented with abdominal pain for 3 days. She had a history of dyspareunia, dysmenorrhea, and a first-trimester miscarriage four years ago. Laparotomy for an abdominal ectopic pregnancy revealed a bicornuate uterus with a gravid non-communicating rudimentary uterine horn containing a dead fetus. Resection of the right non-communicating uterine horn was done with preservation of the right ovary. s2002 Conclusion Despite the rarity and difficulty in the diagnosis of uterine anomalies in low-resource settings, it is important for clinicians, especially obstetricians and gynecologists, to be aware of a bicornuate uterus with a non-communicat
Abstract
Background Bicornuate uterus is a rare congenital uterine anomaly that occurs due to incomplete fusion of the mullerian ducts during fetal development, resulting in a single cervix and two uterine horns with partial to complete separation with or without communication between the cavities. Pregnancy in a rudimentary non-communicating uterine horn of a bicornuate uterus is an even rare occurrence, usually due to transperitoneal migration of sperms or zygote, and it is often associated with fetal demise and uterine rupture. We report a case of a bicornuate uterus unicollis with a third-trimester fetal demise in a non-communicating rudimentary uterine horn with focus on diagnosis, investigations and management in a low resource setting. s2001 Case Presentation The patient was a 24-year-old Ugandan, gravida 2 para 0+1 at 29 weeks of gestation who presented with abdominal pain for 3 days. She had a history of dyspareunia, dysmenorrhea, and a first-trimester miscarriage four years ago. Laparotomy for an abdominal ectopic pregnancy revealed a bicornuate uterus with a gravid non-communicating rudimentary uterine horn containing a dead fetus. Resection of the right non-communicating uterine horn was done with preservation of the right ovary. s2002 Conclusion Despite the rarity and difficulty in the diagnosis of uterine anomalies in low-resource settings, it is important for clinicians, especially obstetricians and gynecologists, to be aware of a bicornuate uterus with a non-communicating rudimentary horn pregnancy that can lead to fetal demise and uterine rupture. Early antenatal diagnosis by ultrasonography is crucial in prevention of future obstetric complications in low resource settings. s2003