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Xu S, Zhang J, Yue S, Qian J, Yang L, Xu YZ, Zhang J. A case of rudimentary uterine horn pregnancy complicated with placental implantation in later stages of pregnancy. Quant Imaging Med Surg 2024; 14:1167-1172. [PMID: 38223025 PMCID: PMC10784043 DOI: 10.21037/qims-23-889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/16/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Shengfang Xu
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
- Medical Imaging Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Jinlong Zhang
- Department of Respiratory Medicine, The 940th Hospital of Joint Logistic Support Force of People’s Liberation Army, Lanzhou, China
| | - Songhong Yue
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Jifang Qian
- Medical Imaging Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Lei Yang
- Medical Imaging Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Yuan-Zhe Xu
- School of Stomatology, Jinan University, Guangzhou, China
| | - Jing Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
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Dhanju G, Goubran A, Zimolag L, Chartrand R, Matthew F, Breddam A. Distinguishing between cornual, angular and interstitial ectopic pregnancy: A case report and a brief literature review. Radiol Case Rep 2023; 18:2531-2544. [PMID: 37235077 PMCID: PMC10208802 DOI: 10.1016/j.radcr.2023.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/09/2023] [Accepted: 04/15/2023] [Indexed: 05/28/2023] Open
Abstract
For all clinical purposes, cornual, angular, and interstitial pregnancies are considered ectopic pregnancies that can have grave consequences for the patient. In this article, we describe and distinguish 3 types of ectopic pregnancies in the cornual region of the uterus. The authors advocate using the "cornual pregnancy" term only for ectopic pregnancies in malformed uteruses. We describe an ectopic pregnancy in a 25-year-old G2P1 patient in the cornual region of the uterus that was missed twice sonographically in the second trimester and had almost fatal consequences in the patient. Radiologists and sonographers should be aware of the sonographic diagnosis of angular, cornual and interstitial pregnancies. Whenever possible, first-trimester transvaginal ultrasound scanning is crucial for diagnosing these 3 types of ectopic pregnancies in the cornual region. In the second and third trimesters, ultrasound tends to become equivocal; hence alternate imaging, such as MRI, might add additional value to the management of the patient. A case report assessment and a comprehensive literature review comprising 61 case reports of ectopic pregnancy in the second and third trimesters are diligently undertaken in the Medline, Embase and Web of Science databases. The major strength of our study is that it is one of the few studies that describe a literature review of ectopic pregnancy in the cornual region exclusively in the second and third trimesters.
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Affiliation(s)
- Gurinder Dhanju
- Department of Public Health, University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2, Canada
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Ashraf Goubran
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Lukasz Zimolag
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Robyn Chartrand
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Frankel Matthew
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Alli Breddam
- Department of Ultrasound, St. Boniface Hospital, Winnipeg, Manitoba, Canada
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Bidiga S, Henry K, Augustino O, Mujuni F, Matovelo D, Ndaboine E, Kihunrwa A, Kiritta R. Rudimentary horn pregnancy, a differential diagnosis of an intraabdominal pregnancy: a case report. J Med Case Rep 2023; 17:210. [PMID: 37170291 PMCID: PMC10176794 DOI: 10.1186/s13256-023-03882-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/08/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Rudimentary horn pregnancy is a rare life-threatening obstetric condition with clinical and sonographic presentation resembling that of an abdominal pregnancy. Preoperative diagnosis of advanced rudimentary horn pregnancy is difficult and cases are often identified incidentally during laparotomy for a presumed abdominal pregnancy. CASE PRESENTATION We report a case of a 29-year-old African woman, gravida 2 para 1 at 28 weeks of gestation complaining of epigastric pain for 7 days with no other associated gastrointestinal or genitourinary symptoms. On examination, she had normal vital signs and an enlarged abdomen sized at 33 cm with unremarkable fetal lie and presentation. She had normal laboratory blood results with an ultrasound revealing an abdominal pregnancy of 28 weeks. The informed decision for conservative management was planned after informing of the benefit and risks of early termination versus conservative management, however, with worsening symptoms an emergency laparotomy had to be performed in which a left unruptured rudimentary horn pregnancy with a viable fetus was identified incidentally and delivery of the fetus followed by surgical excision of the horn was done. The postoperative period was uneventful, and the patient was discharged home with her newborn. CONCLUSION Rudimentary horn pregnancy is very rare and often indistinguishable from an abdominal pregnancy in advanced gestation age. First trimester ultrasound is by far the only noninvasive sensitive diagnostic modality for rudimentary horn pregnancy. Laparotomy with horn excision remains the standard of care for advanced rudimentary horn pregnancy.
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Affiliation(s)
- Semtama Bidiga
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Kiwango Henry
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Onesmo Augustino
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Fridolin Mujuni
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Dismas Matovelo
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Edgar Ndaboine
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Albert Kihunrwa
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Richard Kiritta
- Department of Obstetrics and Gynecology, Well Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
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Jomaa S, Ahmad A, Adwan D. Successful diagnosis and management of prerupture rudimentary horn pregnancy in the second trimester: a case report. Radiol Case Rep 2021; 16:3068-3071. [PMID: 34429804 PMCID: PMC8365452 DOI: 10.1016/j.radcr.2021.07.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/18/2021] [Accepted: 07/18/2021] [Indexed: 11/21/2022] Open
Abstract
Rudimentary horn pregnancy has concerns due to the high incidence of an extreme risk of a life-threatening rupture. Thus, early diagnosis and management are essential to preserving the patient's life. We present a successful diagnosis and management of a prerupture rudimentary horn pregnancy in a 24-year-old woman presented with chronic pelvic pain and amenorrhea for the last 3 months. On physical examination, she had a mobile, nontender mass equals 16 weeks of gestation. Transvaginal ultrasound revealed an empty uterus with signs of a decidual reaction and a gestational sac adjacent to the uterus and surrounded by less than a 2 mm-in-thickness muscular wall with a positive fetal heart rate. The gestational age was 16 weeks based on biparietal diameter and femur length. Based on these findings rudimentary horn pregnancy was suspected. Laparotomy was performed, unicornuate uterus with unruptured, left rudimentary horn pregnancy was observed, and the pregnant horn with the ipsilateral tube was excised. To conclude, an empty uterus and extrauterine gestational sac surrounded by a thin muscular wall (<2 mm) on ultrasound should raise the suspicion of rudimentary horn pregnancy.
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Affiliation(s)
- Sami Jomaa
- Faculty of Medicine, Damascus University, Damascus, 97009 Syria
| | - Afaf Ahmad
- Faculty of Medicine, Damascus University, Damascus, 97009 Syria
| | - Dema Adwan
- Department of Emergency, University Hospital of Obstetrics and Gynecology, Damascus University, Damascus, 97009 Syria
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