Unruptured term pregnancy with a live fetus with placenta percreta in a non-communicating rudimentary horn

Distinguishing between cornual, angular and interstitial ectopic pregnancy: A case report and a brief literature review

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.

Successful Management of a Noncommunicating Rudimentary Uterine Horn Pregnancy by Laparoscopic Surgery: A Case Report and Literature Review

Pregnancy in a noncommunicating rudimentary horn is extremely rare but can cause serious clinical complications, such as uterine rupture. The standard treatment is excision of the rudimentary horn, and recently, in some cases, laparoscopic resection has been performed in the first trimester of gestation. Herein, we present a case of noncommunicating rudimentary horn pregnancy (NCRHP), which was diagnosed by magnetic resonance imaging at 6 weeks of gestation and treated by laparoscopic surgery. However, we have also found some rare cases in which patients could obtain live newborn babies. Since management is affected by the different levels of obstetric medical care and diagnostic tools, we also performed a review and analysis of NCRHP. A PubMed search yielded 103 cases reported in the English literature. Correct diagnosis and laparoscopic treatment were achieved more frequently in developed countries, especially in the first trimester of gestation. On the other hand, symptoms, including abdominal pain and hypovolemic shock, tended to occur in the second trimester of gestation. This period was also found to be a risk factor for uterine rupture. Among 18 patients at the third trimester of gestation, 13 obtained live neonatal infants. Therefore, detailed information about this disease is crucial for proper treatments.

Prerupture diagnosis of a pregnant rudimentary uterine horn

This clinical case reports prerupture diagnosis of a rudimentary horn pregnancy in a 27-year-old formerly healthy woman presented with moderate to severe suprapubic abdominal pain at the gestational age of 12 + 0 weeks. The suspected diagnosis of this pregnant rudimentary horn via transvaginal ultrasound was acknowledged during an emergency exploratory laparotomy. The simple transvaginal ultrasound criteria suggested by the present study would help clinicians avoid time-consuming inefficient investigative procedure and rule out this rare life-threatening condition by taking into account the rudimentary horn pregnancy as a differential diagnosis in patients presenting with abdominal pain.

Unruptured pregnancy in a noncommunicating rudimentary horn at 37 weeks with a live fetus: a case report

We report an extremely rare case of an unruptured non-communicating rudimentary horn full-term pregnancy. A woman who had a uterine malformation was misdiagnosed as uterus didelphys and gave birth to a live, healthy fetus. The correct diagnosis was not made until cesarean section at 37 4/7 weeks. The case suggests that women who are pregnant in a rudimentary horn could obtain a full-term delivery and give birth to a live and healthy baby.

Live Birth Following a Term Pregnancy in a Non-communicating Rudimentary Horn of a Unicornuate Uterus

A case report of a live birth following a term pregnancy located in a non-communicating rudimentary horn of a unicornuate uterus in a rural hospital in Nigeria is presented. A 32-year-old primiparous woman registered for antenatal care at a rural missionary hospital at 28 weeks gestation. She had intermittent unexplained vaginal bleeding prior to booking and multiple ultrasound scans in different centers affirmed a viable intrauterine pregnancy. She had an elective cesarean section at 38 weeks gestational age on account of a persistent oblique breech presentation and “low lying placenta.” Intra-operatively, the pregnancy was found in a non-communicating pouch continuous with the left fallopian tube and separate from the uterine cavity. A female baby weighing 2.2 kg with no gross deformity was delivered. Resection of the rudimentary horn and repair were done. The possibility of a uterine anomaly should be considered by clinicians and sonographers in unexplained intermittent early pregnancy bleeding.