Pregnancy Outcome in Unicornuate Uterus with Rudimentary Horn
Keywords:
Pregnancy, Rudimentary Horn, Unicornuate Uterus
Abstract
Background: Unicornuate uterus with rudimentary horn is one of the rare mullerian congenital anomalies (class-II) and consists of a relatively normal appearing uterus on one side with rudimentary horn on the other side. Pregnancy can occur either in unicornuate uterus or in rudimentary horn. If pregnancy occurs in unicornuate uterus, outcome may be spontaneous abortion, preterm labour or term delivery. Obstetric complications like breech presentation, IUGR, dysfunctional labour and caesarean section also are more common. If pregnancy occurs in rudimentary horn, rupture is a rule when un-diagnosed. Aim: To study pregnancy outcome in unicornuate uterus with rudimentary hornMethods: This is a study of 8 cases diagnosed at laparotomy/ LSCS at Mamata general hospital over a period of 5years from November 2010 to october2015. Pregnancy outcome of 18 pregnancies in these 8 cases was studied retrospectively.Results: 5 (27.8%) patients came with rudimentary horn pregnancy. 4(80%) were ruptured and one(20%) was unruptured. 13 (72.2%) pregnancies occurred in unicornuate uterus. 3 pregnancies (23.1%) aborted spontaneously. Preterm and term deliveries were seen in 3 (23.1%) and 7 (53.8%) pregnancies respectively. Obstetric complications present were breech-1(7.7%), IUGR-3(23.1%), oligohydramnios- 4(30.8%), intra-uterine death-2 (15.4%) and LSCS- 6(46.2%). There were 8 (61.5%) live births.All the four ruptured rudimentary horn pregnancies presented around 20 weeks of gestation. Out of these one patient died of irreversible shock.Conclusion: Pregnancy in unicornuate uterus with rudimentary horn is associated with poor pregnancy outcome. Especially pregnancy in rudimentary horn has considerable morbidity and occasional mortality.References
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9. Vani Malhotra, Pinkey Lakra, Smiti Nanda, Mee-nakshi Chauhan, et al. Clinical Spectrum of Un-icornuate Uterus with Noncommunicating Rudi-mentary Horn: Five-Year Analysis at a Tertiary Care Center J gynaec surgery. Vol. 30, Number 2, 2014 DOI: 10.1089/gyn.2013.007
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11. G. Nagarathna et al., Pre-rupture diagnosis and management of rudimentary horn pregnancy in second trimester Int. J Pharm Biomed Res 2011, 2(3), 179-181
12. Deepti Sharma, MG Usha, Ramesh G, S Sudha: Laparoscopic resection of unruptured rudimentary horn pregnancy . journal of gyneac endoscopy and surgery:2011, vol 2, issue 2, pg 101-104
13. Nahum G: Rudimentary uterine horn pregnancy: case report on surviving twins delivered 8 days apart. J Reprod Med 1997, 42:525-532.
14. Goel P, Saha PK, Mehra R, Huria A: Unruptured postdated pregnancy with a live fetus in a noncom-municating rudimentary horn. Indian J med Sci 2007 Jan;61(1):23-7
15. Patra S, Puri M, Trivedi SS, Yadav R, Bali J: Un-ruptured term pregnancy with a live fetus with pla-centa percreta in a non-communicating rudimentary horn. Congenit Anom (Kyoto), 2007;47(4):156-7
16. Anne S. Deviwold, Norman phan, Adyin Arici. Anatomic factors in recurrent pregnancy loss. Se-min Reprod. Med. 2006; 24(1):25-32
17. Paul C.Lin Reproductive outcomes in women with uterine anomalies. Journal of women’s reproductive health. Jan 2004, 13 (1): 33-39
2. Patrick I Okonta, Harrison Abedi, Caroline Ajuyah, Lawrence Omo-Aghoja. Pregnancy in a noncom-municating rudimentary horn of a unicornuate ute-rus: a case report Cases Journal 2009,2 :6624
3. Simon C, Martinez L, Pardo F, Tortajada M, Pellicer A. Mu¨llerian defects in women with normal re-productive outcome. Fertil Steril 1991;56:1192.
4. P.K. Heinonen: Unicornuat uterus & rudimentary horn. J fertility & sterility, 1997;68:224-230
5. Ahmed S. Elagwany, Hisham H. Elgamal, Tamer M. Abdeldayem. Ruptured ectopic pregnancy in non-communicating right rudimentary horn: A case report Apollo medicine 16th october201
6. Bhattacharya TK, Sengupta P. Rudimentary horn pregnancy. Med J Armed Forces India 2005;61:377
7. Tsafrir A, Rojansky W, Yithaksela H, Gomori JM, Nadjar M. 1st trimester prerupture sonographic di-agnosis and confirmation by MRI. J Ultrasound Med 2005;24:219.
8. Reichman D, Laufer MR, Robinson BK. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2015 Jun;103(6):1615-8.
9. Vani Malhotra, Pinkey Lakra, Smiti Nanda, Mee-nakshi Chauhan, et al. Clinical Spectrum of Un-icornuate Uterus with Noncommunicating Rudi-mentary Horn: Five-Year Analysis at a Tertiary Care Center J gynaec surgery. Vol. 30, Number 2, 2014 DOI: 10.1089/gyn.2013.007
10. Goel P, Aggarwal A, Devi K, Takkar N, Saha PK, Huria :Unicornuate uterus with non-communicating rudimentary horn – different clinical presentations. J Obstet Gynecol India 2005;55:155-158
11. G. Nagarathna et al., Pre-rupture diagnosis and management of rudimentary horn pregnancy in second trimester Int. J Pharm Biomed Res 2011, 2(3), 179-181
12. Deepti Sharma, MG Usha, Ramesh G, S Sudha: Laparoscopic resection of unruptured rudimentary horn pregnancy . journal of gyneac endoscopy and surgery:2011, vol 2, issue 2, pg 101-104
13. Nahum G: Rudimentary uterine horn pregnancy: case report on surviving twins delivered 8 days apart. J Reprod Med 1997, 42:525-532.
14. Goel P, Saha PK, Mehra R, Huria A: Unruptured postdated pregnancy with a live fetus in a noncom-municating rudimentary horn. Indian J med Sci 2007 Jan;61(1):23-7
15. Patra S, Puri M, Trivedi SS, Yadav R, Bali J: Un-ruptured term pregnancy with a live fetus with pla-centa percreta in a non-communicating rudimentary horn. Congenit Anom (Kyoto), 2007;47(4):156-7
16. Anne S. Deviwold, Norman phan, Adyin Arici. Anatomic factors in recurrent pregnancy loss. Se-min Reprod. Med. 2006; 24(1):25-32
17. Paul C.Lin Reproductive outcomes in women with uterine anomalies. Journal of women’s reproductive health. Jan 2004, 13 (1): 33-39
Published
2016-01-01
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