Introduction
Prevalence of unicornuate uterus is 0.1% in the population, with 74%
of unicornuate uterus having a rudimentary horn, which is present due to
partial development of one mullerian duct. Rudimentary horn can be
communicating or non-communicating depending on their fusion with the
larger horn. When rudimentary horn fuses, it has a communication with
the larger uterine horn, and when fusion fails, there is no
communication between the rudimentary horn and the larger horn, with
70-90% of the times, rudimentary horn not communicating with the main
horn [1]. Mullerian anomalies lead to multiple problems like
infertility, endometriosis, dysmenorrhoea, recurrent mis-carriages,
preterm birth, fetal growth restriction, placental abnormalities,
increase caesarean section rates which affect morbidity and mortality of
women[2][1][3]. Sometimes, unicornuate uterus has been
associated with other malformations like musculoskeletal malformations,
auditory defects, Hirschprung disease, absent gall bladder [2] and
VACTERL anomalies [4].
Diagnosing uterine anomalies early, if possible during adolescents , and
later during early pregnancy period will help to reduce morbidity and
mortality with uterine rupture being as high as 80% [5], most
uterine horn rupture occurring at 10-15 weeks of gestation
[6][7]. There has been reports of pregnancy in rudimentary horn
up till term, live [8, 9] and with fetal demise [3] but such
conditions are extremely rare and should be avoided. If the clinician
has an ectopic mind, and is suspicious that he’s dealing with ectopic
pregnancy, he should keep in mind that he may be dealing with a uterine
anomaly, else diagnosis may be missed. Detecting it is of utmost
importance, because if not detected in time, pregnancy will progress to
a stage where rupture is inevitable, and this will be detrimental for
the woman.
We present a case where we detected pregnancy in the rudimentary horn of
unicornuate uterus early by 3D vaginal ultrasound. Treatment was
primarily surgical with laparoscopy being the mode of surgery.