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Rudimentary horn pregnancy

April 13, 2024

Pregnancy in a rudimentary horn of the uterus is a very rare type of ectopic pregnancy.[1][2][3] This type of pregnancy can be life-threatening, as the rudimentary horn is not meant to sustain a pregnancy and is at risk of rupturing.[4]

Unicornuate uterus with rudimentary horn is a type of congenital uterine anomaly that arises when one of the Müllerian ducts fails to develop fully, resulting in a small rudimentary horn on one side of the uterus. Different terms have been used in the literature to describe the rudimentary horn, such as uterus bicornis with accessory horn, uterus bicornis unicollis with rudimentary horn, uterus bicornis unicollis with atretic horn, hernia uterus inguinale, and Roberts uterus.[5]

Complications edit

This condition is considered a medical emergency, as rupture of the rudimentary horn can occur in the late first or second trimester of pregnancy (between 10 and 15 weeks of gestation), leading to massive bleeding and threatening the patient's life.[6] Pregnancy in a rudimentary horn is typically associated with several complications, including intrauterine growth restriction, low amniotic fluid levels, preterm birth, fetal death, and occasionally, full-term gestation.[7] While there have been cases of successful live births, the prognosis for pregnancy in the rudimentary horn is generally poor.[6][8]

Epidemiology edit

It is reported that 1 out of every 200 to 600 fertile women have a congenital uterine anomaly, while the occurrence of unicornuate uterus with rudimentary horn is even less common, with a frequency of 1 in 100,000.[6] Although pregnancy in the rudimentary horn is extremely rare, it can lead to an ectopic gestation with an incidence of 1 in 100,000 to 1 in 140,000 pregnancies.[6][8]

Diagnosis edit

Diagnosing rudimentary horn pregnancy requires specific tests, such as hysteroscopy, hysterosalpingography, and laparoscopy, and close monitoring is essential if a person with a suspected rudimentary horn becomes pregnant to avoid the risk of rupture and its complications. Recent progress in diagnostic imaging techniques, including magnetic resonance imaging and ultrasound, have enabled the detection of these pregnancies before they lead to rupture.[9][10] Obstetric ultrasonography, particularly the transvaginal method, is used for attempting prenatal diagnosis.[6]

Many patients experience acute abdominal pain, and it can be challenging to differentiate rudimentary horn pregnancy from other acute abdominal or gestational problems through ultrasound, leading to a high rate of misdiagnosis.[11] Additionally, during advanced stages of gestation, rudimentary horn pregnancy can closely resemble abdominal pregnancy.[12]

Management edit

The standard approach for managing a rudimentary horn, regardless of the trimester, is to remove it along with the corresponding tube using either laparoscopy or laparotomy.[13] This is advised because the functional endometrial horn has a higher risk of ectopic pregnancy, infertility, and dysmenorrhoea.[13]

References edit

  1. ^ Siwatch, Sujata; Mehra, Reeti; Pandher, Dilpreet Kaur; Huria, Anju (2012-11-27). "Rudimentary horn pregnancy: a 10-year experience and review of literature". Archives of Gynecology and Obstetrics. 287 (4). Springer Science and Business Media LLC: 687–695. doi:10.1007/s00404-012-2625-7. ISSN 0932-0067. PMID 23183713.
  2. ^ Dahiya, Krishna; Duhan, Nirmala; Nanda, Smiti (2011). "Rudimentary Horn Pregnancy: Series of Four Cases and Review of the Literature". Journal of Gynecologic Surgery. 27 (3). Mary Ann Liebert Inc: 139–141. doi:10.1089/gyn.2010.0032. ISSN 1042-4067.
  3. ^ Ambusaidi, Qamariya; Jha, Chitra (2014). "Pregnancy in the Rudimentary Uterine Horn Case Report of an Unusual Presentation = عرض لحالة نادرة لحمل في قرن رحم غير مكتمل النمو". Sultan Qaboos University Medical Journal. 14 (1): 134–138. doi:10.12816/0003349. ISSN 2075-0528. PMC 3916269. PMID 24516746.
  4. ^ Zhang, Salina; Lamari, Alessandra; Ferris, Edward; Maseelall, Priya (2022). "Fertility after treatment of a noncommunicating rudimentary horn pregnancy: A case report". Case Reports in Women's Health. 35. Elsevier BV: e00429. doi:10.1016/j.crwh.2022.e00429. ISSN 2214-9112. PMC 9287488. PMID 35855949.
  5. ^ Jayasinghe, Yasmin; Rane, Ajay; Stalewski, Harry; Grover, Sonia (2005). "The Presentation and Early Diagnosis of the Rudimentary Uterine Horn". Obstetrics & Gynecology. 105 (6). Ovid Technologies (Wolters Kluwer Health): 1456–1467. doi:10.1097/01.aog.0000161321.94364.56. ISSN 0029-7844. PMID 15932844.
  6. ^ a b c d e Chopra, Seema; Keepanasseril, Anish; Rohilla, Meenakshi; Bagga, Rashmi; Kalra, Jaswinder; Jain, Vanita (2009-03-13). "Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis". Archives of Gynecology and Obstetrics. 280 (6). Springer Science and Business Media LLC: 907–910. doi:10.1007/s00404-009-1013-4. ISSN 0932-0067. PMID 19283398.
  7. ^ Zhang, Yu; Pang, Yingxin; Zhang, Xue; Zhao, Zhe; Liu, Peishu (2020-08-21). "Full-term pregnancy in a rudimentary horn with a live fetus". Medicine. 99 (34). Ovid Technologies (Wolters Kluwer Health): e21604. doi:10.1097/md.0000000000021604. ISSN 0025-7974. PMC 7447397. PMID 32846770.
  8. ^ a b Pal, Kalpana; Majumdar, Subrata; Mukhopadhyay, Sambit (2006-05-13). "Rupture of rudimentary uterine horn pregnancy at 37 weeks gestation with fetal survival". Archives of Gynecology and Obstetrics. 274 (5). Springer Science and Business Media LLC: 325–326. doi:10.1007/s00404-006-0170-y. ISSN 0932-0067. PMID 16699796.
  9. ^ Ueda, Makiko; Ota, Kuniaki; Takahashi, Toshifumi; Suzuki, Satoshi; Suzuki, Daisuke; Kyozuka, Hyo; Jimbo, Masatoshi; Soeda, Shu; Watanabe, Takafumi; Fujimori, Keiya (2021-10-26). "Successful pregnancy and term delivery after treatment of unicornuate uterus with non-communicating rudimentary horn pregnancy with local methotrexate injection followed by laparoscopic resection: a case report and literature review". BMC Pregnancy and Childbirth. 21 (1). Springer Science and Business Media LLC: 715. doi:10.1186/s12884-021-04195-5. ISSN 1471-2393. PMC 8547051. PMID 34702216.
  10. ^ Dhanawat, Juhi; Pape, Julian; Stuhlmann-Laeisz, Christiane; Maass, Nicolai; Freytag, Damaris; Gitas, Georgios; Alkatout, Ibrahim (2021). "Ectopic pregnancy in noncommunicating horn of unicornuate uterus: 3D-ultrasound and primary laparoscopic management". Clinical Case Reports. 9 (5). Wiley: e04261. doi:10.1002/ccr3.4261. ISSN 2050-0904. PMC 8142796. PMID 34084520.
  11. ^ Zhang, Duo-Duo; Gao, Ying; Lang, Jing-He; Zhu, Lan (2018-12-20). "Diagnosis and Treatment of Rudimentary Horn Pregnancy". Chinese Medical Journal. 131 (24). Ovid Technologies (Wolters Kluwer Health): 3012–3014. doi:10.4103/0366-6999.247200. ISSN 0366-6999. PMC 6302637. PMID 30539921.
  12. ^ Bidiga, Semtama; Henry, Kiwango; Augustino, Onesmo; Mujuni, Fridolin; Matovelo, Dismas; Ndaboine, Edgar; Kihunrwa, Albert; Kiritta, Richard (2023-05-12). "Rudimentary horn pregnancy, a differential diagnosis of an intraabdominal pregnancy: a case report". Journal of Medical Case Reports. 17 (1). Springer Science and Business Media LLC: 210. doi:10.1186/s13256-023-03882-5. ISSN 1752-1947. PMC 10176794. PMID 37170291.
  13. ^ a b Jomaa, Sami; Ahmad, Afaf; Adwan, Dema (2021). "Successful diagnosis and management of prerupture rudimentary horn pregnancy in the second trimester: a case report". Radiology Case Reports. 16 (10). Elsevier BV: 3068–3071. doi:10.1016/j.radcr.2021.07.044. ISSN 1930-0433. PMC 8365452. PMID 34429804.

April 13, 2024
rudimentary, horn, pregnancy, pregnancy, rudimentary, horn, uterus, very, rare, type, ectopic, pregnancy, this, type, pregnancy, life, threatening, rudimentary, horn, meant, sustain, pregnancy, risk, rupturing, unicornuate, uterus, with, rudimentary, horn, typ. Pregnancy in a rudimentary horn of the uterus is a very rare type of ectopic pregnancy 1 2 3 This type of pregnancy can be life threatening as the rudimentary horn is not meant to sustain a pregnancy and is at risk of rupturing 4 Unicornuate uterus with rudimentary horn is a type of congenital uterine anomaly that arises when one of the Mullerian ducts fails to develop fully resulting in a small rudimentary horn on one side of the uterus Different terms have been used in the literature to describe the rudimentary horn such as uterus bicornis with accessory horn uterus bicornis unicollis with rudimentary horn uterus bicornis unicollis with atretic horn hernia uterus inguinale and Roberts uterus 5 Contents 1 Complications 2 Epidemiology 3 Diagnosis 4 Management 5 ReferencesComplications editThis condition is considered a medical emergency as rupture of the rudimentary horn can occur in the late first or second trimester of pregnancy between 10 and 15 weeks of gestation leading to massive bleeding and threatening the patient s life 6 Pregnancy in a rudimentary horn is typically associated with several complications including intrauterine growth restriction low amniotic fluid levels preterm birth fetal death and occasionally full term gestation 7 While there have been cases of successful live births the prognosis for pregnancy in the rudimentary horn is generally poor 6 8 Epidemiology editIt is reported that 1 out of every 200 to 600 fertile women have a congenital uterine anomaly while the occurrence of unicornuate uterus with rudimentary horn is even less common with a frequency of 1 in 100 000 6 Although pregnancy in the rudimentary horn is extremely rare it can lead to an ectopic gestation with an incidence of 1 in 100 000 to 1 in 140 000 pregnancies 6 8 Diagnosis editDiagnosing rudimentary horn pregnancy requires specific tests such as hysteroscopy hysterosalpingography and laparoscopy and close monitoring is essential if a person with a suspected rudimentary horn becomes pregnant to avoid the risk of rupture and its complications Recent progress in diagnostic imaging techniques including magnetic resonance imaging and ultrasound have enabled the detection of these pregnancies before they lead to rupture 9 10 Obstetric ultrasonography particularly the transvaginal method is used for attempting prenatal diagnosis 6 Many patients experience acute abdominal pain and it can be challenging to differentiate rudimentary horn pregnancy from other acute abdominal or gestational problems through ultrasound leading to a high rate of misdiagnosis 11 Additionally during advanced stages of gestation rudimentary horn pregnancy can closely resemble abdominal pregnancy 12 Management editThe standard approach for managing a rudimentary horn regardless of the trimester is to remove it along with the corresponding tube using either laparoscopy or laparotomy 13 This is advised because the functional endometrial horn has a higher risk of ectopic pregnancy infertility and dysmenorrhoea 13 References edit Siwatch Sujata Mehra Reeti Pandher Dilpreet Kaur Huria Anju 2012 11 27 Rudimentary horn pregnancy a 10 year experience and review of literature Archives of Gynecology and Obstetrics 287 4 Springer Science and Business Media LLC 687 695 doi 10 1007 s00404 012 2625 7 ISSN 0932 0067 PMID 23183713 Dahiya Krishna Duhan Nirmala Nanda Smiti 2011 Rudimentary Horn Pregnancy Series of Four Cases and Review of the Literature Journal of Gynecologic Surgery 27 3 Mary Ann Liebert Inc 139 141 doi 10 1089 gyn 2010 0032 ISSN 1042 4067 Ambusaidi Qamariya Jha Chitra 2014 Pregnancy in the Rudimentary Uterine Horn Case Report of an Unusual Presentation عرض لحالة نادرة لحمل في قرن رحم غير مكتمل النمو Sultan Qaboos University Medical Journal 14 1 134 138 doi 10 12816 0003349 ISSN 2075 0528 PMC 3916269 PMID 24516746 Zhang Salina Lamari Alessandra Ferris Edward Maseelall Priya 2022 Fertility after treatment of a noncommunicating rudimentary horn pregnancy A case report Case Reports in Women s Health 35 Elsevier BV e00429 doi 10 1016 j crwh 2022 e00429 ISSN 2214 9112 PMC 9287488 PMID 35855949 Jayasinghe Yasmin Rane Ajay Stalewski Harry Grover Sonia 2005 The Presentation and Early Diagnosis of the Rudimentary Uterine Horn Obstetrics amp Gynecology 105 6 Ovid Technologies Wolters Kluwer Health 1456 1467 doi 10 1097 01 aog 0000161321 94364 56 ISSN 0029 7844 PMID 15932844 a b c d e Chopra Seema Keepanasseril Anish Rohilla Meenakshi Bagga Rashmi Kalra Jaswinder Jain Vanita 2009 03 13 Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn retrospective analysis Archives of Gynecology and Obstetrics 280 6 Springer Science and Business Media LLC 907 910 doi 10 1007 s00404 009 1013 4 ISSN 0932 0067 PMID 19283398 Zhang Yu Pang Yingxin Zhang Xue Zhao Zhe Liu Peishu 2020 08 21 Full term pregnancy in a rudimentary horn with a live fetus Medicine 99 34 Ovid Technologies Wolters Kluwer Health e21604 doi 10 1097 md 0000000000021604 ISSN 0025 7974 PMC 7447397 PMID 32846770 a b Pal Kalpana Majumdar Subrata Mukhopadhyay Sambit 2006 05 13 Rupture of rudimentary uterine horn pregnancy at 37 weeks gestation with fetal survival Archives of Gynecology and Obstetrics 274 5 Springer Science and Business Media LLC 325 326 doi 10 1007 s00404 006 0170 y ISSN 0932 0067 PMID 16699796 Ueda Makiko Ota Kuniaki Takahashi Toshifumi Suzuki Satoshi Suzuki Daisuke Kyozuka Hyo Jimbo Masatoshi Soeda Shu Watanabe Takafumi Fujimori Keiya 2021 10 26 Successful pregnancy and term delivery after treatment of unicornuate uterus with non communicating rudimentary horn pregnancy with local methotrexate injection followed by laparoscopic resection a case report and literature review BMC Pregnancy and Childbirth 21 1 Springer Science and Business Media LLC 715 doi 10 1186 s12884 021 04195 5 ISSN 1471 2393 PMC 8547051 PMID 34702216 Dhanawat Juhi Pape Julian Stuhlmann Laeisz Christiane Maass Nicolai Freytag Damaris Gitas Georgios Alkatout Ibrahim 2021 Ectopic pregnancy in noncommunicating horn of unicornuate uterus 3D ultrasound and primary laparoscopic management Clinical Case Reports 9 5 Wiley e04261 doi 10 1002 ccr3 4261 ISSN 2050 0904 PMC 8142796 PMID 34084520 Zhang Duo Duo Gao Ying Lang Jing He Zhu Lan 2018 12 20 Diagnosis and Treatment of Rudimentary Horn Pregnancy Chinese Medical Journal 131 24 Ovid Technologies Wolters Kluwer Health 3012 3014 doi 10 4103 0366 6999 247200 ISSN 0366 6999 PMC 6302637 PMID 30539921 Bidiga Semtama Henry Kiwango Augustino Onesmo Mujuni Fridolin Matovelo Dismas Ndaboine Edgar Kihunrwa Albert Kiritta Richard 2023 05 12 Rudimentary horn pregnancy a differential diagnosis of an intraabdominal pregnancy a case report Journal of Medical Case Reports 17 1 Springer Science and Business Media LLC 210 doi 10 1186 s13256 023 03882 5 ISSN 1752 1947 PMC 10176794 PMID 37170291 a b Jomaa Sami Ahmad Afaf Adwan Dema 2021 Successful diagnosis and management of prerupture rudimentary horn pregnancy in the second trimester a case report Radiology Case Reports 16 10 Elsevier BV 3068 3071 doi 10 1016 j radcr 2021 07 044 ISSN 1930 0433 PMC 8365452 PMID 34429804 Retrieved from https en wikipedia org w index php title Rudimentary horn pregnancy amp oldid 1217166439, wikipedia, wiki, book, books, library,

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