Abstrato

Pregnancy in the rudimentary horn. The culprit behind a catastrophical outcome

Mayuri Ahuja

Introduction: Pregnancy in rudimentary horn of uterus is of rare occurrence and too in the non-communicating horn is a rare entity. The rate of occurrence is 1: 76000 to 1: 50,000. The sensitivity of ultrasound in detecting this entity is only 26%. This entity is many a times missed on ultrasound and which could result in maternal morbidity and mortality.

Case A 24-year-old G3P2L1 with history of preterm labor presented at 13weeks pregnancy with shock and distended abdomen. USG suggestive of 13 weeks of IUD which was intrauterine with moderate ascites. The provisional diagnosis of IUD with septic shock with ascites patients was given fluids, antibiotics. The patient condition detiorated and paracentesis showed hemoperitoneum. The patient was taken for laparotomy and intra op showed fetus n the abdominal cavity with the placenta attached to the then identified rudimentary horn. The diagnosis was made intraoperatively as no separate fallopian tube was attached to this hypertrophied horn. The rudimentary horn was resected and patient resuscitated with massive blood transfusion and inotropes. The patient’s condition stabilized post operatively and patient discharged in stable condition.

Conclusion: The rudimentary horn can be a culprit behind a catastrophical outcome in case of shock and distended abdomen with USG suggestive of intra uterine pregnancy