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Published in: Archives of Gynecology and Obstetrics 4/2013

01-04-2013 | General Gynecology

Rudimentary horn pregnancy: a 10-year experience and review of literature

Authors: Sujata Siwatch, Reeti Mehra, Dilpreet Kaur Pandher, Anju Huria

Published in: Archives of Gynecology and Obstetrics | Issue 4/2013

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Abstract

Rudimentary horn pregnancy is rare, but can cause considerable morbidity and mortality. We discuss five cases presented to our hospital in the last 10 years and systematically review the 10-year literature of rudimentary horn pregnancies diagnosed antenatally pre-rupture.

Objectives of the review

The aim of the review was to find radiologic investigations/criteria to diagnose rudimentary horn pregnancy antenatally pre-rupture.

Search methods

A systematic literature review was carried out in Pubmed search for rudimentary horn pregnancies. The radiologic findings of the cases diagnosed before rupture were analyzed.

Results

Ultrasound is the most commonly used technique, though MRI seems to delineate details better. Non-continuity of the lumen of the cervix with the pregnant uterine horn is an important imaging finding. High clinical suspicion and radiologic skill for diagnosis are emphasized.

Conclusions

The review presents the existing imaging criteria to diagnose rudimentary horn pregnancy and suggests future research to enhance the limited evidence.
Literature
1.
go back to reference Reichman D, Laufer MR, Robinson BK (2009) Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril 91(5):1886–1894PubMedCrossRef Reichman D, Laufer MR, Robinson BK (2009) Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril 91(5):1886–1894PubMedCrossRef
2.
go back to reference Nahum GG (2002) Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases. J Reprod Med 47(2):151–163PubMed Nahum GG (2002) Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases. J Reprod Med 47(2):151–163PubMed
3.
go back to reference Jayasinghe Y, Rane A, Stalewski H, Grover S (2005) The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol 105(6):1456–1467PubMedCrossRef Jayasinghe Y, Rane A, Stalewski H, Grover S (2005) The presentation and early diagnosis of the rudimentary uterine horn. Obstet Gynecol 105(6):1456–1467PubMedCrossRef
4.
go back to reference Nahum GG, Stanislaw H, McMahon C (2004) Preventing ectopic pregnancies: how often does transperitoneal transmigration of sperm occur in effecting human pregnancy? BJOG 111(7):706–714PubMedCrossRef Nahum GG, Stanislaw H, McMahon C (2004) Preventing ectopic pregnancies: how often does transperitoneal transmigration of sperm occur in effecting human pregnancy? BJOG 111(7):706–714PubMedCrossRef
5.
go back to reference O’Leary JL, O’Leary JA (1963) Rudimentary horn pregnancy. Obstet Gynecol 22:371–375PubMed O’Leary JL, O’Leary JA (1963) Rudimentary horn pregnancy. Obstet Gynecol 22:371–375PubMed
6.
go back to reference McCarthy E (1999) A case report and review of pregnancies in rudimentary noncommunicating uterine horns. Aust N Z J Obstet Gynaecol 39(2):188–190PubMedCrossRef McCarthy E (1999) A case report and review of pregnancies in rudimentary noncommunicating uterine horns. Aust N Z J Obstet Gynaecol 39(2):188–190PubMedCrossRef
7.
go back to reference Goel P, Saha PK, Mehra R, Huria A (2007) Unruptured postdated pregnancy with a live fetus in a noncommunicating rudimentary horn. Indian J Med Sci 61(1):23–27PubMedCrossRef Goel P, Saha PK, Mehra R, Huria A (2007) Unruptured postdated pregnancy with a live fetus in a noncommunicating rudimentary horn. Indian J Med Sci 61(1):23–27PubMedCrossRef
8.
go back to reference Jain R, Gami N, Puri M, Trivedi S (2010) A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. J Hum Reprod Sci 3(2):113–115PubMedCrossRef Jain R, Gami N, Puri M, Trivedi S (2010) A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. J Hum Reprod Sci 3(2):113–115PubMedCrossRef
9.
go back to reference Fitzmaurice LE, Ehsanipoor RM, Porto M (2010) Rudimentary horn pregnancy with herniation into the main uterine cavity. Am J Obstet Gynecol 202(3):e5–e6PubMedCrossRef Fitzmaurice LE, Ehsanipoor RM, Porto M (2010) Rudimentary horn pregnancy with herniation into the main uterine cavity. Am J Obstet Gynecol 202(3):e5–e6PubMedCrossRef
10.
go back to reference Abreu R, Barros S, Jardim O, Morais C (2010) Failure of prostaglandin induction labor in a Müllerian abnormality. Arch Gynecol Obstet 282(2):143–147PubMedCrossRef Abreu R, Barros S, Jardim O, Morais C (2010) Failure of prostaglandin induction labor in a Müllerian abnormality. Arch Gynecol Obstet 282(2):143–147PubMedCrossRef
11.
go back to reference Chopra S, Keepanasseril A, Rohilla M, Bagga R, Kalra J, Jain V (2009) Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis. Arch Gynecol Obstet 280(6):907–910PubMedCrossRef Chopra S, Keepanasseril A, Rohilla M, Bagga R, Kalra J, Jain V (2009) Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis. Arch Gynecol Obstet 280(6):907–910PubMedCrossRef
12.
go back to reference Buntugu K, Ntumy M, Ameh E, Obed S (2008) Rudimentary horn pregnancy: pre-rupture diagnosis and management. Ghana Med J 42(2):92–94PubMed Buntugu K, Ntumy M, Ameh E, Obed S (2008) Rudimentary horn pregnancy: pre-rupture diagnosis and management. Ghana Med J 42(2):92–94PubMed
13.
go back to reference Contreras KR, Rothenberg JM, Kominiarek MA, Raff GJ (2008) Hand-assisted laparoscopic management of a midtrimester rudimentary horn pregnancy with placenta increta: a case report and literature review. J Minim Invasive Gynecol 15(5):644–648PubMedCrossRef Contreras KR, Rothenberg JM, Kominiarek MA, Raff GJ (2008) Hand-assisted laparoscopic management of a midtrimester rudimentary horn pregnancy with placenta increta: a case report and literature review. J Minim Invasive Gynecol 15(5):644–648PubMedCrossRef
14.
go back to reference Kadan Y, Romano S (2008) Rudimentary horn pregnancy diagnosed by ultrasound and treated by laparoscopy—a case report and review of the literature. J Minim Invasive Gynecol 15(5):527–530PubMedCrossRef Kadan Y, Romano S (2008) Rudimentary horn pregnancy diagnosed by ultrasound and treated by laparoscopy—a case report and review of the literature. J Minim Invasive Gynecol 15(5):527–530PubMedCrossRef
15.
go back to reference Henriet E, Roman H, Zanati J, Lebreton B, Sabourin JC, Loic M (2008) Pregnant noncommunicating rudimentary uterine horn with placenta percreta. JSLS 12(1):101–103PubMed Henriet E, Roman H, Zanati J, Lebreton B, Sabourin JC, Loic M (2008) Pregnant noncommunicating rudimentary uterine horn with placenta percreta. JSLS 12(1):101–103PubMed
16.
go back to reference Taori K, Saha BK, Shah D, Khadaria N, Jadhav V, Jawale R (2008) Sonographic diagnosis of uncomplicated first-trimester pregnancy in the rudimentary horn of a unicornuate uterus. J Clin Ultrasound 36(1):45–47PubMedCrossRef Taori K, Saha BK, Shah D, Khadaria N, Jadhav V, Jawale R (2008) Sonographic diagnosis of uncomplicated first-trimester pregnancy in the rudimentary horn of a unicornuate uterus. J Clin Ultrasound 36(1):45–47PubMedCrossRef
17.
go back to reference Park JK, Dominguez CE (2007) Combined medical and surgical management of rudimentary uterine horn pregnancy. JSLS 11(1):119–122PubMed Park JK, Dominguez CE (2007) Combined medical and surgical management of rudimentary uterine horn pregnancy. JSLS 11(1):119–122PubMed
18.
go back to reference Chopra S, Suri V, Aggarwal N (2007) Rudimentary horn pregnancy: prerupture diagnosis and management. Indian J Med Sci 61(1):28–29PubMedCrossRef Chopra S, Suri V, Aggarwal N (2007) Rudimentary horn pregnancy: prerupture diagnosis and management. Indian J Med Sci 61(1):28–29PubMedCrossRef
19.
go back to reference Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D (2007) Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol 30(5):765–770PubMedCrossRef Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D (2007) Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol 30(5):765–770PubMedCrossRef
20.
go back to reference Sevtap HK, Aral AM, Sertac B (2007) An early diagnosis and successful local medical treatment of a rudimentary uterine horn pregnancy: a case report. Arch Gynecol Obstet 275(4):297–298PubMedCrossRef Sevtap HK, Aral AM, Sertac B (2007) An early diagnosis and successful local medical treatment of a rudimentary uterine horn pregnancy: a case report. Arch Gynecol Obstet 275(4):297–298PubMedCrossRef
21.
go back to reference Cash RL, Rahmani R, Herer ER (2006) First trimester screening aids in the diagnosis and management of an ectopic pregnancy in a noncommunicating uterine horn. J Clin Ultrasound 34(9):446–449PubMedCrossRef Cash RL, Rahmani R, Herer ER (2006) First trimester screening aids in the diagnosis and management of an ectopic pregnancy in a noncommunicating uterine horn. J Clin Ultrasound 34(9):446–449PubMedCrossRef
22.
go back to reference Sönmezer M, Taskin S, Atabekoğlu C, Güngör M, Unlü C (2006) Laparoscopic management of rudimentary uterine horn pregnancy: case report and literature review. JSLS 10(3):396–399PubMed Sönmezer M, Taskin S, Atabekoğlu C, Güngör M, Unlü C (2006) Laparoscopic management of rudimentary uterine horn pregnancy: case report and literature review. JSLS 10(3):396–399PubMed
23.
go back to reference Tsafrir A, Rojansky N, Sela HY, Gomori JM, Nadjari M (2005) Rudimentary horn pregnancy: first-trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging. J Ultrasound Med 24(2):219–223PubMed Tsafrir A, Rojansky N, Sela HY, Gomori JM, Nadjari M (2005) Rudimentary horn pregnancy: first-trimester prerupture sonographic diagnosis and confirmation by magnetic resonance imaging. J Ultrasound Med 24(2):219–223PubMed
24.
go back to reference Hemlatha AL, Divya P, Bharathi M, Parshwanath HA (2005) Ectopic pregnancy unusually occuring in rudimentary uterine horn—report of two cases. Indian J Pathol Microbiol 48(2):245–247PubMed Hemlatha AL, Divya P, Bharathi M, Parshwanath HA (2005) Ectopic pregnancy unusually occuring in rudimentary uterine horn—report of two cases. Indian J Pathol Microbiol 48(2):245–247PubMed
25.
go back to reference Shinohara A, Yamada A, Imai A (2005) Rupture of noncommunicating rudimentary uterine horn at 27 weeks’ gestation with neonatal and maternal survival. Int J Gynaecol Obstet 88(3):316–317PubMedCrossRef Shinohara A, Yamada A, Imai A (2005) Rupture of noncommunicating rudimentary uterine horn at 27 weeks’ gestation with neonatal and maternal survival. Int J Gynaecol Obstet 88(3):316–317PubMedCrossRef
26.
go back to reference Cutner A, Saridogan E, Hart R, Pandya P, Creighton S (2004) Laparoscopic management of pregnancies occurring in non-communicating accessory uterine horns. Eur J Obstet Gynecol Reprod Biol 113(1):106–109PubMedCrossRef Cutner A, Saridogan E, Hart R, Pandya P, Creighton S (2004) Laparoscopic management of pregnancies occurring in non-communicating accessory uterine horns. Eur J Obstet Gynecol Reprod Biol 113(1):106–109PubMedCrossRef
27.
go back to reference Ozeren S, Caliskan E, Corakci A, Ozkan S, Demirci A (2004) Magnetic resonance imaging and angiography for the prerupture diagnosis of rudimentary uterine horn pregnancy. Acta Radiol 45(8):878–881PubMedCrossRef Ozeren S, Caliskan E, Corakci A, Ozkan S, Demirci A (2004) Magnetic resonance imaging and angiography for the prerupture diagnosis of rudimentary uterine horn pregnancy. Acta Radiol 45(8):878–881PubMedCrossRef
28.
go back to reference Sutkin G, Jazayeri A (2003) Diagnosis of a rudimentary uterine horn in pregnancy. J Ultrasound Med 22(9):985–988PubMed Sutkin G, Jazayeri A (2003) Diagnosis of a rudimentary uterine horn in pregnancy. J Ultrasound Med 22(9):985–988PubMed
29.
go back to reference Edelman AB, Jensen JT, Lee DM, Nichols MD (2003) Successful medical abortion of a pregnancy within a noncommunicating rudimentary uterine horn. Am J Obstet Gynecol 189(3):886–887PubMedCrossRef Edelman AB, Jensen JT, Lee DM, Nichols MD (2003) Successful medical abortion of a pregnancy within a noncommunicating rudimentary uterine horn. Am J Obstet Gynecol 189(3):886–887PubMedCrossRef
30.
go back to reference Vo CV, Dinh TV, Hankins GD (2003) Value of ultrasound in the early diagnosis of prerupture uterine horn pregnancy. A case report. J Reprod Med 48(6):471–473PubMed Vo CV, Dinh TV, Hankins GD (2003) Value of ultrasound in the early diagnosis of prerupture uterine horn pregnancy. A case report. J Reprod Med 48(6):471–473PubMed
31.
go back to reference Daskalakis G, Pilalis A, Lykeridou K, Antsaklis A (2002) Rupture of noncommunicating rudimentary uterine horn pregnancy. Obstet Gynecol 100(5 Pt 2):1108–1110PubMedCrossRef Daskalakis G, Pilalis A, Lykeridou K, Antsaklis A (2002) Rupture of noncommunicating rudimentary uterine horn pregnancy. Obstet Gynecol 100(5 Pt 2):1108–1110PubMedCrossRef
32.
go back to reference Adolph AJ, Gilliland GB (2002) Fertility following laparoscopic removal of rudimentary horn with an ectopic pregnancy. J Obstet Gynaecol Can 24(7):575–576PubMed Adolph AJ, Gilliland GB (2002) Fertility following laparoscopic removal of rudimentary horn with an ectopic pregnancy. J Obstet Gynaecol Can 24(7):575–576PubMed
33.
go back to reference Smolders D, Deckers F, Pouillon M, Vanderheyden T, Vanderheyden J, De Schepper A (2002) Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus. Eur Radiol 12(1):121–124PubMedCrossRef Smolders D, Deckers F, Pouillon M, Vanderheyden T, Vanderheyden J, De Schepper A (2002) Ectopic pregnancy within a rudimentary horn in a case of unicornuate uterus. Eur Radiol 12(1):121–124PubMedCrossRef
34.
go back to reference Kukreti M, Singhal VP, Kukreti R, Prakash A (2004) Pregnancy in a rupturing non-communicating rudimentary horn masquerading as epigastric pain. Aust N Z J Obstet Gynaecol 44(5):470–472PubMedCrossRef Kukreti M, Singhal VP, Kukreti R, Prakash A (2004) Pregnancy in a rupturing non-communicating rudimentary horn masquerading as epigastric pain. Aust N Z J Obstet Gynaecol 44(5):470–472PubMedCrossRef
35.
go back to reference Rana A, Gurung G, Rawal S, Bista KD, Adhukari S, Ghimire RK (2008) Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy. J Obstet Gynaecol Res 34(2):247–251PubMedCrossRef Rana A, Gurung G, Rawal S, Bista KD, Adhukari S, Ghimire RK (2008) Surviving 27 weeks fetus expelled out of the ruptured rudimentary horn and detected a month later as a secondary abdominal pregnancy. J Obstet Gynaecol Res 34(2):247–251PubMedCrossRef
36.
go back to reference Emembolu JO (1989) Rudimentary horn pregnancy associated with pre-eclampsia. Int J Gynaecol Obstet 30(4):367–370 Emembolu JO (1989) Rudimentary horn pregnancy associated with pre-eclampsia. Int J Gynaecol Obstet 30(4):367–370
Metadata
Title
Rudimentary horn pregnancy: a 10-year experience and review of literature
Authors
Sujata Siwatch
Reeti Mehra
Dilpreet Kaur Pandher
Anju Huria
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 4/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2625-7

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