Obstetric morbidity and the diagnostic dilemma in pregnancy in rudimentary horn: retrospective analysis.

Abstract

BACKGROUND:

Pregnancy in rudimentary horn of uterus, a form of ectopic gestation, is associated with significant rates of morbidity and mortality. Despite the recent advances in the ultrasonography, diagnosis of cornual pregnancy still remains elusive; with confirmatory diagnosis usually made during laparotomy. The aim of the present study is to analyze the obstetric implications and the diagnostic dilemma of rudimentary horn pregnancy.

MATERIALS AND METHODS:

Records of women diagnosed with ectopic pregnancy in the rudimentary horn, during the years 2004 to 2008, managed in a referral hospital in northern India; were reviewed for their diagnostic difficulties and the associated morbidity.

RESULTS:

During the four year study period, rudimentary horn pregnancies accounted for 12 pregnancies. Non communicating horn accounted for 75% of the cases. The mean age of women at presentation was 26 +/- 5.11 years and the period of gestation at diagnosis varied between 10 and 34 weeks. Preruputure diagnosis was possible only in two cases and sensitivity of ultrasonographic diagnosis was 33.3%. Laprotomy with excision of rudimentary horn and salpingectomy was done in all cases. Multiple blood transfusions were required in 83.3% of women.

CONCLUSION:

Management of pregnancy in a rudimentary uterine horn continues to be a challenge to this day. Maintaining a higher degree of alertness, especially in high risk groups by emergency staff is required to prevent the morbidity, as they may present with acute uterine rupture in pregnancy.

• Authors: Seema Chopra, Anish Keepanasseril, Meenakshi Rohilla, Rashmi Bagga, Jaswinder Kalra, Vanita Jain
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 280 Issue 6 Pg. 907-10 (Dec 2009) ISSN: 1432-0711 [Electronic] Germany
• PMID: 19283398 (Publication Type: Journal Article)

Topics

• Adult
• Female
• Humans
• Laparotomy
• Pregnancy
• Pregnancy, Ectopic (diagnosis, diagnostic imaging, surgery)
• Retrospective Studies
• Ultrasonography
• Uterus (abnormalities, diagnostic imaging)
• Young Adult