Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Arch Gynecol Obstet. 2009 Dec;280(6):907-10. doi: 10.1007/s00404-009-1013-4. Epub 2009 Mar 13.
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.
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.
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.
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.
子宫残角妊娠是一种异位妊娠，其发病率和死亡率都很高。尽管超声技术近年来有了进步，但对子宫残角妊娠的诊断仍然很困难；通常只有在剖腹探查时才能确诊。本研究旨在分析子宫残角妊娠的产科并发症和诊断难题。
回顾性分析 2004 年至 2008 年期间在印度北部一家转诊医院诊断为子宫残角妊娠的患者的病历，分析其诊断困难和相关并发症。
在四年的研究期间，子宫残角妊娠占 12 例。其中，无交通的残角占 75%。患者的平均年龄为 26±5.11 岁，诊断时的妊娠周期为 10 至 34 周。只有 2 例在妊娠破裂前做出诊断，超声诊断的敏感性为 33.3%。所有患者均行剖腹手术切除残角和输卵管切除术。83.3%的患者需要多次输血。
时至今日，子宫残角妊娠的处理仍然是一个挑战。急诊工作人员需要保持高度警惕，特别是对高危人群，以防止因妊娠破裂而导致的发病率。
