Ambusaidi Qamariya, Jha Chitra
Department of Obstetrics & Gynecology, Royal Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2014 Feb;14(1):e134-8. doi: 10.12816/0003349. Epub 2014 Jan 27.
A unicornuate uterus with a rudimentary horn is a uterine anomaly resulting from the incomplete development of one of the Müllerian ducts and an incomplete fusion with the contralateral side. Pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. Usually the diagnosis is missed and may present as an emergency with haemoperitoneum. The standard treatment is the surgical excision of the horn. A gravida 2, para 1 patient presented at 23 weeks' gestation with fetal demise. Repeated failed attempts at induction of labour raised the suspicion of an abnormally located pregnancy which was confirmed by magnetic resonance imaging. She underwent a laparotomy with right rudimentary horn excision. The final diagnosis of a non-communicating rudimentary horn pregnancy was made intraoperatively and was confirmed by histopathology. This case highlights the importance of an early ultrasound in detecting uterine anomalies and the need for high clinical suspicion.
单角子宫合并残角子宫是一种子宫畸形，由一侧苗勒管发育不全且与对侧未完全融合所致。子宫残角妊娠是一种罕见的临床情况，报道的发生率为每100,000至140,000次妊娠中有1例。通常诊断会被漏诊，可能以腹腔积血的急症形式出现。标准治疗方法是手术切除残角。一名孕2产1的患者在妊娠23周时出现胎儿死亡。多次引产失败引发了对妊娠位置异常的怀疑，磁共振成像证实了这一点。她接受了剖腹手术，切除右侧残角子宫。术中最终诊断为非交通性残角子宫妊娠，并经组织病理学证实。该病例强调了早期超声检查在检测子宫畸形中的重要性以及高度临床怀疑的必要性。
