Della Corte Luigi, Fabozzi Annamaria, Giampaolino Pierluigi, Saccone Gabriele, Pizzuti Laura Micol, Romeo Valeria, Maurea Simone, Bifulco Giuseppe
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Public Health, University of Naples Federico II, Naples, Italy.
Eur J Obstet Gynecol Reprod Biol. 2019 Apr;235:133-135. doi: 10.1016/j.ejogrb.2019.02.018. Epub 2019 Feb 27.
Female genital malformations, as the unicornuate uterus, are deviations from normal anatomy that could impair the reproductive potential of a woman or her health. We present a rare case of a 20-week spontaneous abortion in a 24 years old patient affected by a misunderstood unicornuate uterus with communicating rudimentary horn, previously diagnosed as bicornuate, and for this reason subjected to induction of abortive labor, using mifepristone and gemeprost. Following the ultrasound exam and MRI, performed due to the failure of the abortive procedure, revealed the diagnosis of unicornuate uterus with (not clear) communicating accessory horn pregnancy, then treated with laparotomy. 3D-ultrasonography, and above all MRI, should be performed in all those cases of suspected uterine anomalies, especially in presence of pregnancy or abortion, with the aim of avoiding wrong treatments, which leads to a high risk of uterine rupture. In this case, given the uncertainty of imaging exams performed in such an advanced second trimester of pregnancy, only the surgical approach was able to discover the real communication.
女性生殖器畸形，如单角子宫，是偏离正常解剖结构的情况，可能会损害女性的生殖潜力或健康。我们报告了一例罕见病例，一名24岁患者怀孕20周时自然流产，她患有被误诊为双角子宫的单角子宫且伴有相通的残角，因此使用米非司酮和吉美前列素进行了引产。由于引产手术失败，随后进行的超声检查和磁共振成像（MRI）显示诊断为单角子宫合并（情况不明）相通的副角妊娠，之后接受了剖腹手术。对于所有疑似子宫异常的病例，尤其是在怀孕或流产的情况下，都应进行三维超声检查，尤其是MRI检查，目的是避免错误的治疗，因为这会导致子宫破裂的高风险。在这种情况下，鉴于在妊娠晚期进行的影像学检查存在不确定性，只有手术方法才能发现真正的相通情况。
