Bruand Mariette, Thubert Thibault, Winer Norbert, Gueudry Pauline, Dochez Vincent
Obstetrics and Gynecology, Centre Hospitalier Universitaire de Nantes, Nantes, FRA.
Cureus. 2020 Mar 6;12(3):e7191. doi: 10.7759/cureus.7191.
The rudimentary horn of uterus is an extremely rare malformation and potentially serious obstetric entity, threatening maternal and fetal outcome. Diagnostic sonography of early pregnancy in a non-communicating rudimentary horn is difficult but important. We report a case of ruptured non-communicating rudimentary horn with unicornuate uterus at 12 weeks' gestation, where diagnosis is made before surgery. Excision of the rudimentary horn and ipsilateral salpingectomy (to prevent a further ectopic tubal gestation), conserving the ovary, is the recommended surgical procedure for patients desiring to maintain their fertility potential. The subsequent obstetric prognosis is reassuring. Diagnostic imaging examinations of the reproductive system after this treatment showed no negative effect from surgery on subsequent fertility and there was no reported case of uterine rupture during subsequent pregnancy in the remaining unicornuate uterus after rudimentary horn excision. Future pregnancies will require extremely close monitoring and a caesarean section is highly recommended.
残角子宫是一种极其罕见的畸形,也是潜在的严重产科疾病,会威胁母婴结局。对非交通性残角子宫进行早期妊娠的诊断性超声检查虽困难但很重要。我们报告一例妊娠12周时非交通性残角子宫合并单角子宫破裂的病例,术前已作出诊断。对于希望保留生育能力的患者,推荐的手术方式是切除残角子宫和同侧输卵管切除术(以防止再次发生输卵管异位妊娠),保留卵巢。后续产科预后令人放心。该治疗后生殖系统的诊断性影像学检查显示,手术对后续生育能力无负面影响,且在切除残角子宫后,剩余单角子宫的后续妊娠期间未报告子宫破裂病例。未来妊娠需要极其密切的监测,强烈建议剖宫产。