Rudimentary uterine horn pregnancy: a mystery diagnosis

Objective: To emphasize the importance of complete ultrasonographic evaluation during the first trimester of pregnancy. Design: Case report. Setting: Obstetric unit in a training and research hospital. Patient(s): A 27-year-old primigravida woman who reached 37 weeks' gestation with a noncommunicating rudimentary horn pregnancy. Intervention(s): The accurate diagnosis of a noncommunicating rudimentary horn pregnancy was made after cesarean section at 37 weeks' gestation. Rudimentary horn excision and ipsilateral salpingectomy were performed during exploration. Main Outcome Measure(s): Early diagnosis using sonography to prevent maternal morbidity and mortality. Result(s): A female baby with a 7/10 apgar score was delivered successfully. The patient and her baby were both discharged in good health. Conclusion(s): Rudimentary uterine horn pregnancy should always be considered as a differential diagnosis of intrauterine pregnancy in a bicornuate uterus. A thorough ultrasonographic examination should be performed on the aspects of the pregnancy and the pelvic anatomy. Lack of knowledge of and experience with mullerian anomalies still makes these anomalies difficult to recognize even with laparoscopy. (Fertil Steril (R) 2009; 92: 2037.e1-e3. (C) 2009 by American Society for Reproductive Medicine.)