Pregnancy in a unicornuate uterus: A case report

被引:26
作者
Caserta D. [1 ]
Mallozzi M. [1 ]
Meldolesi C. [2 ]
Bianchi P. [1 ]
Moscarini M. [1 ]
机构
[1] Department of Gynecological-Obstetric and Urological Sciences, University of Rome Sapienza, Sant'Andrea Hospital, Rome 00189
[2] Department of Gynecological-Obstetric, S. Pietro Fatebenefratelli Hospital, Rome 00189
关键词
Congenital Müllerian malformations; Congenital uterine anomalies; Pregnancy outcomes; Pregnancy unicornuate uterus;
D O I
10.1186/1752-1947-8-130
中图分类号
学科分类号
摘要
Introduction. A unicornuate uterus accounts for 2.4 to 13% of all Müllerian anomalies. A unicornuate uterus with a non-communicating rudimentary horn may be associated with gynecological and obstetric complications such as infertility, endometriosis, hematometra, urinary tract anomalies, abortions, and preterm deliveries. It has a poor reproductive outcome and pregnancy management is still unclear. Case presentation. We report a case of a 26-year-old Caucasian woman presenting with a unicornuate uterus with a non-communicating rudimentary horn. The diagnosis of the anomaly was based on two-dimensional and three-dimensional sonography. The excision of her symptomatic rudimentary horn and her ipsilateral fallopian tube was performed laparoscopically. The growth of the fetus was normal. At 20 weeks' pregnancy, her cervix started shortening and a tocolytic therapy was started. A cesarean delivery was successfully performed at 39 weeks and 4 days' gestation. Conclusions: Although the reproductive outcome of women with unicornuate uterus is poor, a successful pregnancy is possible. Routine excision of the rudimentary horn should be undertaken during non-pregnant state laparoscopically, and it would be necessary to screen such pregnancies for the development of intrauterine growth retardation with serial ultrasound assessments of the estimated fetal weight and the cervix length. © 2014 Caserta et al.; licensee BioMed Central Ltd.
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共 15 条
[1]  
Chan Y.Y., Jayaprakasan K., Tan A., Thornton J.G., Coomarasamy A., Raine-Fenning N.J., Reproductive outcomes in women with congenital uterine anomalies: A systematic review, Ultrasound Obstet Gynecol, 38, pp. 371-382, (2011)
[2]  
Hua M., Odibo A.O., Longman R.E., Macones G.A., Roehl K.A., Cahill A.G., Congenital uterine anomalies and adverse pregnancy outcomes, Am J Obstet Gynecol, 205, 6, (2011)
[3]  
Akar M.E., Bayar D., Yildiz S., Ozel M., Yilmaz Z., Reproductive outcome of women with unicornuate uterus, Australian and New Zealand Journal of Obstetrics and Gynaecology, 45, 2, pp. 148-150, (2005)
[4]  
Reichman D., Laufer M.R., Robinson B.K., Pregnancy outcomes in unicornuate uteri: A review, Fertil Steril, 91, 5, pp. 1886-1894, (2009)
[5]  
Grimbizis G.F., Campo R., Gordts S., Brucker S., Gergolet M., Tanos V., Li T.-C., De Angelis C., Di Spiezio Sardo A., Clinical approach for the classification of congenital uterine malformations, Gynecol Surg, 9, pp. 119-129, (2012)
[6]  
Thakur S., Sood A., Sharma C., Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: A case report, Case Rep Obstet Gynecol, 2012, (2012)
[7]  
Rackow B.W., Arici A., Reproductive performance of women with mullerian anomalies, Current Opinion in Obstetrics and Gynecology, 19, 3, pp. 229-237, (2007)
[8]  
Fedele L., Bianchi S., Zanconato G., Berlanda N., Bergamini V., Laparoscopic removal of the cavitated noncommunicating rudimentary uterine horn: Surgical aspects in 10 cases, Fertility and Sterility, 83, 2, pp. 432-436, (2005)
[9]  
Theodoridis T.D., Saravelos H., Chatzigeorgiou K.N., Zepiridis L., Grimbizis G.F., Vavilis D., Loufopoulos A., Bontis J.N., Laparoscopic management of unicornuate uterus with non-communicating rudimentary horn (three cases), Reproductive BioMedicine Online, 12, 1, pp. 128-130, (2006)
[10]  
Khati N.J., Frazier A.A., Brindle K.A., The unicornuate uterus and its variants. Clinical presentation, imaging findings, and associated complications, J Ultrasound Med, 31, pp. 319-331, (2012)