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Case Reports
. 2015 Jan;13(1):49-52.

Unruptured rudimentary horn pregnancy presenting with acute haemoperitoneum with combined intrauterine pregnancy: A case report

Meenakshi Lallar  1 , Rajesh Nandal  2 , Deepak Sharma  3
Affiliations
Case Reports

Unruptured rudimentary horn pregnancy presenting with acute haemoperitoneum with combined intrauterine pregnancy: A case report

Meenakshi Lallar et al. Iran J Reprod Med. 2015 Jan.

Abstract

Background: The incidence of rudimentary heterotopic uterine horn pregnancy varies from 1:76,000 to 1:140,000. However the incidence of twin pregnancy i.e. intrauterine pregnancy in unicornuate uterus and its associated rudimentary horn pregnancy is estimated to be around 1 in 10 million gestations.

Case: Here, we present 19 year old pramigravida women with acute haemoperitoneum with diagnosis of unruptured rudimentary horn pregnancy combined by intrauterine pregnancy. The patient was managed with emergency laparatomy and resuscitation. Rudimentary horn containing foetus was excised and intrauterine pregnancy was left untouched. The intrauterine pregnancy was supported with progesterone and tocolytics and the patient delivered a newborn of 2.8 kg through spontaneous labor at 37 weeks of gestation.

Conclusion: Heterotopic pregnancies incidence have increased in comparison to past and there should be high level of suspicion for this rare event as this is often associated with high maternal and fetal morbidity and mortality where diagnosis is difficult and challenging and easily missed. . Timely intervention provides survival of intrauterine pregnancy in case of twin pregnancy, even in low resource settings where usually the diagnosis is missed before acute event.

Keywords: Cornual Heterotopic Pregnancy; Haemoperitoneum; Maternal mortality; Neonatal mortality.

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Figures

Figure 1
Figure 1
Unicornuate uterus of 16 weeks gestation with intact left rudimentary horn pregnancy of around 16 weeks. A vessel running superficially over the rudimentary horn had been torn probably due to expansion of the horn leading to haemoperitoneum
Figure 2
Figure 2
Intact foetus inside the rudimentary horn which was excised
See this image and copyright information in PMC

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