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Review
. 2019 Jul;47(7):3427-3434.
doi: 10.1177/0300060519850422. Epub 2019 May 27.

Pregnancy in a blind hemi-cavity of Robert's uterus with ipsilateral renal agenesis: a case report and literature review

Qiao-Mei Yang  1 , Hua Li  1 , Su-Hui He  2 , Dan Chen  1 , Li Chen  1
Affiliations
Review

Pregnancy in a blind hemi-cavity of Robert's uterus with ipsilateral renal agenesis: a case report and literature review

Qiao-Mei Yang et al. J Int Med Res. 2019 Jul.

Abstract

Robert’s uterus is an asymmetric septate uterus with a noncommunicating cavity and is a rare Müllerian anomaly. We present a rare case of pregnancy in a blind cavity and the first report of ipsilateral renal agenesis. A 23-year-old primigravida woman presented to our hospital at 7 weeks and 3 days of gestation after an abortion had failed. Three-dimensional ultrasound and magnetic resonance imaging showed pregnancy in a blind hemi-cavity of Robert’s uterus with an ipsilateral renal anomaly. Surgery was performed by hysteroscopy with laparoscopic and ultrasound guidance. The pregnancy was removed and the asymmetric septum was resected. A single normal uterine cavity with bilateral tubal ostium remained. The treatment was considered to be satisfactory. Menstruation ceased to be painful and the uterus was not scarred. Robert’s uterus can be well evaluated by an experienced ultrasound physician and magnetic resonance imaging. Such patients may have renal agenesis and the urinary system must be simultaneously evaluated. Pregnancy in a blind hemi-cavity is extremely rare and easily ignored by gynecologists and sonographers. Timely and accurate diagnosis of this condition is essential to obtain minimally invasive treatment.

Keywords: Müllerian anomaly; Robert’s uterus; blind hemi-cavity; pregnancy; renal agenesis; surgery; ultrasound.

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Figures

Figure 1.
Figure 1.
Two-dimensional ultrasound images. (A) Right rudimentary uterine horn pregnancy (black arrow) and left unicornuate uterus (white arrows). (B) Absent right kidney (white arrows) and an ectatic left kidney
Figure 2.
Figure 2.
Three-dimensional ultrasound images. (A) Pregnancy (black arrow) in the right blind cavity and left cavity is connected to the cervix preoperatively. (B) The shape of the uterine cavity is closer to normal without a uterine septum and intrauterine adhesions postoperatively
Figure 3.
Figure 3.
Magnetic resonance images. Axial (A) and coronal (B) images show pregnancy (black arrows) in the right blind cavity
Figure 4.
Figure 4.
Photograph of laparoscopy. The uterus is slightly enlarged on the right side, the external fundal shape is normal, and the right uterine surface shows endometriosis (black arrows)
Figure 5.
Figure 5.
Images of hysteroscopy. (A) The right cavity has an asymmetrical uterine septum (black arrow). (B) In the left cavity, a left tubal ostium (black arrow) can be seen. (C) In the right cavity, there is pregnancy tissue (black arrow). (D) The two cavities were connected in the second operation
See this image and copyright information in PMC

References

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Supplementary concepts