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Case Reports
. 2020 Oct 24;2020(10):rjaa366.
doi: 10.1093/jscr/rjaa366. eCollection 2020 Oct.

First-trimester rupture of a gravid bicornuate uterus after prior vaginal deliveries, simulating a ruptured ectopic pregnancy: a case report

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Case Reports

First-trimester rupture of a gravid bicornuate uterus after prior vaginal deliveries, simulating a ruptured ectopic pregnancy: a case report

Joel Noutakdie Tochie et al. J Surg Case Rep. .

Abstract

The first-trimester rupture of a bicornuate uterus (BU) is a rare obstetrical emergency, especially following previous normal vaginal deliveries where it is often misdiagnosed. A 24-year-old G3P2002 woman presented at 11 weeks of gestation with sudden onset of severe left iliac fossa pain without other symptoms. On examination, she was fully conscious and hemodynamically unstable with signs of peritoneal irritation, a distended pouch of Douglas and a slightly enlarged uterus and a tender left adnexal mass. The diagnosis of a ruptured ectopic pregnancy was made and a laparotomy was done. Intra-operative findings were hemoperitoneum, a left ruptured BU and a dead fetus. Surgical management entailed hysterorrarphy, left salpingectomy and conservation of both ovaries. Her postoperative course was uneventful and future fertility was preserved. We recommend a high index of suspicion of ruptured BU as a differential diagnosis of acute abdomen in the first trimester in women with previous term vaginal deliveries.

Keywords: gynecology; obstetrics; ruptured bicornuate uterus.

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Figures

Figure 1
Figure 1
A 2D pelvic ultrasound scan showing a normal size uterus, with thick endometrium (A), peritoneal fluid, and an abdominally aborted gestational sac containing a dead embryo (B) mimicking a ruptured ectopic pregnancy.
Figure 2
Figure 2
Intra-operative findings; hemoperitoneum, a bicornate uterus with a left non-communicating ruptured corporeal atrophic rudimentay uterine horn (LUH), a dead embryo (DE), an intact right uterine horn of normal size.
Figure 3
Figure 3
Hysterorraphy at the level of left uterine horn corpus. Frontal view (A), and lateral view (B).

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References

    1. Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011;17:761–71. - PMC - PubMed
    1. Singh N, Singh U, Verma ML. Ruptured bicornuate uterus mimicking ectopic pregnancy: a case report. J Obstet Gynaecol Res 2013;39:364–6. - PubMed
    1. Elyan A, Saeed M. Mullerian duct anomalies: clinical concepts. Ain Shams J Obstetr Gynecol 2004;1:11–20.
    1. Dohbit JS, Mbouche L, Ngo Um ME, Tompeen I, Tochie JN, Ayissi G, et al. A fortuitous diagnosis of pyonephrosis complicating pyeloureteral junction syndrome during pregnancy:a case report. Clin Res Obst Gynecol 2018;1:1–4.
    1. Dohbit JS, Meka ENU, Tochie JN, Kamla I, Danwang C, Tianyi FL, et al. Diagnostic ambiguity of aseptic necrobiosis of a uterine fibroid in a term pregnancy: a case report. BMC Preg Childbirth 2019 J; 19:9. - PMC - PubMed

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