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Case Reports in Obstetrics and Gynecology
Volume 2012 (2012), Article ID 985076, 4 pages
http://dx.doi.org/10.1155/2012/985076
Case Report

Ruptured Rudimentary Horn Pregnancy at 25 Weeks with Previous Vaginal Delivery: A Case Report

1Department of Obstetrics & Gynecology, K. S. Hegde Medical Academy, Karnataka, Mangalore 575018, India
2Department of Obstetrics & Gynecology, Mysore Medical College & Research Institute, Karnataka, Mysore 570001, India

Received 6 March 2012; Accepted 28 April 2012

Academic Editors: B. A. Gbolade, M. Geary, and O. Picone

Copyright © 2012 Deepa V. Kanagal and Lokeshchandra C. Hanumanalu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. Timely laparotomy, excision of the horn, and blood transfusion saved the patient.