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Rudimentary Linear Failure

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Failure of fusion of one of the mullerian ducts with partial fusion with the opposite side results in the formation of a rudimentary horn with unicornuate uterus.If a pregnancy occurs in a rudimentary horn result is usually a rupture either in first or second trimester and it is usually a life threatening condition .The phenomenon is quite a rare entity and there are very few reported cases. This specific instance is an example of a case in which a pregnancy of 16 weeks occured in the rudimentary horn of a unicornuate uterus, resulting in a a rupture.
Once a pregnancy occurs in the rudimentary horn,it is an immensely infrequent condition and results in rupture either in the first or second trimester. Buthan and Gibbon were the pioneers who …show more content…
XX presented to the emergency department with the history of pain abdomen and bleeding per vagina for 2 days with history of amenorrhoea for four months. On examination, her pulse was 120 /min, BP 80/60 mmHg and there was severe pallor. Per abdominal examination revealed distension with guarding and tenderness in the lower abdomen.On per vaginal examination uterus was just bulky and fornicial tenderness was felt. Emergency USG was done which showed massive hemoperitoneum with a 16 weeks pregnancy in the adnexae. Patient was immediately put for emergency laparoscopic exploration.Fig 3: 16 weeks fetus in peritoneal cavity with hemoperitoneum. On laparoscopy findings where 16 weeks fetus in the abdominal cavity along with the placenta with large hemoperitoneum. Site of rupture was the rudimentary non communicating horn. Laparoscopic excision of the horn done and specimen of placenta and fetus done via mini lap. Specimen along with the placenta and fetus removed via mini lap. On admission Hb was 4gm%. Intra operatively 3 units of blood transfused. The patient recovered completely with an uneventful postoperative period and she went home on the 5th postoperative …show more content…
Excision and removal of a small rudimentary horn through the laparoscopic port suprapubically has been reported by Dicker et al. Pregnancy of a 5*5cm rudimentary horn was removed laparoscopically by You et al. Once diagnosis is complete, it is recommended for the patient to undergo immediate surgical excision even in unruptured cases. Additionally prior to conception, surgical removal is recommended to prevent acute complications. Instances of third trimester pregnancy along with live birth following caesarean section has also been reported in such a

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