Ruptured Ectopic Pregnancy in the Rudimentary Horn of Bicornuate Uterus: A Case Report
Journal Title: MedPulse -International Medical Journal - Year 2014, Vol 1, Issue 5
Abstract
Introduction: Rupture uterus in first and second trimester in a non-scarred uterus is generally seen with associated mullerian anomalies. A 22 year old 4th gravida with previous 2 spontaneous abortions and a full term normal delivery came with 16 weeks pregnancy presented with pain in abdomen since 6 hours prior to admission and hypovolemic shock. Though she had taken regular antenatal visits in another hospital and a transabdominal scan the previous day, with the report opining s/o? Ectopic pregnancy or pregnancy in small cornu by the side, the diagnosis of the fetus in the rudimentary horn was missed. Her routine blood investigations were done on admission. A provisional diagnosis of rupture of right rudimentary horn of a bicornuate uterus was made after clinical examination and a TransVaginal Sonography was done which showed that the cervix continuing into a normal uterus with no fetus within it and a vague right adnexal mass. Transabdominal scan also showed vague hypoechoic mass in the right adnexa with a fetus of 15-16 weeks above the mass with absent cardiac activity. So decision for Emergency exploratory laparotomy was made with resuscitation and on opening the abdomen bicornuate uterus was present, non communicating rudimentary horn present ruptured ectopic pregnancy present in the rudimentary horn. Hemoperitoneum was present 750gms clots removed, excision of the ruptured horn was done and blood transfusion was done and patient’s life was saved.
Authors and Affiliations
Shreyaa Sriram, Smita Bhat, U. T. Bhosale
Keywords
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