Genevieve Lennox1, Sophia Pantazi2, Johannes Keunen3, Tim Van Mieghem4, Lisa Allen3. 1. Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON. 2. Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON; Department of Medical Imaging, Mount Sinai Hospital, Toronto ON. 3. Department of Obstetrics and Gynaecology, University of Toronto, Toronto ON; Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON. 4. Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto ON.
Abstract
BACKGROUND: Pregnancy in a rudimentary uterine horn is a rare form of ectopic pregnancy with a high risk of rupture. Management usually involves excision of the rudimentary horn. If diagnosed after the first trimester, it has been managed in the past by laparotomy. CASE: A primigravid woman was found on routine ultrasound to have a rudimentary horn pregnancy. The diagnosis was confirmed on MRI, and a thin uterine wall was demonstrated. Management comprised fetal injection of potassium chloride followed by complete laparoscopic excision of the rudimentary horn at 16 weeks' gestation. CONCLUSION: Laparoscopic management of a mid-trimester rudimentary horn pregnancy is feasible, but expert radiological characterization is required for optimal surgical planning.
BACKGROUND: Pregnancy in a rudimentary uterine horn is a rare form of ectopic pregnancy with a high risk of rupture. Management usually involves excision of the rudimentary horn. If diagnosed after the first trimester, it has been managed in the past by laparotomy. CASE: A primigravid woman was found on routine ultrasound to have a rudimentary horn pregnancy. The diagnosis was confirmed on MRI, and a thin uterine wall was demonstrated. Management comprised fetal injection of potassium chloride followed by complete laparoscopic excision of the rudimentary horn at 16 weeks' gestation. CONCLUSION: Laparoscopic management of a mid-trimester rudimentary horn pregnancy is feasible, but expert radiological characterization is required for optimal surgical planning.
Authors: Ângela Rodrigues; Ana Raquel Neves; Maria Geraldina Castro; Miguel Branco; Fernanda Geraldes; Fernanda Águas Journal: Case Rep Womens Health Date: 2019-10-31