RUPTURE ECTOPIC PREGNANCY AT 14 WEEKS IN NONCOMMUNICATING RUDIMENTARY HORN OF UNICORNUATE UTERUS: A CASE REPORT

Rudimentary horn pregnancy is rare but, if occurs it gives a grave risk to the health of the pregnant woman. In most cases it presents in the form of ectopic pregnancy. Despite availability of good USG facility, it is very difficult to timely diagnose rudimentary horn pregnancy. Confirmatory diagnosis made only by laparoscopy or during laparotomy. In the rudimentary horn the constitution of the muscle wall thickness is variable so the pregnancy can be accommodated until late pregnancy. Here we present a case of 24 years female Gravida3 Para2 Live2 with 14 weeks pregnancy presented to us in shock with clinical features of ruptured ectopic pregnancy. On laparotomy we found non-communicating rudimentary horn rupture with dead fetus in peritoneal cavity

Scar endometriosis – A clinical rarity.

Scar endometriosis is a rare occurrence. Endometriosis is presence of endometrium at ectopic sites, other than the uterine cavity. Though the common sites of endometriosis are pelvic structures, extra pelvic endometriosis is occasionally seen. But presence of endometriosis in previous incision scars is extremely rare. Endometriosis in abdominal incision sites following Cesarean scions, hysterectomy, ovarian endometrioma removal are described. Very few cases of endometriosis at episiotomy site are also described in literature. This case report describes two such cases of scar endometriosis. The first case had scar endometriosis following a laparotomy done for rudimentary horn pregnancy. The second case had endometriosis in the scar of previous laparscopic surgeries, performed for ovarian endometrioma.

Pregnancy in rudimentary horn of uterus.

A 20-year-old primigravida with 3 months amenorrhea presented with complaints of acute abdominal pain. Her vital systemic parameters were stable. On vaginal examination, the patient was provisionally diagnosed of right cornual ectopic pregnancy, which was confirmed sonographically, and taken up for surgery. There was moderate hemoperitoneum and rupture of right horn of uterus with products protruding. The rudimentary horn was excised. The patient was discharged and advised contraception and follow-up.