Unicornuate uterus with functional non communicating rudimentary horn: a refractory cause of dysmenorrhea

Mullerian duct anomalies are rare. Unicornuate uterus with a non-communicating rudimentary horn is a rare type of mullerian duct anomaly which occurs due to defective fusion of malformed duct with contralateral duct. The incidence is approximately 1:100000. Patient usually remain asymptomatic due to the absence of functional endometrium in most of the cases. If the rudimentary uterine horn has an endometrium lined uterine cavity and doesn’t communicate externally then the signs and symptoms of obstructed menstruation appears, as soon as menarche begins. It will be associated with severe dysmennorhoea and hematometra. Other complications may be abdominal lump, chronic pelvic pain, infertility, endometriosis, adenomyosis and ectopic pregnancy in rudimentary horn. Authors are presenting a case of refractory dysmenorrhea with lump abdomen in a patient with unicornuate uterus with functional non communicating horn. In a patient with refractory dysmenorrhea mullerian duct anomaly should be kept as differential diagnosis.

A Case of Unruptured Non - communicating Rudimentary Horn Pregnancy Progressed to the Third Trimester of Pregnancy / 대한산부인과학회잡지

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower parts of one of the Miillerian ducts, in which there is a failure of fusion of the two ducts, The incidence of this uterine anomaly is rare. Many cases of rudimentary uterine horn are not discovered since they do not become involved in a pregnancy, and thus remain symptomless and uncomplicated, and the diagnosis usually being made only with pregnancy with rupture. In this presentation, we describe a case of diagnosis and management of unruptured non-communicating rudimentary uterine horn pregnancy at the third trimester. The patient diagnosed by ultrasonography and MRI, was hospitalized for further evaluation and delivery under the impression of unruptured non-communicating rudimentary horn pregnancy. A living male infant weighing 1,930 gm was delivered by cesarean section at 33+l weeks due to impending preterm labor. Some articles concerned this subject were reviewed briefly to discuss relevant method of diagnosis, treatment, and clinical characteristics.