Rupture Right Side Rudimentary Horn of Uterus

at 21 Weeks of Pregnancy

 A 27 years old gravida two, Para one, delivered her first baby normally. She was seen one week ago in a routine antenatal care visit with ultrasound scan findings of a single alive fetus, gestational age 20 weeks, placenta fundal. Amniotic fluid normal amount, no fetal congenital anomalies could be detected.

 One week later she was transferred from emergency room with severe abdominal pain.

Ultrasound scan done with a single fetus, gestational age 21 weeks, amniotic fluid normal amount, no fetal heart activity, no fetal movement. Excessive free fluid in the peritoneal cavity, it was an intrauterine fetal death. The baby was out side the pelvis, easily moving manually.

The patient general conditions deteriorated & her Hb decreased from 10 gm% to 6.8 gm%, urgent Laparotomy done through a vertical incision. An intact gestational sac with placenta attached to it was found floating high in the abdomen, there was a ruptured right side rudimentary horn of the uterus.

The uterus was of normal size & position. Excision of the uterine horn & Partial salpingectomy done. The ovary was preserved, it was a male baby, weight 600 gm, patient received 2 units of blood, was discharged in fair conditions at the fifth day, stitches were removed at the seventh day.

Around one & a half year later, she had her third pregnancy which was normal & ended in a normal vaginal delivery. 

Correspondence:      Dr.Zohair Zaki.

    Head of Department of Obstetrics & Gyneacology.

                        Alagailat   General   Hospital

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