Pregnancy of 22 Weeks in the Rudimentary Horn of the Uterus

Abstract Background: Mullerian anomalies occur in 1%–5% of women. The unicornuate uterus occurs when one of the paramesonephric/Mullerian ducts fails to develop, resulting in a uterus with one Fallopian tube. Most unicornuate uteri have a rudimentary horn without communication to the uterine cavity. Management of pregnancy in women with Mullerian anomalies can be challenging. Case: The case of a 22-week pregnancy in a rudimentary detached horn is presented. After a thorough discussion with the patient, the decision was made to proceed with exploratory laparotomy and removal of the pregnancy. A decision was made not to perform resuscitation of the fetus after delivery. Results: The patient's postoperative course was uneventful and she was discharged to go home on postoperative day 3. Conclusions: Careful monitoring is required, as pregnancies in the rudimentary horn of the uterus may not develop adequately or provide the muscular and vascular support required to maintain the pregnancy. Ultrasound was helpf...