• George Daskalakis, Athanasios Pilalis, Katerina Lykeridou, and Aris Antsaklis.
• First Department of Obstetrics and Gynaecology, Alexandra Hospital, University of Athens, Athens, Greece.
• Obstet Gynecol. 2002 Nov 1; 100 (5 Pt 2): 1108-10.

BackgroundWe present a rare case of pregnancy in a noncommunicating rudimentary horn that ruptured at 20 weeks.CaseA 30-year-old woman presented with a history of two spontaneous abortions. An ultrasound scan showed a bicornuate uterus, with one normal and one hypoplastic horn. Hysterosalpingography revealed a single uterine cavity with only one tube, suggesting a unicornuate uterus. Hysteroscopy and laparoscopy were recommended but declined. She presented again 2 months later at 7 weeks' gestation. A single intrauterine pregnancy in the hypoplastic right horn was diagnosed. A transvaginal scan showed a single cervical canal in continuity with the left uterine horn, which led to the suspicion of a pregnancy in a rudimentary horn. The option of pregnancy termination was offered. A laparoscopy was repeatedly suggested but declined. Excision of a ruptured noncommunicating rudimentary horn and ipsilateral salpingectomy were performed after an emergency laparotomy at 20 weeks because of the sudden onset of abdominal pain and signs of shock.ConclusionAlthough a rudimentary horn pregnancy had been suspected before the laparotomy, the patient presented as a clinical emergency. This report, like others, indicates that prompt diagnosis and immediate removal of the rudimentary horn is lifesaving.

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