PDF(Pubmed)
Abstract：
Unicornuate uterus with rudimentary horn is a rare structural uterine anomaly resulting from incomplete Mullerian duct development and/or fusion. Pregnancy in rudimentary horn is an uncommon presentation of a Mullerian anomaly and may lead to substantial morbidity and mortality due to high risk of uterine rupture with intraabdominal hemorrhage. Medical and/or surgical management may be undertaken; however, currently, no treatment guidelines exist. We describe the management of a 12-week rudimentary horn pregnancy in a 25-year-old multiparous patient with a prior spontaneous preterm breech vaginal delivery and one spontaneous early term cephalic vaginal delivery in whom this congenital uterine condition was previously unknown. The rudimentary horn, nonviable pregnancy, and contiguous ipsilateral fallopian tube were excised laparoscopically without complication. Given the infrequency of rudimentary horn pregnancies and the high risk for obstetric complications, a high index of suspicion should be maintained. We emphasize that a history of preterm birth or malpresentation should raise suspicion for maternal Mullerian anomaly, and that a minimally invasive approach can be feasible for treatment of a rudimentary horn pregnancy.
摘要：
单角子宫是一种罕见的结构性子宫异常，由不完全的苗勒管发育和/或融合引起。初角妊娠是穆勒异常的罕见表现，由于子宫破裂和腹腔内出血的高风险，可能导致大量发病率和死亡率。可以进行医疗和/或手术管理；但是，目前,没有治疗指南。我们描述了一名25岁的多胎患者的12周基本角妊娠的管理，该患者先前有自发性早产臀位阴道分娩和一名自发性早期头阴道分娩，而这种先天性子宫疾病以前是未知的。基本的号角，无法存活的怀孕，腹腔镜下切除相邻的同侧输卵管，无并发症。鉴于短角妊娠的频率较低，产科并发症的风险较高，应该保持高度怀疑。我们强调，早产或流产史应该引起对母系Mullerian异常的怀疑，并且微创方法可以用于治疗初级角妊娠。
