MULLERIAN DUCT ANOMALIES;

UNICORNUATE UTERUS WITH OR WITHOUT RUDIMENTARY HORN PREGNANCY

Abstract

Background: Müllerian duct anomalies (MDAs) occur with an incidence estimated to be 4.3%. A unicornuate uterus with or
without a rudimentary horn; is a type of mullerian duct abnormality with a frequency of 0.4%. Rudimentary horn pregnancies are rare obstetric
complication and may cause difficulty in diagnosis and subsequent management. Objective: To alert about Mullerian duct abnormalities
especially unicornuate uterus with or without rudimentary horn. Design: Case series. Setting: Study was conducted in the department of
Gynecology and obstetrics unit1, Allied Hospital Faisalabad. Duration of study: Cases detected during September 2006-0ctober 2011.
Subjects and methods: All admitted cases of MDA whether obstetric or gynecological were included. We calculated cases of unicornuate
Uterus with or without rudimentary horn, also included cases of rudimentary horn pregnancy with or without rupture. Results: There were120
cases of MDA out of which 8 (6.6%) were of unicornuate uterus. Out of 8 unicornuate uteri, 7/8 (87.5%) were with rudimentary horn and1/8
(12.5%) without rudimentary horn. Left rudimentary horn in 4/8 patient (50%), right in 3/8 (37.5%) without horn1/8 (12.5%).Out of 7 rudimentary
horn 1/7 gynecologic and 6/7 were obstetric, 5/7 (71.42%) ruptured in second trimester, and1/7 (14.28%) term pregnancy. In 1/7 (14.28%) horn
not removed because tubal ligation was done. Unilateral renal agenesis was present in 3/8 patient (37.5 %). Ovaries were preserved in 3/7
patients (66%). Conclusions: There must be high index of suspicion for Mullerian duct abnormalities especially rudimentary horn for achieving
good success in diagnosis and management.