Unicornuate uterus

Prevalence of congenital uterine anomalies varies between 3.4 -5% and Mullerian anomalies are found more often in subfertile patients compared to fertile controls.Unicornuate uterus with rudimentary horn is a rare type of Mullerian duct malformation and result from defective fusion of the malformed duct with contralateral duct. A unicornuate uetrus is a type 2 classification with unilateral hypoplasia or agenesis that can be further subclassified into communicating ,no cavity and no horn. A fibrous/fibromuscular band usually connects the horn of the duct but in 80-90% of the cases there is no communication and is often associated with ectopic pregnancies. The rudimentary horn may consist of a functional endometrial cavity or it may be a small solid lump of uterine muscle with no functional endometrium. This malformation is rare and can be associated with many complications throughout a women's reproductive life beginning from menarche when hormonal stimulation may gradually activate the endometrium of the rudimentary horn. The resulting obstruction of the menstrual flow may cause hematometra leading to endometriosis and infertility. The presence of a maternal uterine anomaly is associated with increased risk of preterm birth, premature prolonged rupture of membranes, breech presentation, Cesarean section, placenta previa, abruption and IUGR. The reproductive performance of a women with unicornuate uterus is poor with a live birth rate of only 29.2%,prematurity rate of 44%,and an ectopic pregnancy rate of 4%. Moreover women with this anomaly present rates of 24.3% first trimester abortion,9.7% of second trimester abortion and 10.5% IUFD. It has been suggested that first trimester abortion,IUGRand stillbirths may be explained by an abnormal uterine blood flow (absent/abnormal uterine/ovarian artery).Second trimester abortion and preterm deliveries are thought to decrease d muscle mass in unicornuate uterus as well as cervical incompetence. Pregnancy in a non communicating rudimentary horn is possible by transperitoneal migration of sperm or fertilised ovum .Variable thickness of rudimentary horn musculature ,dysfynctional endometrium , and poor distensibility of myometrium lead to rupture of rudimentary horn. The risk of uterine rupture is 50-90% with most ruptures(approximately 80%) occurring by the end of second trimester and can be life threatening condition for the mother resulting from hemoperitoneum and hemorrhagic shock.It is difficult to diagnose preoperatively and in the literature ,only 5% of rudimentary horn pregnancies are diagnosed preoperatively and the remaining were found unexpectedly at laparotomy.

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@Viraj R. Naik If you are pregnant and have a small uterus, you can opt for a vitamin therapy. It makes use of certain fluid preparations which, when consumed daily, can be quite useful.

Enriched by unique informative post Thanx sir Only crazy question is have you come across such case


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Thanks for informative talk

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