The pregnancy outcomes of patients with a rudimentary uterine horn v1

Objectives: To evaluate the presentation, assessment, treatment, and pregnancy outcomes of 22 women with a rudimentary uterine horn. Methods: We reviewed the data regarding the outcomes of patients with a rudimentary horn pregnancy (RHP) who were managed at Peking Union Medical College Hospital over the last 30 years. Twenty-two pregnant patients with a rudimentary horn have been treated at our institute over the last 30 years. All patients with RHP were divided into two groups: Type A (n=4), a rudimentary horn with a cavity that communicated with the uterus; and Type B (n=7), a rudimentary horn with a cavity that did not communicate with the uterus. We classified all 22 patients into a communicating group or a noncommunicating group according to the anatomical connection of the rudimentary horn to the contralateral hemiuterus. Results: The mean gestational age of Type A patients (23.5 weeks) was significantly higher (P=0.046) than that of Type B patients (10 weeks). The rudimentary uterine horn carried 4 of 5 (80%) pregnancies in the communicating group. Three case of rudimentary horn pregnancies ruptured before a gestational age of 12 weeks, and one abortion occurred after 12 weeks. In the noncommunicating group, 7 of 17 (41.2%) cases were RHPs, and 3 ruptured after a gestational age of 12 weeks. Conclusions: The diagnosis and management of the rudimentary uterine horn continues to be challenging. Medical and radiological personnel must maintain a high degree of alertness to prevent the morbidity associated with this condition. In particular, patients with RHP (Type A), who have a higher chance being misdiagnosed before 12 gestational weeks, have a higher risk of potential complications. If pregnancy in the rudimentary horn is diagnosed, excision of the pregnant horn is recommended, regardless of the type of unicornuate uterus