OP11.01: Pregnancy in a blind hemi‐cavity of Robert's uterus with a septal Hole: a rare case report

A 43-year-old woman, gravida 3 para 2, at 17+6 weeks gestation, presented with a normal menstrual history and no dysmenorrhea. Ultrasonography showed a large amount of amniotic fluid accumulating in the right uterine cavity, with the fetus located in the left uterine horn and severely restricted in movement. No obvious amniotic fluid echoes were seen around the fetus, but a muscular septum enveloping the fetus was observed. The umbilical cord passed through a septal hole to the right compartment (see figures 1a,b), with placental attachment to the left wall. Colour Doppler flow imaging (CDFI) revealed umbilical cord blood flow signals (see figure 1c). MRI confirmed these findings, depicting a malformed uterine body with a fetus in the left horn (see figures 2a,b). Given the risk of uterine rupture, she underwent an emergency Caesarean section. The surgery revealed a protruding left uterine horn (see figure 3a) and a muscular septum separating the left horn from the right compartment (see figure 3b). A small hole, approximately 1 centimetre in diameter, was palpable on the septum, through which the umbilical cord passed. Post-incision, a stillborn male fetus was delivered. The uterus returned to its normal shape after the surgery. In conclusion, pregnancy in the blind pouch of Robert's uterus is an exceptional and complex condition requiring immediate and accurate management. This case highlights the need for careful monitoring and intervention. Further research is imperative to enhance our understanding and improve management strategies for such rare presentations. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.