EP21.41: Unicornuate uterus with non‐communicating rudimentary horn pregnancy: a case report and diagnostic challenge

Rudimentary horn pregnancy (RHP) is an exceedingly rare occurrence, often challenging to diagnose due to its atypical clinical presentation. This report presents the case of a 23-year-old G2P1L1 female with a known unicornuate uterus and left-sided non-communicating rudimentary horn. The patient referred to the radiology department with a history of 2 months of amenorrhea and per vaginal bleeding, approximately at 12 weeks of gestation. Despite an uneventful gestational history and regular menstrual cycles, emergency obstetric ultrasound revealed a single fetus within the rudimentary horn on left side, measuring CRL-3.5CM and GA-10 WEEK 3 DAYS, with absent fetal cardiac activity. The ultrasound further characterised the unicornuate uterus with a 1.5cm endometrial thickness and no gestational sac-like structure was observed in the right horn of the uterus. Classification of the anomaly revealed a Class II unicornuate uterus/unicornis unicollis (ASRM classification). This case underscores the importance of considering RHP in cases of amenorrhea and per vaginal bleeding, particularly in patients with known uterine anomalies. Prompt diagnosis and appropriate medical management are crucial to mitigate the risks associated with this rare condition. 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.