MULLERIAN DUCT ANOMALIES – A SURPRISING COMPLICATION IN NULLIPARA PREGNANCIES – A CASE SERIES

Mullerian duct anomalies arise from incomplete fusion or absorption of primordial ducts. While most patients remain asymptomatic throughout the duration of pregnancy. There is an increased risk of rupture in the second trimester, causing maternal and perinatal morbidity and mortality. We present three cases of abnormal uteri during pregnancy in nulliparous condition. The first case threatened second trimester pregnancy with acute abdominal symptoms and shock. She underwent exploratory laparotomy revealing a ruptured left rudimentary horn with 1 liter of hemoperitoneum. The fetus and placenta were located in the abdomen, and resection of the rudimentary cornua was performed. The second case concerned a complicated term pregnancy with intrauterine fetal demise (IUFD). Emergency lower segment cesarean section (LSCS) was necessary due to failed induction, revealing a uterine rupture at the anterolateral surface of a unicornuate uterus with a communicating horn. The ruptured cornua was surgically removed. Third case involved successful term twin gestation in a unicornuate uterus with agenesis of left rudimentary cornua. Presented series underscores the importance of maintaining a high index of suspicion for this uncommon pregnancy complication. Pregnancy involving Müllerian anomalies is uncommon and can lead to severe complicati SYNOPSIS: ons like rupture uteri. Early detection is crucial to prevent maternal death.