Fourteen weeks Missed Abortion in Non-communicating Rudimentary Horn of a Unicornuate uterus- A Rare Case of Unruptured Ectopic Pregnancy

Background: Unicornuate uterus with a rudimentary horn is an anomaly of the mullerian duct. This condition results when one of the paired mullerian ducts fails to fuse completely. Pregnancy in the rudimentary horn of the unicornuate uterus is very difficult to diagnose on ultrasound and can be easily missed out. Pregnancy is usually detected after rupture of pregnant horn. Ninety percent of such cases rupture in second trimester. Case Presentation: Here we report a case of 18-year-old-lady presented with 14 weeks missed abortion. On ultrasonog- raphy, unruptured cornual ectopic pregnancy was suspected. Exploratory laparotomy was done. Intra-operatively there was unruptured ectopic pregnancy in non-communicating left horn of a unicornuate uterus. The rudimentary horn with unruptured pregnancy was excised. This case is reported because of its rarity as well as to stress the need for high index of suspicion and role of ultrasonography in the diagnosis of this rare and dreadful entity. Conclusion: Pregnancy in rudimentary horn is a rare condition. A high index of suspicion and careful ultrasound exami- nation can detect the condition earlier before rupture. If missed, it can be catastrophic. CME J 2025; 4(2):76-81