Ruptured Rudimentary Horn Pregnancy at 33 Weeks of Gestation With a Live Baby

Pregnancy in a complex Müllerian anomaly is an uncommon and potentially catastrophic obstetric condition. It often remains undiagnosed until the patient presents in an emergency setting. Presentation of a rudimentary horn pregnancy near term is uncommon, as most patients present earlier with acute abdominal pain and/or features of hypovolaemic shock following rupture. The diagnosis of a ruptured rudimentary horn pregnancy at the time of presentation is challenging and may be misinterpreted as other obstetric emergencies, such as uterine rupture, placental abruption, or bleeding from placenta percreta. Delayed diagnosis and inadequate intervention can significantly increase maternal and neonatal morbidity and mortality. We successfully salvaged the mother and fetus in a case of complex Müllerian horn pregnancy that presented with acute abdominal pain and features of hypovolaemic shock. A high index of suspicion for uterine rupture was maintained until surgery.