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A rare case of first-trimester ruptured bicornuate uterus in a primigravida

INTRODUCTION: Bicornuate uterus (BU) is a rare uterine anomaly result from incomplete fusion of the two Müllerian ducts during embryogenesis. BU very rarely can lead to rupture of the uterus during the early pregnancy with high mortality and morbidity rates. PRESENTATION OF CASE: A primigravida in t...

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Autores principales: Hefny, Ashraf F., Kunhivalappil, Fathima T., Nambiar, Ritu, Bashir, Masoud O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573601/
https://www.ncbi.nlm.nih.gov/pubmed/26255004
http://dx.doi.org/10.1016/j.ijscr.2015.07.019
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author Hefny, Ashraf F.
Kunhivalappil, Fathima T.
Nambiar, Ritu
Bashir, Masoud O.
author_facet Hefny, Ashraf F.
Kunhivalappil, Fathima T.
Nambiar, Ritu
Bashir, Masoud O.
author_sort Hefny, Ashraf F.
collection PubMed
description INTRODUCTION: Bicornuate uterus (BU) is a rare uterine anomaly result from incomplete fusion of the two Müllerian ducts during embryogenesis. BU very rarely can lead to rupture of the uterus during the early pregnancy with high mortality and morbidity rates. PRESENTATION OF CASE: A primigravida in the first trimester (9 weeks) presented complaining of epigastric pain and vomiting for one day. Ultrasound scan was performed at the 7th week of pregnancy and showed a BU with single intrauterine gestational sac in the right horn. On presentation, the patient was pale and irritable. Urgent ultrasound scan showed viable fetus in the right horn, free fluids in Morrison’s pouch. Laparotomy showed BU with pregnancy in the ruptured right horn. The defect in the uterus was repaired. Postoperatively, the patient was advised to use contraceptive pills for one year. DISCUSSION: Our patient has a sonographic diagnosis of BU at the 7th gestational week. At that stage, nothing was done except close follow up of the pregnancy. When she developed severe epigastric pain, initially, we thought of peptic ulcer disease complications. Even after deterioration of the patients’ condition, the diagnosis was not clear as the urgent ultrasound showed a viable fetus. Blood and fluid replacement therapy, and exploratory laparotomy were essential to save the patient’s life. CONCLUSION: This case highlights the fact that uterine rupture can occur in early pregnancy when associated with uterine anomaly. Early sonographic diagnosis has a major contribution in evaluation and management.
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spelling pubmed-45736012015-10-19 A rare case of first-trimester ruptured bicornuate uterus in a primigravida Hefny, Ashraf F. Kunhivalappil, Fathima T. Nambiar, Ritu Bashir, Masoud O. Int J Surg Case Rep Case Report INTRODUCTION: Bicornuate uterus (BU) is a rare uterine anomaly result from incomplete fusion of the two Müllerian ducts during embryogenesis. BU very rarely can lead to rupture of the uterus during the early pregnancy with high mortality and morbidity rates. PRESENTATION OF CASE: A primigravida in the first trimester (9 weeks) presented complaining of epigastric pain and vomiting for one day. Ultrasound scan was performed at the 7th week of pregnancy and showed a BU with single intrauterine gestational sac in the right horn. On presentation, the patient was pale and irritable. Urgent ultrasound scan showed viable fetus in the right horn, free fluids in Morrison’s pouch. Laparotomy showed BU with pregnancy in the ruptured right horn. The defect in the uterus was repaired. Postoperatively, the patient was advised to use contraceptive pills for one year. DISCUSSION: Our patient has a sonographic diagnosis of BU at the 7th gestational week. At that stage, nothing was done except close follow up of the pregnancy. When she developed severe epigastric pain, initially, we thought of peptic ulcer disease complications. Even after deterioration of the patients’ condition, the diagnosis was not clear as the urgent ultrasound showed a viable fetus. Blood and fluid replacement therapy, and exploratory laparotomy were essential to save the patient’s life. CONCLUSION: This case highlights the fact that uterine rupture can occur in early pregnancy when associated with uterine anomaly. Early sonographic diagnosis has a major contribution in evaluation and management. Elsevier 2015-07-29 /pmc/articles/PMC4573601/ /pubmed/26255004 http://dx.doi.org/10.1016/j.ijscr.2015.07.019 Text en © 2015 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Hefny, Ashraf F.
Kunhivalappil, Fathima T.
Nambiar, Ritu
Bashir, Masoud O.
A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title_full A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title_fullStr A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title_full_unstemmed A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title_short A rare case of first-trimester ruptured bicornuate uterus in a primigravida
title_sort rare case of first-trimester ruptured bicornuate uterus in a primigravida
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573601/
https://www.ncbi.nlm.nih.gov/pubmed/26255004
http://dx.doi.org/10.1016/j.ijscr.2015.07.019
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