Clinical implications of the unicornuate uterus with rudimentary horn

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Abstract
Of 20 patients with unicornuate uteri unexpectedly found during operative procedures, 18 had concomitant rudimentary horn. Suspicion of ectopic pregnancy, chronic pelvic pain or pelvic tumor, was most frequently the primary reason for hospitalization. Endometriosis (20%) was the most common surgical finding. Only 1 hematometra of the rudimentary horn was found. Two tubal pregnancies and 2 pregnancies in the rudimentary horn, 1 with rupture of the horn and 1 with placenta accreta in the horn, were observed. Treatment was the simple excision of the rudimentary horn in 12 cases. Fetal survival rate was 71%, prematurity 15% and perinatal mortality 7.4% in 35 pregnancies and 27 deliveries. High incidence of breech presentation (33%) and cesarean section rate (30%) was observed. Two out of 3 pregnancies with cervical cerclage ended successfully. Of 15 pyelograms performed, 9 (60%) showed abnormalities, the most frequent being the absence of a kidney.