Accidental discovery of Unicornuate uterus during laparotomy for ruptured uterus: A case report

Abstract

Background: Unicornuate uterus is one of the congenital anomalies that results from hypoplasia or agenesis of the Mullerian ducts. Its incidence is not well established due to varied classification systems. It is commonly diagnosed during evaluation for recurrent pregnancy losses and dysmenorrhoea. Some are diagnosed accidentally during Caesarean sections and laparotomies. This case is unique as she had previous recurrent pregnancy losses and a failed cervical cerclage in her th 4 pregnancy. She also had a Caesarean section in this facility in the past but proper diagnosis of her condition had not been made prior to the index pregnancy. Case  presentation We report a unicornuate uterus accidentally diagnosed during laparotomy for a ruptured unicornuate +3 uterus in a 29 year ol3d G7P3 2A at a gestational age of 35weeks and 2days. She had laparotomy with delivery of a fresh still born. There was an oblique rupture in the lower segment of the unicornuate uterus involving part of the previous incision. She had repair of the  unicornuate uterus because she insisted on her desire for future reproduction.
Conclusion: Clinicians should always consider congenital uterine anomalies as one of the causes of recurrent pregnancy losses especially where cervical cerclage fails. Exhaustive evaluation of patients like this with 3D-ultrasonography and hysterosapingography in the preconception period will help to identify this anomaly. There is need for meticulous intraoperative examination of the pelvic and abdominal organs to forestall missing anomalies such as this.

Key words- Accidental discovery, Unicornuate uterus, Laparotomy, ruptured uterus