Bicornuate Uterus with Abdominal Pregnancy; Diagnostic Challenges in Resource Limited Settings: A Case Report

Abstract

Both bicornuate uterus and abdominal pregnancies are rarely encountered incidences in the clinical practice of Obstetrics and Gynaecology. Abdominal pregnancy is a life threatening form of ectopic pregnancy with a high maternal mortality and even higher perinatal mortality rates. Bicornuate uterus is associated with reproductive difficulties particularly recurrent miscarriages, rupture of uterine horn in early pregnancy and preterm births. We present a case report of 36 years old elderly primigravida at 18 weeks of gestation who presented with generalized abdominal pain associated with scanty vaginal spotting and at laparotomy she was found to have a bicornuate uterus and abdominal pregnancy initially managed as missed abortion. Diagnosis of both conditions pose a great challenge in resource limited settings and often leads to missed or delayed diagnosis which may cause death of the mother and almost always that of the fetus.

Keywords: Abdominal pregnancy, Laparotomy, mullerian duct anomaly diagnostic challenges and maternal / perinatal mortality