Bicornuate uterus with second trimester fetal demise in a rudimentary horn

Abstract

Bicornuate uterus is a congenital uterine anomaly associated with reproductive complications such as recurrent pregnancy loss, preterm birth, cervical insufficiency and uterine rupture. A bicornuate uterus occurs owing to failure of septal resorption after fusion of the paramesonephric ducts during organogenesis, resulting in a uterus divided into two horns. Most cases are only identified once reproductive difficulty is experienced or as an incidental finding in patients with a normal obstetric history. Here we present a patient who had two previous normal vaginal deliveries at term who was incidentally found to have a bicornuate uterus with second trimester fetal demise in the rudimentary horn. A hysterotomy and bilateral tubal ligation was performed, and the patient was discharged in good health after 48 hours.