Introduction: Mullerian malformations are a group of malformations that result from an
alteration of embryonic development. Most cases are asymptomatic, however, in
pregnant patients it has been associated
with recurrent abortion or premature delivery. Case presentation: 12 + 2
weeks pregnant woman consulted for abdominal pain, vomiting and fever. During the study, a transvaginal
ultrasound was performed, where two endometric cavities and a pregnancy in the right horn were
observed. The evolution of the patient was torpid, reaching hypovolemic shock,
resolved by an emergency laparotomy where the rupture of the right horn was
found. Discussion: The bicornuate uterus is the
consequence of a partial fusion of the paramesonephric ducts during the fetal development, resulting in two functional uterine horns. Patients with bicornuate uterus may be asymptomatic, a uterine rupture is a rare but potentially severe complication of the
bicornuate uterus and is usually presented during first and second trimester. Conclusions: Pregnancy with Mullerian
anomalies often has
References
[1]
Raj, N., et al. (2019) An Observational Study of Effect of Mullerian Anomalies on Pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8, 115-1161.
[2]
Hefny, A.F., Kunhivalappil, F.A., Nambiar, R. and Bashir, M.O. (2015) A Rare Case of First-Trimester Ruptured Bicornuate Uterus in a Primigravida. International Journal of Surgery Case Reports, 14, 98-100.
https://doi.org/10.1016/j.ijscr.2015.07.019
[3]
Venetis, C.A., Papadopoulos, S.P., Campo, R., Gordts, S., Tarlatzis, B.C. and Grimbizis, G.F. (2014) Clinical Implication of Congenital Uterine Anomalies: A Meta-Analisis of Comparative Studies. Reproductive BioMedicine, 29, 665-683.
https://doi.org/10.1016/j.rbmo.2014.09.006
[4]
Ravasia, D., Brain, P.H. andPollard, J.F. (1999) Incidence of Uterine Rupture among Women with Müllerian Duct Anomalies Who Attempt Vaginal Birth after Cesarean Delivery. American Journal of Obstetrics and Gynecology, 181, 877-881.
https://doi.org/10.1016/S0002-9378(99)70318-2
[5]
Beguería, R. (2009) Malformaciones Müllerianas: Clasificación, diagnóstico y manejo. Ginecología y obstetricia clínica, 10, 165-169.
[6]
Chandler, T.M., Machan, L.S., Cooperberg, P.L., Harris, A.C. and Chang, S.D. (2009) Müllerian Duct Anomalies: From Diagnosis to Intervention. The British Journal of Radiology, 82, 1034-1042. https://doi.org/10.1259/bjr/99354802
[7]
Aguilar, C., García-Herrero, S., Medrano, J.V. and Melo, M.A.B. (2008) Pronóstico reproductivo de las malformaciones müllerianas. Progresos de Obstetricia y Ginecología, 51, 721-736. https://doi.org/10.1016/S0304-5013(08)76314-3
[8]
Bruand, M., Thubert, T., Winter, N., et al. (2020) Rupture of Non-Communicating Rudimentary Horn of Uterus at 12 Weeks’ Gestation. Cureus, 12, e7191.
https://doi.org/10.7759/cureus.7191
[9]
Hiersch, L., et al. (2015) The Association between Mullerian Anomalies and Short-Termpregnancy Outcome. The Journal of Maternal-Fetal & Neonatal Medicine, 29, 2573-2578. https://doi.org/10.3109/14767058.2015.1098613
[10]
Erez, O., Dukler, D., Novack, L., et al. (2007) Trial of Labor and Vaginal Birth after Cesarean Section in Patients with Uterine Müllerian Anomalies: A Population-Based Study. American Journal of Obstetrics and Gynecology, 196, 537.e1-537.e11.
https://doi.org/10.1016/j.ajog.2007.01.012
[11]
Nitzsche, B., Dwiggins, M. and Catt, S. (2017) Uterine Rupture in a Primigravid Patient with Unscarred Bicornuate Uterus at Term. Case Reports in Women’s Health, 15, 1-2. https://doi.org/10.1016/j.crwh.2017.03.004
[12]
Chiriboga, R. and Gonzaga-Aguilar, D. (2019) útero didelfo, bicolis con embarazo gemelar: Revisión de la literatura a propósito de un caso. Revista chilena de obstetricia y ginecología, 84, 75-81. https://doi.org/10.4067/S0717-75262019000100075