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This case highlights the critical role of early radiological screening by ultrasound in identifying uterine anomalies. In this report, we discuss a 39-year-old pregnant woman, gravida 4 para 3, and her fetus at gestational age 18 weeks. The patient was referred to the Obstetrics and Gynecology Emergency Department at Qatif Central Hospital, Saudi Arabia, from a private hospital due to an ultrasound study indicating a possible ectopic pregnancy with an abdominal fetal location.

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A 23-year-old woman, conceived by ovulation induction presented at 10 weeks amenorrhea with abdominal pain and a positive urinary Beta HCG. 2D ultrasound suggested a right-sided ectopic pregnancy. On 3D ultrasound imaging, an unicornuate uterus with a right rudimentary horn pregnancy of size 6 cm was diagnosed [Figure 1].

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A non-communicating rudimentary uterine horn is a Müllerian abnormality that manifests due to abnormal Müllerian duct development. This abnormality is associated with endometriosis, infertility, and pregnancy complications, including ectopic pregnancy, abnormal fetal presentation, abruption, increased fetal mortality and morbidity, preterm rupture of membranes, preterm birth, intrauterine growth restriction, and uterine rupture. If pregnancy does occur, there is a high risk of complications, most notably rupture of the rudimentary horn.

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Article Synopsis
  • Developmental problems with the genital tract happen when parts of certain ducts don't fuse properly during fetal development.
  • A 24-year-old woman had a rare condition called ruptured rudimentary horn pregnancy that almost caused her death.
  • Doctors performed emergency surgery when they saw she had a serious internal bleeding, highlighting the importance of recognizing unusual pregnancy issues in patients with severe abdominal pain.
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