# Laparoscopic Management of a 12-Week Pregnancy Loss in a Rudimentary Uterine Horn

## TL;DR

This paper describes a rare case of a 12-week pregnancy in a uterine rudimentary horn managed successfully through laparoscopic surgery.

## Contribution

The paper presents a novel case report of laparoscopic management of a rare uterine horn pregnancy with clinical implications.

## Key findings

- Laparoscopic excision of the rudimentary horn, nonviable pregnancy, and fallopian tube was performed without complications.
- A history of preterm birth or malpresentation may indicate an underlying Mullerian anomaly.
- Minimally invasive surgical approaches can be effective for treating rare uterine horn pregnancies.

## Abstract

Unicornuate uterus with rudimentary horn is a rare structural uterine anomaly resulting from incomplete Mullerian duct development and/or fusion. Pregnancy in rudimentary horn is an uncommon presentation of a Mullerian anomaly and may lead to substantial morbidity and mortality due to high risk of uterine rupture with intraabdominal hemorrhage. Medical and/or surgical management may be undertaken; however, currently, no treatment guidelines exist. We describe the management of a 12-week rudimentary horn pregnancy in a 25-year-old multiparous patient with a prior spontaneous preterm breech vaginal delivery and one spontaneous early term cephalic vaginal delivery in whom this congenital uterine condition was previously unknown. The rudimentary horn, nonviable pregnancy, and contiguous ipsilateral fallopian tube were excised laparoscopically without complication. Given the infrequency of rudimentary horn pregnancies and the high risk for obstetric complications, a high index of suspicion should be maintained. We emphasize that a history of preterm birth or malpresentation should raise suspicion for maternal Mullerian anomaly, and that a minimally invasive approach can be feasible for treatment of a rudimentary horn pregnancy.