A Case of Uterine Abnormalities with A Developed Rudimentary Horn

Background:

A 25-year unmarried lady was suffering from heavy menstrual bleeding and severe pain in the lower abdomen for 3 months.  She came to the Department of Obstetrics and Gynaecology at Yashoda Hospitals, Hyderabad, Her lower abdomen was tender. A laparoscopy was performed under general anesthesia. After thorough clinical wake up which revealed a unicornuate uterus with a rudimentary horn which means during the development of the child only one half of the uterus developed and the other half remained as a rudimentary horn which does not communicate with the developed half and this rudimentary horn showed adenomyosis, as well as endometriosis, was noted in the patient.

Discussion:

Adenomyosis is when the inner lining of the uterus gets lodged in the muscle layer of the uterus and Endometriosis is when the lining tissue gets lodged elsewhere in the abdomen. Endometriotic deposits were seen on the left horn of the uterus (the developed half) and the peritoneal cavity showed blood, called hemoperitoneum after evaluating all this, the abdomen was opened called laparotomy and the non-connecting right horn was removed and the right fallopian tube had to be removed as it was only connected to the right horn, the endometriotic deposits were also removed, both the ovaries were healthy and were conserved”, Said Dr. Bhagyalaxmi.

Conclusion:

The uterus is a girl child who is in her mother’s womb, develops as two separate halves which fuse and form one uterus. Any deviation from this can cause uterine anomalies. They occur in less than 5% of all women but are seen in up to 25% of women who had miscarriages or premature deliveries.  Women with such abnormalities can have a wide variety of symptoms like no menstrual cycles, severe menstrual cramps (dysmenorrhea), cyclical abdominal pain, infertility, repeated first and second-trimester pregnancy loss based on the type of abnormality. But, Hysterolaparoscopy is the gold standard for diagnosing such abnormalities.

“I was in a lot of pain which was increasing, Dr. Bhagyalaxmi motivated me to get this procedure done and  I am glad that I got it done. Now I am pain-free and being managed medically” says the patient.

About Author –

Dr. Bhagya Lakshmi, Consultant Obstetrics, Gynecologist & Laparoscopic Surgeon, Yashoda Hospitals – Hyderabad
MD (OBG)