chapter  5
26 Pages

Unicornuate Uterus and Rudimentary Uterine Horn

Among the earliest descriptions of congenital uterine malformations were reports of rudimentary uterine horns. These cases came to clinical attention because of their dramatic presentations. In one of the earliest reports in 1699, Mauriceau described a case of maternal death secondary to a ruptured pregnancy in a rudimentary horn.1 The early literature focused on the obstetric difficulties and the attendant morbidity and mortality secondary to the catastrophic outcomes associated with these abnormalities. Maternal mortality was high, and it was unusual for the diagnosis to be made prior to a complicated obstetric event.2 A retrospective collection of 84 cases from the literature published up to 1900 suggested that a noncommunicating rudimentary horn was the most common uterine abnormality and accounted for 78% of cases reported.3 A mortality of 47% was described in this series. The frequency of this observation reflected a reporting bias. Disasters came to clinical attention. More prevalent but clinically silent abnormalities simply went unnoticed. The clinical entities described in many of these early reports were a combination of a unicornuate uterus with an obstructed rudimentary horn that usually ended in catastrophic events.