Early first trimester diagnosis and total laparoscopic management of rudimentary uterine horn pregnancy

Rudimentary uterine horn pregnancy is rare, with a reported incidence of 1 in 76,000 to 1 in 150,000. This report aims to advance knowledge regarding this rare condition, importance of MRI imaging in characterizing congenital uterine anomalies and the feasibility of a total laparoscopic management approach. A 26 year old female presented with new onset abdominal pain at 6 weeks gestation. Ultrasound imaging initially suggested that the pregnancy was located within a unicornuate uterus. However further imaging (ultrasound and MRI) instead located the pregnancy within a noncommunicating right-sided rudimentary uterine horn, with a left-sided unicornuate uterus. This uterine anomaly was newly diagnosed in early pregnancy and required a multidisciplinary approach to determine optimal management. A total laparoscopic approach was successfully used to excise the right uterine horn and fallopian tube to prevent recurrence and future complications including tubal ectopic pregnancy.