OBJECTIVE: Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in a rudimentary horn is rare, represents a form of ectopic gestation. The diagnosis of the rudimentary horn pregnancy is very difficult before it ruptures.
CASE: We present a case of pregnancy in the communicating horn that was difficult to diagnose preoperatively. An emergency exploratory laparotomy was done considering abdominal ectopic pregnancy after the patient was given misoprostol for missed abortion from referral hospital. Our ultrasound evaluation revealed abdominal ectopic pregnancy. Intra operative finding was unruptured rudimentary horn. A non-viable female fetus with a birth weight of 200 g was delivered. The ruptured rudimentary horn and left tube were excised together.
CONCLUSION: Despite advances in ultrasound, the diagnosis of pregnancy in the rudimentary horn remains difficult with definitive diagnosis being made at laparotomy. It is very important to have high index of suspicion especially in resource limited setting where most patients present with rupture.
KEYWORDS: Rudimentary horn, Ectopic pregnancy, Mekelle University
(Ethiopian Journal of Reproductive Health; 2018; 10; 4: 62-66)