Term pregnancy and vaginal delivery from unicornuate uterus after laparoscopic treatment of a cavitate rudimentary horn by an endoscopic stapler

摘要

Gynecologic and obstetric pathologies may be associated with the presence of a cavitate rudimentary horn such as hematometra, chronic pelvic pain, severe dysmenorhea, increased risk of endometriosis, uterine rupture in pregnancy when implantation occurs inside the pathologic horn and intrauterine growth retardation (IUGR) or preterm labor when the implantation is in the unicornuate uterus. Laparoscopy has been demonstrated to have an important role for the diagnosis and the treatment of this specific Miillerian anomaly. The removal of the cavitate rudimentary horn is always indicated. Normal pregnancies and vaginal deliveries have been described after laparotomic removal of the rudimentary horn: six cases of term pregnancy and five cases of vaginal delivery have been reported after laparoscopic laser treatment of the malformation. We describe a case of uneventful term pregnancy and uncomplicated vaginal delivery after laparoscopic treatment by an endoscopic stapler of an unicornuate uterus with controlateral cavitate rudimentary horn, class II.b according to American Fertility Society (AFS) classification.