Second-trimester rudimentary uterine horn pregnancy: rupture after labor induction with misoprostol

Obstet Gynecol. 2005 Nov;106(5 Pt 2):1160-2. doi: 10.1097/01.AOG.0000182989.06439.68.


Background: Uterine anomalies are often first suspected after bimanual or ultrasonographic examination. Currently there are no specific recommendations for further evaluation of asymptomatic women with suspected uterine anomalies in pregnancy.

Case: A young primigravida with a history of an ultrasound diagnosis of bicornuate uterus presented with mild abdominal pain. An ultrasound examination showed a viable 18-week fetus with anhydramnios in the left uterine horn. Labor induction with misoprostol culminated in uterine rupture. At laparotomy, a ruptured left noncommunicating rudimentary uterine horn of a unicornuate uterus was noted.

Conclusion: Pregnancies within noncommunicating uterine horns significantly increase the risk of potentially catastrophic outcome, therefore, consideration should be given to performing 3-dimensonal ultrasonography and/or magnetic resonance imaging examinations to determine the nature of uterine anomalies. Caution should be exercised if prostaglandins are considered for use in this setting.

Publication types

  • Case Reports

MeSH terms

  • Abdomen, Acute / etiology
  • Abortifacient Agents, Nonsteroidal / adverse effects
  • Abortifacient Agents, Nonsteroidal / therapeutic use
  • Adult
  • Female
  • Humans
  • Labor, Induced / adverse effects*
  • Laparotomy
  • Misoprostol / adverse effects
  • Misoprostol / therapeutic use
  • Placenta Accreta / diagnosis
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / surgery
  • Pregnancy Trimester, Second
  • Pregnancy, Ectopic / diagnosis*
  • Pregnancy, Ectopic / surgery
  • Ultrasonography, Prenatal
  • Uterine Rupture / etiology*
  • Uterine Rupture / surgery
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging
  • Uterus / surgery


  • Abortifacient Agents, Nonsteroidal
  • Misoprostol