Successful term delivery after laparoscopic resection of a non-communicating rudimentary horn in a patient with a unicornuate uterus: a case report.

Unicornuate uterusaccompanied by a non-communicating rudimentary horn is a rare uterine malformation. If a embryo is implanted into the rudimentary horn, continuation of pregnancy is difficult due to the risk of uterine rupture. We recently performed laparoscopic resection of the right rudimentary horn after two right rudimentary horn pregnancies in a woman, in whom a normal pregnancy occurred in the left unicornuate uterus, leading to successful delivery of a baby. This case is presented herein. The diagnostic procedures leading to identification of this rare malformation were prompted by inability to remove uterine contents during surgery performed after a diagnosis of missed abortion. A right rudimentary horn pregnancy, which had occurred twice, was treated with methotrexate. To prevent further pregnancy in the right rudimentary horn, resection of this rudimentary horn was planned and successfully implemented under laparoscopic guidance. This surgical procedure is usually difficult, but fertility could be preserved by employing minimally invasive surgery, involving the use of a LigaSureTM Vessel Sealing System to avoid ligation and assure virtually no bleeding. Soon after surgery, a natural pregnancy in the left unicornuate uteruswas confirmed. Intrauterine fetal growth was normal, and transvaginal delivery at term was possible.