Clinical implications of the unicornuate uterus with rudimentary horn.

Twenty patients with unicornuate uteri were unexpectedly found during operative procedures. Of these, 18 women had unicornuate uteri with concomitant rudimentary horn and only two were without. Suspicion of ectopic pregnancy, chronic pelvic pain, or pelvic tumor, was most frequently the primary reason for admittance to hospital. Endometriosis (20%) was the most common finding in surgical procedures. Only one hematometra of the rudimentary horn was found. Two tubal pregnancies and two pregnancies in the rudimentary horn, one with rupture of the horn and one with placenta accreta in the horn, were observed. Treatment was the simple excision of the rudimentary horn in 12 cases. Fetal survival rate was 71%, prematurity 15%, and perinatal mortality 7.4% in 35 pregnancies and 27 deliveries. High incidence of breech presentation (33%) and cesarean section rate (30%) was observed. Two out of three pregnancies with cervical cerclage ended successfully. Of 15 pyelograms performed, nine (60%) showed abnormalities, the most frequently being the absence of a kidney.