Unicornuate uterus and rudimentary horn

OBJECTIVE: To evaluate clinical implications of the unicornuate uterus and rudimentary horn. DESIGN: A retrospective study. SETTING: A university hospital. PATIENT(S): Forty-two women who had a unicornuate uterus with or without rudimentary horn. INTERVENTION(S): The rudimentary horn was removed in 21 cases. MAIN OUTCOME MEASURE(S): Presence of other anomalies, fertility, and outcome of pregnancies were studied. RESULT(S): A right unicornuate uterus with noncommunicating rudimentary horn was the most common type of uterine anomaly. Unilateral renal agenesis was found in 13 (38%) of 34 cases. Six (14%) of the 42 patients had primary infertility. Thirty-four women produced 93 pregnancies; ectopic pregnancy (EP; rudimentary horn, tubal) occurred in 20 of these cases (22%). The pregnant uterine horn ruptured in 3 of 7 cases. Eight (57%) of the 14 women with infertility underwent treatment by IVF-ET; 4 of them conceived, and 2 had term delivery. The fetal survival rate was 61%, prematurity 17%, fetal growth retardation 5%, and the spontaneous intrauterine (IU) abortion rate was 16%. Pregnancy-induced hypertension (PIH) was more common in women lacking a kidney than in those with two kidneys. CONCLUSION(S): The high number of EPs indicates removal of rudimentary horn and its tube when diagnosed. The prognosis of IU pregnancy is not impaired in the unicornuate uterus although prematurity threatens. Unilateral renal agenesis is associated with PIH.