Abstract

Pregnancy in a noncommunicating rudimentary horn of the uterus is extremely rare and usually terminates in rupture during first or second trimester of pregnancy.Diagnosis of such cases with prior vaginal delivery is difficult. It can be missed in routine ultrasonograms and in majority is detected after rupture. 30 year old P3L1S2 presented to the Emergency Medical Ward with an acute abdomen and shock. Surgical and gynaecological advice was seeked, a provisional diagnosis of ruptured ectopic pregnancy made as the patient gave history of over the counter consumption of abortion pills a month ago. At laprotomy a unicornuate uterus with ruptured noncommunicating rudimentary horn was seen with massive hemoperitoneum. The need for high index of suspicion is recognized in such cases.The incidence is estimated at 1 per 100000 to140000 pregnancies.There are no definitive clinical criteria to detect this life threatening condition specially when it mimics other medical and surgical emergencies.