Pregnancy and Congenital Uterine Anomalies: Case Series ()
Affiliation(s)
1Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
2ANAKO Mother and Child Medical Center, Yaoundé, Cameroon.
3Faculty of Health Sciences, University of Buea, Buea, Cameroon.
4Endoscopic Surgery and Human Reproductive Teaching Hospital, Yaoundé, Cameroon.
ABSTRACT
Background: Congenital Uterine Anomalies
are malformations of the Uterus which
occur during embryonic life and result from the abnormal
formation, fusion or resorption of the Mullerian ducts. Most of them are asymptomatic and diagnosis is done incidentally or
during examinations performed for other purposes. We report three cases of
women with pregnancies in malformed uteri. Aim: To depict the diagnostic
challenges and therapeutic aspects of
management of pregnancies in congenitally malformed Uteri. Case Presentation: The first case was a
22-year-old student who came to consult for a second opinion on the management
of an ectopic pregnancy. A 2D Ultrasound done prior revealed an ectopic
pregnancy but failed to specify its location in a rudimentary uterine horn. Management with a Multi-dose
Methotrexate regimen was initiated but progress was not favorable. She came to
us for a second opinion on management. Diagnostic
laparoscopy was done and revealed an ectopic pregnancy in a rudimentary uterine
horn. This was confirmed by histopathology. Management consisted of resection of the rudimentary horn
and a right total salpingectomy. The second case was that of a woman
who presented with spotting in early pregnancy. An Obstetric 2D
ultrasound done revealed a bicornuate Uterus with a Gestational sac in one
horn. She was placed on progesterone supplementation for 2 weeks, with regular
antenatal contacts. She had an elective cesarean section at 39 weeks. Surgery
revealed a complete Bicornuate Uterus. The post-operative period was uneventful
with no complications. The third case was that of a woman with a past history
of five successive spontaneous abortions, who presented with spotting at
about 8 weeks of gestation. An Obstetric Ultrasound done revealed a Bicornuate
Uterus and an embryo in one cornus. She was admitted, given her poor obstetric
history, for about 14 days and placed on progesterone supplementation till 20
weeks of gestation. Antenatal contacts were regular and she had an emergency
cesarean section at 36 weeks. There were no complications in the post
operative period. Conclusion: The high degree of diagnostic accuracy makes 3D ultrasound the diagnostic modality
of choice. Nevertheless, 2D and Hysterosalpingography can be used as well.
Management of pregnancies in women with congenital Uterine anomalies varies per case as presenting symptoms and outcomes
with pregnancies are not alike. When diagnosed out of pregnancy, and depending on the type of anomaly, surgical
management may be recommended.
Share and Cite:
Mangwi, A. , Nji, A. , Pascale, M. , Sandrine, M. , Etienne, B. and Cyrille, N. (2023) Pregnancy and Congenital Uterine Anomalies: Case Series.
Open Journal of Obstetrics and Gynecology,
13, 802-813. doi:
10.4236/ojog.2023.134069.
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