Uterine Rupture Associated with Placenta Accreta in a Communicating Pseudo-unicornus: A Case Report and Review of the Literature
Published: 2022-12-31
Page: 294-299
Issue: 2022 - Volume 5 [Issue 1]
Niang Ndama *
Gynecological and Obstetrical Clinic, Aristide Le Dantec Hospital, Dakar, Senegal, Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal and Cheikh Anta Diop University, Dakar, Senegal.
Diop Khary
Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal.
Diop Alioune
Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal.
Ndiaye Awa
Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal.
Badji Amadou
Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal.
Sene Mamadou
Public Health Establishment level 1, Touba Ndamatou, Diourbel, Senegal.
Diouf Abdoul Aziz
Gynecological and Obstetrical Clinic, Aristide Le Dantec Hospital, Dakar, Senegal and Cheikh Anta Diop University, Dakar, Senegal.
Diouf Alassane
Gynecological and Obstetrical Clinic, Aristide Le Dantec Hospital, Dakar, Senegal and Cheikh Anta Diop University, Dakar, Senegal.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Uterine malformations are abnormalities of the development of the Müllerian ducts and represent 1 to 4% in terms of prevalence in the population. Pregnancy constitutes a circumstance of discovery of this congenital anomaly with an increased risk of obstetrical complications, the most dreaded of which are ectopic pregnancy and uterine rupture.
Case Presentation: We report in our observation a case of uterine malformation associated with pregnancy. This was a 20 years old female patient with a 34 SA pregnancy who presented with abdomino-pelvic pain. On clinical examination a threat of preterm delivery was suspected. Obstetrical ultrasound revealed a prævia mass suggesting adnexal torsion or a prævia myoma. A laparotomy was carried out, which revealed a communicating pseudo-unicornuate uterus (AFS class II type 3) with the pregnancy located in the communicating part. A subserous uterine rupture associated with a placenta accreta was noted at this level. Fetal extraction was performed followed by a hemostasis hysterectomy. The postoperative course was unremarkable with a healthy live infant.
Conclusion: These rare cases require a good prenatal follow-up with early ultrasound. This is often difficult in rural areas where the low socio-economic level favors a delay in diagnosis and management and the mode of discovery remains during an obstetrical complication.
Keywords: Uterine malformations, pseudo unicornuate uterus, uterine rupture, rudimentary horn