Paper Title
Rupture of Non-Communicating Rudimentary Horn of Unicornuate Uterus- A Catastrophic Wonder

Abstract
Unicornuate uterus is a rare Mullerian anomaly resulting due to partial or complete lack of development of one Müllerian duct between the 7th and 8th week of gestation.The functioning unicornuate uterus may or may not be associated with a rudimentary uterine horn.The incidence of rudimentary–horn pregnancy is estimated to be one in 76,000 pregnancies.1 Seventy-five to ninety percent of unicornuate uteri with rudimentary horns are non-communicating.3 Pregnancy in the non communicatingrudimentay horn of a unicornuate uterus have very ill fate with about more than 50% cases culminating into uterine rupture associated with fatal intraperitoneal hemorrhage and shock. Often such pregnancies are identified in the mid second to late second trimester when such catastrophe occurs.Here is the case report of a 25 year old second gravida para one with a successful previous vaginal delivery at 20 weeks of gestation who was referred to our hospital for severe anemia and shock. The only symptom of the woman was acute abdominal pain and recurrent vomiting and dizziness.On examination there was diffuse distension and tenderness of the abdomen.Bimanual examination showed a closed cervical os with forniceal fullness. Laparotomy done with the suspicion of rupture uterus revealed rupture at the fundus of a non-communicating rudimentary horn of a unicornuate uterus, massive hemoperitoneum with afloating dead fetus in the peritoneal cavity. The non-communicating rudimentary horn was resected and ipsilateral salpingectomy performed. The case is unique as unlike most cases with a functioning non-communicating rudimentary horn, our patient had successful prior vaginal delivery with no history of abortions, had regular menstrual history and no history of cyclical abdominal pain during menses.