Catastrophic Hemorrhage after Rupture of Rudimentary Horn Pregnancy Which Once Misdiagnosed as Uterus Bicornis

A 22-year-old, primigravida, at 18 weeks’ gestation presented with an acute onset of abdominal pain, severe hypotension and tachycardia. It has been revealed in her previous medical history that she had been operated with a presumptive diagnosis of ectopic pregnancy and due to the intraoperative misdiagnosis of uterus bicornis, the intact right uterine pregnancy in the rudimentary horn was left in place to continue in another hospital. After the operation, prophylactic cerclage was performed. She was urgently brought to a private hospital and emergency laparotomy was performed for the presumptive diagnosis of intraperitoneal hemorrhage. A significant hemoperitoneum was encountered with the fetus floating freely with the placenta in the peritoneal cavity. The right rudimentary uterine horn had a fundal rupture that necessitated performing a rudimentary uterine and ipsilateral tubal excision. The patient recovered uneventfully.