{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:05:58Z","timestamp":1784289958168,"version":"3.55.0"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,21]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>A ruptured rudimentary horn pregnancy is an obstetric emergency. It presents clinically similar to a ruptured tubal ectopic pregnancy. In patients with a known uterine anomaly, it is a risk that can be anticipated; however, in patients with a previous caesarean, who are unaware of having a uterine anomaly, it becomes a diagnostic challenge. We present such a case of a multigravida with a previous caesarean section who presented at 15 weeks gestation with severe abdominal pain and hypotension. On ultrasonography, a single extrauterine fetal demise with features of uterine rupture and massive haemoperitoneum was noted. Subsequently, exploratory laparotomy revealed a unicornuate uterus with a left-sided ruptured non-communicating horn. This case highlights the complexity of the diagnosis and management of acute abdomen in pregnancy with features of shock in an undiagnosed case of unicornuate uterus. It also emphasises the importance of documentation and communication of intraoperative findings with the patient.<\/jats:p>","DOI":"10.1136\/bcr-2025-271781","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:40:11Z","timestamp":1784288411000},"page":"e271781","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ruptured rudimentary horn pregnancy in a unicornuate uterus"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3684-8646","authenticated-orcid":false,"given":"Aditi","family":"Jha","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapnali Rajendra","family":"Borade","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayshree P","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Dr DY Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"2026071704400634000_19.7.e271781.1","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.fertnstert.2021.09.025","article-title":"ASRM m\u00fcllerian anomalies classification 2021","volume":"116","author":"Pfeifer","year":"2021","journal-title":"Fertil Steril"},{"key":"2026071704400634000_19.7.e271781.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2020.01.003"},{"key":"2026071704400634000_19.7.e271781.3","doi-asserted-by":"crossref","DOI":"10.1186\/s13244-024-01879-2","article-title":"Mullerian anomalies: revisiting imaging and classification","volume":"16","author":"Dixit","year":"2025","journal-title":"Insights Imaging"},{"key":"2026071704400634000_19.7.e271781.4","first-page":"131","article-title":"Unicornuate uterus and ectopic (undescended) ovary","volume":"3","author":"Ombelet","year":"2011","journal-title":"Facts, Views Vis Obgyn"},{"key":"2026071704400634000_19.7.e271781.5","doi-asserted-by":"crossref","unstructured":"Mohammed AA , Abdelfattah AI , Ali MM . Lodan Abdelrahman Elmubarak,Intact non-communicating rudimentary horn pregnancy in a patient with a history of two cesarean sections: A case report,Case Reports in Women\u2019s Health. 2024;e00570:2214\u20139112.","DOI":"10.1016\/j.crwh.2023.e00570"},{"key":"2026071704400634000_19.7.e271781.6","doi-asserted-by":"crossref","first-page":"3012","DOI":"10.4103\/0366-6999.247200","article-title":"Diagnosis and Treatment of Rudimentary Horn Pregnancy","volume":"131","author":"Zhang","year":"2018","journal-title":"Chin Med J"},{"key":"2026071704400634000_19.7.e271781.7","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/j.1471-0528.2004.00162.x","article-title":"Preventing ectopic pregnancies: how often does transperitoneal transmigration of sperm occur in effecting human pregnancy?","volume":"111","author":"Nahum","year":"2004","journal-title":"BJOG"},{"key":"2026071704400634000_19.7.e271781.8","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.tjog.2016.06.009","article-title":"Pregnancy in a noncommunicating rudimentary horn of a unicornuate uterus: Prerupture diagnosis and management","volume":"55","author":"Lai","year":"2016","journal-title":"Taiwan J Obstet Gynecol"},{"key":"2026071704400634000_19.7.e271781.9","doi-asserted-by":"crossref","first-page":"3012","DOI":"10.4103\/0366-6999.247200","article-title":"Diagnosis and Treatment of Rudimentary Horn Pregnancy: Analysis of Eleven Cases","volume":"131","author":"Zhang","year":"2018","journal-title":"Chin Med J (Engl)"},{"key":"2026071704400634000_19.7.e271781.10","first-page":"151","article-title":"Rudimentary uterine horn pregnancy. The 20th-century worldwide experience of 588 cases","volume":"47","author":"Nahum","year":"2002","journal-title":"J Reprod Med"},{"key":"2026071704400634000_19.7.e271781.11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40738-018-0051-7","article-title":"Diagnosis and management of a heterotopic pregnancy and ruptured rudimentary uterine horn","volume":"4","author":"Brady","year":"2018","journal-title":"Fertil Res Pract"},{"key":"2026071704400634000_19.7.e271781.12","doi-asserted-by":"crossref","first-page":"3741","DOI":"10.18203\/2320-1770.ijrcog20243615","article-title":"Rupture of gravid rudimentary horn","volume":"13","author":"Anand","year":"2024","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2026071704400634000_19.7.e271781.13","first-page":"39","article-title":"Rupture of left horn of bicornuate uterus at twenty weeks of gestation","volume":"46","author":"Kore","year":"2000","journal-title":"J Postgrad Med"},{"key":"2026071704400634000_19.7.e271781.14","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13256-023-03882-5","article-title":"Rudimentary horn pregnancy, a differential diagnosis of an intraabdominal pregnancy: a case report","volume":"17","author":"Bidiga","year":"2023","journal-title":"J Med Case Reports"},{"key":"2026071704400634000_19.7.e271781.15","first-page":"1214","article-title":"Comparative Analysis of Uterine Exteriorization Versus in Situ Repair During Caesarean Section at a Tertiary Care Center","volume":"6","author":"None","year":"2025","journal-title":"Int J Med Pharm Res"},{"key":"2026071704400634000_19.7.e271781.16","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000161321.94364.56"},{"key":"2026071704400634000_19.7.e271781.17","doi-asserted-by":"publisher","DOI":"10.1148\/rg.326125515"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:40:14Z","timestamp":1784288414000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,17]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2025-271781"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271781","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}