The unicornuate uterus is a congenital developmental malformation caused by incomplete development of one side of the paramesonephric duct. The unicornuate uterus often does not communicate with the uterine cavity of the better-developed side, but is connected to it by fibrous bundles. Unicornuate pregnancy refers to the implantation and growth of the fertilized egg in the unicornuate uterus.
There may be two possible scenarios for the fertilization of cornual pregnancy:
1. The sperm swims from the opposite fallopian tube to the affected fallopian tube to combine with the egg and enter the cornual.
2. The fertilized egg swims from the opposite fallopian tube to the affected fallopian tube and then implants in the cornual.
The cornual uterine wall is underdeveloped and cannot withstand the growth and development of the fetus. It often occurs in the middle stage of pregnancy, leading to spontaneous rupture of the cornual uterus, causing severe internal hemorrhage, symptoms similar to interstitial pregnancy of the fallopian tube. Occasionally, there are cases where the pregnancy reaches full term, and uterine contractions may occur during labor, but due to the impossibility of vaginal delivery, the fetus often dies during labor. B-ultrasound imaging can assist in diagnosis, and surgery should be performed as soon as possible after diagnosis to remove the cornual uterus. If the fetus is alive, cesarean section should be performed first, followed by the removal of the cornual uterus.
