Rupture of pregnancy in the communicating rudimentary uterine horn at 34 weeks

Pregnancy in the rudimentary horn is rare and represents a form of ectopic gestation. Despite advances in ultrasound, prenatal diagnosis remains elusi ve, with confirmatory diagnosis being made at laparotomy. Because of variab le muscular constitution of the wall of the rudimentary horn, pregnancy can be accommodated until late in pregnancy, when rupture occurs manifesting c ommonly as acute abdomen with high risk of maternal mortality. The rudiment ary horn may or may not communicate with the uterine cavity with majority o f cases being non-communicating. We present a case of pregnancy in the comm unicating horn that was difficult to diagnose which ruptured at 34 weeks an d a review of literature.