Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian abnormality that may cause many gynecologic and obstetric complications. Pregnancy in a rudimentary horn is very rare, with an estimated incidence of 1 in 100,000 to 1 in 140,000 pregnancies. The natural history of rudimentary horn pregnancy (RHP) is usually rupture of pregnant horn in the second or third trimester, resulting in life- threatening heavy bleeding. Materials and Methods: In this series, 4 cases of RHP are discussed. The first case presented after failure of induction with prostaglandins. Two cases presented with abdominal pain, whereas the fourth case presented in hypovolumic shock. Conclusions: This condition should be diagnosed before conception or at least before rupture, and rudimentary horn should be excised to prevent rupture in future pregnancy. Nonresponders of induced abortion should be investigated with a high index of suspicion. (J GYNECOL SURG 27:139)
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