Rudimentary horn pregnancies: dilemmas in diagnosis

Rudimentary horn pregnancy is a rare obstetric entity and the diagnosis and management may pose some problems especially in a low-resource center. We report a case of G1P0 with pregnancy of 28 weeks gestation with diagnosed intrauterine fetal death, which was suspected as extra uterine pregnancy bases on failed attempts of termination of pregnancy and on laparotomy, a dead fetus of 16 weeks was found in left unruptured noncommunicating horn of unicornuate uterus. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. It requires a high index of suspicion.