Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus

Background: Robert’s uterus is a rare müllerian duct anomaly described as an asymmetric septate uterus with a noncommunicating cavity. Its main presentation is recurrent cyclical abdominal pain. However, patients with Robert’s uterus may present with recurrent pregnancy loss and infertility. Case: W...

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Main Authors: Ji-Chen Wang, De-Ying Wei, Chen Su, Qi Han, Yong-Hao Gai
Format: Article
Language:English
Published: IMR Press 2021-10-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805194
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author Ji-Chen Wang
De-Ying Wei
Chen Su
Qi Han
Yong-Hao Gai
author_facet Ji-Chen Wang
De-Ying Wei
Chen Su
Qi Han
Yong-Hao Gai
author_sort Ji-Chen Wang
collection DOAJ
description Background: Robert’s uterus is a rare müllerian duct anomaly described as an asymmetric septate uterus with a noncommunicating cavity. Its main presentation is recurrent cyclical abdominal pain. However, patients with Robert’s uterus may present with recurrent pregnancy loss and infertility. Case: We herein report a rare presentation of Robert’s uterus in a 23-year-old woman who suffered from primary infertility without a history of dysmenorrhea. Preoperative two-dimensional ultrasound (2D-US) suggested that the patient only had a partial septate uterus. A hysteroscopy found only the right side of the uterine cavity with a narrow channel while the left uterine cornua and left tubal ostium were not visualized. Intraoperative transabdominal 2D-US confirmed that there were two uterine cavities, a blind hemi-cavity, and a contralateral communicating hemi-cavity. Subsequently, the asymmetric septum was successfully removed by ultrasound-guided hysteroscopy. Conclusion: For patients diagnosed with septate uterus by 2D-US, three-dimensional ultrasound or magnetic resonance imaging is required to make a definitive diagnosis and to help with surgical planning. If results are inconclusive, intraoperative ultrasound-guided hysteroscopic metroplasty may be a reliable pathway for the definitive diagnosis and treatment of Robert’s uterus.
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spelling doaj-art-78f728afba4544ae97afa117d752822a2025-08-20T03:48:35ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-10-014851219122310.31083/j.ceog4805194S0390-6663(21)00032-4Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterusJi-Chen Wang0De-Ying Wei1Chen Su2Qi Han3Yong-Hao Gai4Department of Ultrasound, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 250021 Jinan, Shandong, ChinaDepartment of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, ChinaDepartment of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, ChinaDepartment of Ultrasound, Maternity & Child Care Center of Dezhou, 253000 Dezhou, Shandong, ChinaDepartment of Ultrasound, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 250021 Jinan, Shandong, ChinaBackground: Robert’s uterus is a rare müllerian duct anomaly described as an asymmetric septate uterus with a noncommunicating cavity. Its main presentation is recurrent cyclical abdominal pain. However, patients with Robert’s uterus may present with recurrent pregnancy loss and infertility. Case: We herein report a rare presentation of Robert’s uterus in a 23-year-old woman who suffered from primary infertility without a history of dysmenorrhea. Preoperative two-dimensional ultrasound (2D-US) suggested that the patient only had a partial septate uterus. A hysteroscopy found only the right side of the uterine cavity with a narrow channel while the left uterine cornua and left tubal ostium were not visualized. Intraoperative transabdominal 2D-US confirmed that there were two uterine cavities, a blind hemi-cavity, and a contralateral communicating hemi-cavity. Subsequently, the asymmetric septum was successfully removed by ultrasound-guided hysteroscopy. Conclusion: For patients diagnosed with septate uterus by 2D-US, three-dimensional ultrasound or magnetic resonance imaging is required to make a definitive diagnosis and to help with surgical planning. If results are inconclusive, intraoperative ultrasound-guided hysteroscopic metroplasty may be a reliable pathway for the definitive diagnosis and treatment of Robert’s uterus.https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805194müllerian anomalyrobert's uterusseptate uterusultrasound
spellingShingle Ji-Chen Wang
De-Ying Wei
Chen Su
Qi Han
Yong-Hao Gai
Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
Clinical and Experimental Obstetrics & Gynecology
müllerian anomaly
robert's uterus
septate uterus
ultrasound
title Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
title_full Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
title_fullStr Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
title_full_unstemmed Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
title_short Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
title_sort intraoperative management of a robert s uterus without hematometra in blind hemi cavity preoperatively misdiagnosed as septate uterus
topic müllerian anomaly
robert's uterus
septate uterus
ultrasound
url https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805194
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AT chensu intraoperativemanagementofarobertsuteruswithouthematometrainblindhemicavitypreoperativelymisdiagnosedasseptateuterus
AT qihan intraoperativemanagementofarobertsuteruswithouthematometrainblindhemicavitypreoperativelymisdiagnosedasseptateuterus
AT yonghaogai intraoperativemanagementofarobertsuteruswithouthematometrainblindhemicavitypreoperativelymisdiagnosedasseptateuterus