IMR Press / CEOG / Volume 48 / Issue 5 / DOI: 10.31083/j.ceog4805194
Open Access Case Report
Intraoperative management of a Robert’s uterus without hematometra in blind hemi-cavity preoperatively misdiagnosed as septate uterus
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1 Department of Ultrasound, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 250021 Jinan, Shandong, China
2 Department of Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, China
3 Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021 Jinan, Shandong, China
4 Department of Ultrasound, Maternity & Child Care Center of Dezhou, 253000 Dezhou, Shandong, China
Clin. Exp. Obstet. Gynecol. 2021, 48(5), 1219–1223; https://doi.org/10.31083/j.ceog4805194
Submitted: 20 October 2020 | Revised: 18 December 2020 | Accepted: 23 December 2020 | Published: 15 October 2021
Abstract

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.

Keywords
Müllerian anomaly
Robert's uterus
Septate uterus
Ultrasound
Figures
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