Yue Wang Ying Zou ^* Huifang Wang ^*

• Ultrasound, Shenzhen Hospital, Peking University, Shenzhen, China

Background: Robert's uterus is a rare congenital uterine anomaly characterized by an asymmetric septum dividing the uterine cavity, creating an obstructed compartment. Pregnancy in the blind pouch of Robert's uterus is exceptionally rare and associated with significant obstetric complications.Case Presentation: This report describes a unique case of an 18-week pregnancy occurring within the left blind pouch of a Robert's uterus. The complexity of the case was increased by the presence of the umbilical cord protruding through a small septal hole into the right uterine compartment. Management and Outcome ： Initial diagnosis was achieved through ultrasonography and subsequently confirmed with MRI. Given the high risk of uterine rupture, an emergency cesarean section was performed at 18 weeks gestation. Intraoperative findings revealed a protruding left uterine horn with a muscular septum separating it from the right compartment. A stillborn male fetus was delivered, and postoperative 3D ultrasound confirmed the restoration of normal uterine external morphology.This case highlights the importance of early diagnosis and appropriate intervention in pregnancies within Robert's uterus. The presence of a septal hole allowing umbilical cord protrusion is a unique feature that may influence pregnancy progression and outcomes in such cases.