Incidental findings of ipsilateral agenesis of the ovary and fallopian tube during cesarean section delivery successfully managed in a resource-limited setting: a case report

Introduction and importance: Unilateral agenesis of the ovary and fallopian tube is a rare reproductive anomaly that may occur with or without associated uterine malformations. Both variations have been reported in the literature. As patients are often asymptomatic, diagnosis typically occurs incidentally during surgery. This case presents a rare combination of ipsilateral ovarian and fallopian tube agenesis with a unicornuate uterus and normal bilateral kidneys. It underscores the need for a multidisciplinary approach involving obstetricians, neonatologists, and nursing care to improve maternal and neonatal outcomes. Clinical presentation: A 27-year-old Black African primigravida at 40 weeks of gestation was admitted with 2 hours of pushing-down pain. She had regular antenatal care at a local health center but no ultrasound due to limited resources. On arrival, obstetric ultrasound with Doppler revealed intrauterine growth restriction and abnormal blood flow. Cardiotocography showed minimal variability with recurrent decelerations, prompting an emergency Cesarean section. Clinical Discussion: Congenital unilateral absence of the fallopian tube with ipsilateral ovarian agenesis is rare and may or may not involve uterine or renal anomalies. These conditions can affect pregnancy outcomes, potentially leading to miscarriage or stillbirth. Nonetheless, cases of full-term delivery have been documented. Conclusion: This rare anomaly can occur with or without additional reproductive or renal abnormalities. Although it may increase pregnancy risks, successful term deliveries are possible. Early diagnosis and careful monitoring are crucial for favorable outcomes. Further research is needed to improve the understanding and management of this condition.