Didelphys uterus: an interesting case report of pregnancy in a rare Mullerian anomaly
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221959Keywords:
Mullerian duct anomalies, Didelphys uterus, Congenital defectsAbstract
Mullerian duct anomalies (MDAs) are congenital defects of the female genital system that arise from abnormal embryological development of the Mullerian ducts. A didelphys uterus, also known as a double uterus, is one of the least common amongst the MDAs. This report discussed a case of pregnancy with uterus didelphys. This patient was a 27-year-old primigravida with 34.2-week gestation with spontaneous conception who presented with decreased fetal movements. On examination patient had a non-communicating, thick vaginal septum extending from the introitus to the cervix was seen and two cervices one on each side of the septum were located. The patient underwent emergency lower segment caesarean section in view of foetal distress and doppler changes. Intra-operatively, evidence of didelphys uteri was seen. Intraoperative and post-operative period was uneventful. A fetus of 1790 gram was delivered, with APGAR 9/10. There were no renal anomalies on subsequent ultrasonography.
References
Heinonen PK. Uterus didelphys: a report of 26 cases. Eur J Obstet Gynecol Reprod Biol. 1984;17(4):345-50.
Heinonen PK. Clinical implications of the didelphic uterus: long-term follow-up of 49 cases. Eur J Obstet Gynecol Reprod Biol. 2000;91(2):183-90.
Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simón C, Pellicer A. Reproductive impact of congenital Müllerian anomalies. Human Reprod. 1997;12(10):2277-81.
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Human Reproduction Update. 2001;7(2):161-74.
Acién P. Reproductive performance of women with uterine malformations. Human Reprod. 1993;8(1):122-6.
Madureira AJ, Mariz CM, Bernardes JC, Ramos IM. Case 94: uterus didelphys with obstructing hemivaginal septum and ipsilateral renal agenesis. Radiology. 2006;239(2):602-6.
Martínez-Beltrán M, Giménez J, Acién P. Uterus didelphys with septate cervix and unilateral endometrial carcinoma: a case report. J Genital System Disord. 2012;1(1).
Jones HW. Reproductive impairment and the malformed uterus. Fertil Steril. 1981;36(2):137-48.
Ludmir J, Samuels P, Brooks S, Mennuti MT. Pregnancy outcome of patients with uncorrected uterine anomalies managed in a high-risk obstetric setting. Obstet Gynecol. 1990;75(6):906-10.
Maneschi I, Maneschi F, Parlato M, Fucà G, Incandela S. Reproductive performance in women with uterus didelphys. Acta Eur Fertil. 1989;20(3):121-4.
Magudapathi C. Uterus didelphys with longitudinal vaginal septum: normal deliver—case report. J Clin Case Rep. 2012;2:13.
Suthar S, Choudhary R, Dadhich S. Rupture uterus in pregnancy with didelphys uterus: a rare case report. J South Asian Federation Obstet Gynecol. 2011;3(3):149-50.
Altwerger G, Pritchard AM, Black JD, Sfakianaki AK. Uterine didelphys and vaginal birth after cesarean delivery. Obstet Gynecol. 2015;125(1):157-9.
Stanislavsky A. Herlyn-Werner-Wunderlich syndrome (HWW). 2015. Available at: http://radiopaedia.org/articles/herlyn-werner-wunderlich-syndrome. Accessed on 15 February 2022.
Lin CC, Chen AC, Chen TY. Double uterus with an obstructed hemivagina and ipsilateral renal agenesis: report of 5 cases and a review of the literature. J Formos Med Assoc. 1991;90(2):195-201.
Karaca L, Pirimoglu B, Bayraktutan U, Ogul H, Oral A, Kantarci M. Herlyn-Werner-Wunderlich syndrome: a very rare urogenital anomaly in a teenage girl. J Emerg Med. 2015;48(3):e73-5.
Raj N, Chavan N. An observational study of effect of Mullerian anomalies on pregnancy. Int J Reprod Contracept Obstet Gynecol. 2021;8.
Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, et al. ASRM m€ullerian anomalies classification 2021. Fertil Steril. 2021;116(5):1238-52.
