Spontaneous pregnancy at term with uterus didelphys: a case report

Romuald Randriamahavonjy, Tanjona A. Ratsiatosika, Sidy Fleurian, Housni IA, Todisoa M. Rakotomboahangy, Rasoanandrianina B. Solange, Hery R. Andrianampanalinarivo


The uterus didelphys results from the absence of fusion of the bilateral mullerian ducts. It is a rare pathology. This malformation concerns 5% of uterine malformations from mullerian ducts and affects one woman in 1,000-30,000. Obstetrical complications of this malformation are numerous. The chance of reaching term for pregnancies with didelphys uterus is reported as 20%–30%. Authors report a case of spontaneous term pregnancy in a 21-year-old primiparous woman with a didelphic uterus. The patient had an unexplained seizure with fetal bradycardia. An emergency cesarean section was performed and allowed the birth of a hypotropic neonate of 2240g and the discovery of didelphic uterus. Pregnancy developed in the left hemi-uterus. Speculum examination at the end of the procedure showed a longitudinal vaginal septum. There was no associated urinary tract and renal malformation. Scheduled cesarean will be performed from her next pregnancy. The uterus didelphys should be diagnosed early. MRI and 3D echography are necessary for diagnosis. Pregnancy is often complicated, and follow-up needs to be planned. Cesarean section is not systematic.


Delivery, Pregnancy, Uterine didelphys, Uterine malformation

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Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7(2):161-74.

Öndeş B. 8th Term pregnancy in uterus didelphys: a rare case report. Case Reports Perinatal Med. 2017;6(1).

Troiano RN, McCarthy SM. Mullerian duct anomalies: imaging and clinical issues. Radiol. 2004;233(1):19-34.

Heinonen PK. Uterus didelphys: a report of 26 cases. European J Obstet Gynecol. 1984;17(5):345-50.

Mordefroid M, Levaillant JM. Malformations utérines: utérus bicorne ou cloisonné?: Critères de différenciation en IRM et échographie 3D. Imagerie de la Femme. 2008;18(2):89-100.

Musset R, Muller P, Netter A, Solal R. Necessity for a global classification of uterine malformations. Associated urinary malformations. Interest of certain peculiarities in the light of 141 cases. Gynecologie Obstet. 1967;66(2):145-66.

Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine‐Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol. 2011;38(4):371-82.

Felker EA. Uterus Didelphys and Pregnancy. J Diag Med Sonograp. 2004; 20(2):131-33

Muller P, Barrat J. Pregnancy and delivery in cases of uterine malformations. In, Roger Vokaer, obstetrics treatise. Ed, Masson Paris, 1985;II:458-71.

N’Gbesso RD, Ouedrago S, Quenum G, Ould-Beddi M, N’Goan-Domoua AM, Koné R. A rare etiology of an obstacle previa by non-uterine uterus (didelphe): contribution of ultrasound. J Radiol 2004;85:655-7.

Magudapath C. Uterus Didelphys with Longitudinal Vaginal Septum: Normal Delivery. J Clin Case Rep. 2012;2:194.

Altwerger G, Pritchard AM, Black JD, Sfakianaki A. Uterine Didelphys and Vaginal Birth After Cesarean Delivery. Obstet Gynecol 2015;125:157-9.

Erez O, Dukler D, Novack L, Rozen A, Zolotnik L, Bashiri A, et al. Trial of labor and vaginal birth after cesarean section in patients with uterine Müllerian anomalies: a population-based study. Am J Obstet Gynecol. 2007;196:537.1-11.

Green LK, Harris RE. Uterine anomalies; frequency of diagnosis and associated obstetrical complications. Obstet Gynecol. 1976;47:427-9.

Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endova ginal sonography and hysterosalpingography. Radiol. 1992;183(3):795-800.