Introduction: Uterine didelphys is an exceptionally rare Müllerian duct anomaly that, when incidentally discovered, can be profoundly disconcerting for attending clinicians, patients, and their families. In this case report, we described an instance of undiagnosed uterine didelphys in a pregnant woman who was admitted at 39 weeks and 4 days of amenorrhea for her third delivery, wherein the condition was coincidentally identified during an elective cesarean section, resulting in a favorable fetal outcome.
Case Presentation: We presented the case of a 32-year-old gravida 4 para 3+0 patient who was admitted at 39 weeks and 4 days of amenorrhea and had a history of three prior cesarean deliveries. She underwent an elective cesarean section. A second nongravid uterus with an ipsilateral fallopian tube and ovary was incidentally observed intraoperatively. Furthermore, a contralateral fallopian tube without an ovary was noted within the same uterus. Subsequent exploration revealed that each uterus had one fallopian tube and ovary, and both uteri shared a single cervix.
Conclusion: Vigilant preoperative assessment of all women scheduled for surgery is imperative to prevent such disconcerting, avoidable occurrences.