Women’s Health Bulletin

Women’s Health Bulletin

Uterine Didelphys in a G4P3+0: A Disturbing Phenomenon at Caesarean Section

Document Type : Case Report

Authors
Abdibasid Shariff Ali 1
Yakub Mohamud 1
Yakub I. Kune 1
Byonanuwe Simon 2
1 Department of Obstetrics and Gynaecology; Garissa County Referral Hospital, Garissa, Kenya
2 Department of Obstetrics and Gynaecology, Kampala International University Western Campus, Bushenyi, Uganda
10.30476/whb.2023.100368.1251
Abstract
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.

Highlights

Byonanuwe Simon: (PubMed)

 

 

How to Cite: Ali AS, Mohamud Y, Kune YI, Byonanuwe S. Uterine Didelphys in a G4P3+0: A Disturbing Phenomenon at Caesarean Section. Women. Health. Bull. 2023;10(4):283-286. doi: 10.30476/WHB.2023.99974.1245.

Keywords
Uterus
Mullerian
Didelphys
Genital
  1. Goulios C, McCuaig R, Hobson L, White S. Management of a twin pregnancy in a didelphys uterus: one fetus in each uterine cavity. BMJ Case Rep. 2020;13(8):e235256. PubMed PMID: 32843451; PubMed Central PMCID: PMC7449565. ##
  2. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2018. ##
  3. Okafor I, Odugu B, Ugwu I, Oko D, Onyekpa IJ, Enyinna PK, et al. Undiagnosed Uterus Didelphys in a Term Pregnancy with Adverse Fetal Outcome: A Case Report. Diversity and Equality in Health and Care. 2016;13(2):177–179. ##
  4. Shahanaj S, Didarul A, Farzana R. Uterine Didelphys with Pregnancy Outcomes: A Case Report. Chattagram Maa-O-Shishu Hospital Medical College Journal. 2018;17(2):53–55. doi: 10.3329/cmoshmcj.v17i2.39779. ##
  5. Dorji N, Tshering S, Wangden T. Uterus didelphys with double vagina diagnosed during third cesarean section: A case report. SAGE Open Med Case Reports. 2022;10:2050313X211072967. doi: 10.1177/2050313X211072967. PubMed PMID: 35070320; PubMed Central PMCID: PMC8777336. ##
  6. Ekanem E, Lalrinawmi L, Sinha A, Abdelrazik T. Pregnancy in a didelphic uterus: a case report of an unusual phenomenon and review of literature. Int J Reprod Contracept Obstet Gynecol. 2021;10(3):1162–1168. doi: 10.18203/2320-1770.ijrcog20210753. ##
  7. Maki Y, Furukawa S, Sameshima H, Ikenoue T. Independent uterine contractions in simultaneous twin pregnancy in each horn of the uterus didelphys. J Obs Gynaecol Res. 2014;40(3):836–9. doi: 10.1111/jog.12219. PubMed PMID: 24245492. ##
  8. Slavchev S, Kostov S, Yordanov A. Pregnancy and Childbirth in Uterus Didelphys: A Report of Three Cases. Medicina. 2020;56(4):198. doi: 10.3390/medicina56040198. PubMed PMID: 32340393; PubMed Central PMCID: PMC7231278. ##
  9. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 24th ed. New York: McGraw-Hill; 2014. p. 683-685. ##
  10. Crowley CM, Botros K, Hegazy IF, Donnell EO. Uterine didelphys: diagnosis, management and pregnancy outcome. BMJ Case Rep. 2021;14(3):e242233. doi: 10.1136/bcr-2021-242233. PubMed PMID: 33782076; PubMed Central PMCID: PMC8009243. ##
  11. Dutta DC. DC Dutta’s Textbook of Obstetrics including Perinatology and Contraception. 8th ed. Jaypee Brothers Medical Publishers; 2015. ##
  12. Linscheid C, Holoch K, Moran HK, Spoozak L. Case Report: Uterine Didelphys and Cervical Agenesis in an 18 Year-Old Woman Presenting with a Pelvic Mass. J Pediatr Adolesc Gynecol. 2021;34(5):758–760. doi: 10.1016/j.jpag.2021.02.100. PubMed PMID: 33601069. ##
  13. Arnold KC, Thai TC, Craig LB. Uterine Didelphys with Bilateral Cervical Agenesis in a 15-Year-Old Girl. J Pediatr Adolesc Gynecol. 2018;31(1):64–66. doi: 10.1016/j.jpag.2017.08.001. PubMed PMID: 28807736. ##
  14. Ćwiertnia A, Borzyszkowska D, Golara A, Tuczyńska N, Kozłowski M, Kwiatkowski S, e al. The Impact of Uterus Didelphys on Fertility and Pregnancy. Int J Environ Res Public Health. 2022;19(17):10571. doi: 10.3390/ijerph191710571. PubMed PMID: 36078286; PubMed Central PMCID: PMC9518538. ##
  15. Öndeş B. 8th Term pregnancy in uterus didelphys: a rare case report. Case Reports in Perinatal Medicine. 2017;6(1):1–4. doi: 10.1515/crpm-2016-0025. ##