Spontaneous pregnancy at term with uterus didelphys: a case report

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.

Download Full-text

UTERUS DIDELPHYS IN NULLIPAROUS AND MULTIPAROUS WOMEN – A RARE ENTITY

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2022.v15i1.43562 ◽

2021 ◽

pp. 4-5

Author(s):

POOJA SINHA ◽

ANKITA JAGLAN ◽

NIRAJ CHOUREY ◽

HIREMATH RAVISHEKAR N ◽

DEEPTI DAHIYA ◽

...

Keyword(s):

Rare Entity ◽

Term Pregnancy ◽

Vaginal Septum ◽

Uterus Didelphys ◽

Emergency Cesarean ◽

First Case ◽

Multiparous Women ◽

Mullerian Ducts ◽

The Right ◽

Previous Cesarean

Uterus didelphys is a rare congenital uterine abnormality in which the embryogenetic fusion of the Mullerian ducts fails to occur. It will lead to the formation of a double uterus with two separate cervices and most often a double vagina with a longitudinal septum as well. Here, we present two different cases of uterus didelphys with varied presentations. The first case is a nulliparous woman presented with post-coital bleeding. On examination, two cervical openings with a longitudinal complete vaginal septum were found, conservative management was done. Findings of didelphys uterus were confirmed on USG. The patient was counseled and discharged. The second case is a multiparous woman with previous cesarean delivery, rupture of membranes, and meconium in this pregnancy with term pregnancy taken up for emergency cesarean section. Dense adhesions and a mass on the right side of uterus were found intraoperatively, which on further inspection confirmed to be patent right horn of uterus. Diagnosis of uterus didelphys was made after doing per speculum and per vaginal examination post-cesarean.

Download Full-text

Term Pregnancy in a Woman with Incomplete Transverse Vaginal Septum- An Interesting Case

Surgical Case Reports ◽

10.31487/j.scr.2020.08.15 ◽

2020 ◽

pp. 1-3

Author(s):

sathiya priya subburaj ◽

Jyotsna sharma ◽

HARITHA SAGILI

Keyword(s):

Cesarean Section ◽

Interesting Case ◽

Elective Cesarean Section ◽

Term Pregnancy ◽

Obstructed Labor ◽

Vaginal Septum ◽

Transverse Vaginal Septum ◽

Elective Cesarean ◽

First Time

Transverse vaginal septum is a rare Mullerian duct anomaly presenting for the first time in pregnancy and labor. A 24-year-old primigravida presented at 39 weeks gestation. Speculum examination revealed a thick transverse vaginal septum with a pinpoint opening in the upper aspect. Elective cesarean section was done followed by digital perforation and dilatation of the septum. The postoperative period was uneventful. At six week follow up there was no restenosis or scarring of the vagina. To avoid complications like obstructed labor and laceration of vagina prophylactic cesarean section is advocated when the thickness of the septum cannot be ascertained on clinical examination.

Download Full-text

OHVIRA Syndrome: A Case Report

Faridpur Medical College Journal ◽

10.3329/fmcj.v14i1.46170 ◽

2020 ◽

Vol 14 (1) ◽

pp. 54-56

Author(s):

Dilruba Zeba ◽

Fahmida Zesmin ◽

Rajib Roy

Keyword(s):

Renal Agenesis ◽

Lower Abdominal Pain ◽

Vaginal Septum ◽

Regular Cycle ◽

Mullerian Ducts ◽

Ohvira Syndrome ◽

Obstructed Hemivagina ◽

Lateral Fusion ◽

Acute Retention

OHVIRA syndrome or Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly of female urogenital tract which is represented by the triad of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis. This rare variant of Müllerian duct anomalies represent failure of vertical and the lateral fusion of Müllerian ducts around 9 weeks of gestation. OHVIRA syndrome comprises about 2-3% of Müllerian abnormalities. A 13 years old girl got admission in FMCH on 15.3.2018 with lower abdominal pain and acute retention of urine. Her menarche was established 6 months back with regular cycle and associated with dysmenorrhoea. Imaging studies revealed uterine didelphys, highly dilated cervix with hematocolpos and absence of right kidney. The vaginal septum was excised. The patient recovered fully and was under follow up for 6 months. There was no evidence of further outflow tract obstruction. Faridpur Med. Coll. J. Jan 2019;14(1): 54-56

Download Full-text

Uterus didelphys with pregnancy and its different maternal and perinatal outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174465 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4690 ◽

Cited By ~ 2

Author(s):

Rajshree Dayanand Katke ◽

Sivanandini Acharya ◽

Soni Mourya

Keyword(s):

Perinatal Outcomes ◽

Caesarian Section ◽

Adverse Outcomes ◽

Congenital Defects ◽

Vaginal Septum ◽

Uterus Didelphys ◽

First Case ◽

Pregnancy And Delivery ◽

Mullerian Ducts ◽

In Pregnancy

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 MDAs. These abnormalities can include failure of development, fusion, canalization, or reabsorption, which normally occurs between 6 and 22 weeks in utero. Most sources estimate an incidence of these abnormalities to be from 0.5 to 5.0% in the general population. It is an observational study of cases of uterine didelphys with pregnancy over a period of 2 years. Uterus didelphys with pregnancy has variable maternal and perinatal outcome. First case presents an uneventful course in pregnancy which was terminated with caesarian section with a healthy baby. Second case presented to us with retained placenta with perforation of left horn which was managed by obstetric hysterectomy. The third case presents a didelphys uterus with a congenitally abnormal fetus with Hydrops fetalis with IUFD at 7th month of gestation terminated by caesarian section due to associated vertical vaginal septum. Pregnancy in a uterus Didelphys deserves early diagnosis of the anomaly, and meticulous care in pregnancy and delivery to avert the associated adverse outcomes.

Download Full-text

Complete Bicornuate Uterus with Complete Longitudinal Vaginal Septum

Journal of Nepal Medical Association ◽

10.31729/jnma.98 ◽

2010 ◽

Vol 49 (179) ◽

Author(s):

A Suwal ◽

A Kumar

Keyword(s):

Cesarean Section ◽

Breech Presentation ◽

Vaginal Septum ◽

Mullerian Anomalies ◽

Bicornuate Uterus ◽

Mullerian Ducts ◽

Lateral Fusion ◽

American Fertility Society ◽

Class Iv

Bicornuate Uterus is a type of lateral fusion disorder of the mullerian ducts. According to the American Fertility Society Classification of Mullerian Anomalies, bicornuate uterus is a class IV anomaly. Incidence of this anomaly varies. This may affect a woman's obstetric, as well as her gynecologic outcome. Here we present a 23 year primigravida at 38 weeks and 5 days gestation with footling breech presentation. She was identified, during cesarean section, of having complete bicornuate uterus with complete longitudinal vaginal septum. Keywords: bicornuate, pregnancy, uterus, vaginal septum

Download Full-text

Emergency Cesarean Section in Case of Aneurysm of the Muscular Intraventricular Septum with Neonatal Follow-up - A Case Report and Review of the Literature

Prenatal Cardiology ◽

10.1515/pcard-2016-0006 ◽

2016 ◽

Vol 6 (1) ◽

pp. 43-49

Author(s):

Joanna Płużańska ◽

Jacek Więcek ◽

Michał Krekora ◽

Jolanta Kiełbasicz-Binikowska ◽

Tomasz Talar ◽

...

Keyword(s):

Case Report ◽

Cesarean Section ◽

Clinical Symptoms ◽

Review Of The Literature ◽

Venous Flow ◽

Neonatal Treatment ◽

Emergency Cesarean Section ◽

Emergency Cesarean ◽

Intraventricular Septum

Abstract We present the case of aneurysm of the muscular intraventricular septum with accompanying cardiomegaly and abnormal venous flow patterns requiring emergency cesarean section and specialized neonatal treatment. At the age of 8 months our patient has no clinical symptoms with a 6 mm scar in intraventricular muscular septum..

Download Full-text

Correlation between Kind of Cesarean Section and Posttraumatic Stress Disorder in Greek Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051592 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1592 ◽

Cited By ~ 2

Author(s):

Eirini Orovou ◽

Maria Dagla ◽

Georgios Iatrakis ◽

Aikaterini Lykeridou ◽

Chara Tzavara ◽

...

Keyword(s):

Cesarean Section ◽

Traumatic Stress ◽

Stress Disorder ◽

Demographic Data ◽

University Hospital ◽

Elective Cesarean Section ◽

Post Traumatic Stress ◽

Emergency Cesarean ◽

Post Traumatic

A birth experience with cesarean section (CS) can be a cause of the development of post-traumatic stress disorder after a cesarean (PTSD-AC) or profile PTSD, for a percentage of women. So far, there is no data on the frequency of PTSD-AC in Greece and this syndrome is often associated with other mental disorders of the postpartum period. The purpose of this research is to associate the kind of CS with PTSD-AC for Greek mothers and the combination of factors that make them less resistant to trauma. A sample of ahundred and sixty-six mothers who gave birth with emergency cesarean section (EMCS) and elective cesarean section (ELCS) at a Greek University hospital have consented to participate in the two phases of the survey, in the 2nd day postpartum and a follow-up in the 6th week postpartum. Medical/demographic data and a life events checklist (LEC-5) with Criterion A and post-traumatic stress checklist (PCL-5) were used to diagnose PTSD and PTSD Profile. Out of166 mothers enrolled, 160 replied to the follow-up (96.4%), ELCS 97 (97%) and EMCS 63 (95%). Twenty (31.7%) EMCS had PTSD and nine (14.3%) had Profile. One (1%) ELCS had PTSD and 4 (4.1%) had Profile. This survey shows a high prevalence rate of PTSD after EMCS with additional risk factors of preterm labor, inclusion in the Neonatal Intensive Care Unit (NICU), a lack of breastfeeding, and a lack of support from the partner.

Download Full-text

A uterus didelphys with a spontaneous labor at term of pregnancy: a rare case and a review of the literature

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2018-0001 ◽

2018 ◽

Vol 7 (2) ◽

Author(s):

Paola Algeri ◽

Sonia M. Rota ◽

Elena Nicoli ◽

Orlando Caruso ◽

Giovanna Spinetti ◽

...

Keyword(s):

Cesarean Section ◽

Preterm Delivery ◽

Rare Case ◽

Review Of The Literature ◽

Uterus Didelphys ◽

Spontaneous Pregnancy ◽

Uterine Anomalies ◽

Delivery Route ◽

The Right ◽

Failure To Progress

Abstract Uterus didelphys accounts for 13% of uterine anomalies and has been correlated with preterm delivery and fetal malpresentation at delivery. A 37-year-old pregnant woman reported a spontaneous pregnancy in the right horn of a uterus didelphys. The course of the pregnancy was complicated by gestational diabetes, but no miscarriage threat or preterm delivery threat was reported during this pregnancy. She arrived at our division, in labor, at 39.2 gestational weeks’. She delivered by cesarean section due to failure to progress at 5 cm. Her post-operative course was uneventful. Vaginal delivery could be a safe option and the induction of labor or the use of oxytocin could be helpful in such cases, but recommended doses and labor time should be evaluated, so cesarean section is to date the most frequent delivery route in uterus didelphys at term.

Download Full-text