Rezai Shadi, Bisram Pameela, Lora Alcantara Isamarie, Upadhyay Ruchi, Lara Carla, Elmadjian Malvina
Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA.
St. George's University, School of Medicine, St. George's, Grenada.
Case Rep Obstet Gynecol. 2015;2015:865821. doi: 10.1155/2015/865821. Epub 2015 Sep 7.
Background. 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. This report discusses a case of didelphys uterus that successfully conceived, carried her pregnancy to term, and delivered vaginally without any significant complications. Case. Patient is a 29-year-old G2P0010 from Bangladesh, initially came a year prior in her first pregnancy, with spontaneous abortion (SAB). Pelvic Sonogram at that time showed a diagnosis of bicornuate versus didelphys uterus. There were no renal anomalies on subsequent abdominal CT scan. Patient presented with the second pregnancy and had uncomplicated prenatal care and did not have signs of preterm labor; fetus showed appropriate growth and the pregnancy was carried in the left uterus. Patient presented at 38 4/7 wks with Premature Rupture of Membrane and underwent induction of labor with Cytotec. Antibiotics were started for chorioamnionitis. Patient had a vaginal delivery with left mediolateral episiotomy and complete tear of vaginal septum. Third stage of labor was complicated with retained placenta, which was removed manually in the operating room with total EBL of 600 cc.
背景。苗勒管异常(MDA)是女性生殖系统的先天性缺陷,由苗勒管胚胎发育异常引起。双子宫,也被称为“双子宫体”,是MDA中最不常见的一种。本报告讨论了一例双子宫病例,该患者成功受孕,足月妊娠,并经阴道分娩,无任何严重并发症。病例。患者为一名29岁来自孟加拉国的女性,孕2产0,既往1年前首次怀孕时发生自然流产(SAB)。当时的盆腔超声检查显示诊断为双角子宫与双子宫。随后的腹部CT扫描未发现肾脏异常。患者第二次怀孕,产前检查无并发症,无早产迹象;胎儿生长正常,妊娠位于左侧子宫。患者在孕38 4/7周时出现胎膜早破,使用米索前列醇引产。因绒毛膜羊膜炎开始使用抗生素。患者经阴道分娩,行左侧会阴侧切术,阴道纵隔完全撕裂。第三产程并发胎盘滞留,在手术室手动取出胎盘,总失血量为600cc。