Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-111 Szczecin, Poland.
Department of Obstetrics and Gynecology, Pomeranian Medical University, 70-111 Szczecin, Poland.
Int J Environ Res Public Health. 2022 Aug 25;19(17):10571. doi: 10.3390/ijerph191710571.
Uterus didelphys occurs as a result of abnormal fusion of the paramesonephric ducts and is characterized by complete duplication of uterine horns, cervix, and very often also the vagina or presence of longitudinal vaginal septum. Most women with a uterus didelphys are asymptomatic; some cases may coincide with dyspareunia or dysmenorrhea. The anomaly is associated with a higher risk of miscarriage, preterm labor, breech delivery, and decreased live births. We present the case of a 26-year-old woman (primigravida) who was known to have uterus didelphys. The diagnosis was made when the patient was 23 years old using ultrasound and hysteroscopy. The patient became pregnant after 18 months of efforts. The patient was referred to prenatal care in the 13th week of pregnancy with vaginal bleeding. In the 23rd week of pregnancy, gestation cholelithiasis was diagnosed. The pregnancy progressed without obstetric complications and the fetus developed normally. Due to the vaginal septum and fact that the patient felt stressed, the pregnancy was terminated at term by cesarean section. We concluded that uterus didelphys can be asymptomatic making an early diagnosis difficult. A pregnancy belongs to a high-risk group and more attention should be paid to this case. Cesarean section should be considered, especially in case of the presence of vaginal septum.
双子宫是由于中肾管发育异常融合所致，其特征为子宫角、宫颈完全重复，且常常伴有阴道重复或存在阴道纵隔。大多数双子宫女性无症状；部分病例可能伴有性交困难或痛经。该异常与流产、早产、臀位分娩和活产减少的风险增加相关。我们报告了 1 例 26 岁初产妇（单胎）的病例，该患者在 23 岁时通过超声和宫腔镜检查确诊为双子宫。经过 18 个月的努力，患者成功怀孕。患者在妊娠 13 周时因阴道出血被转诊至产前检查。妊娠 23 周时，诊断为妊娠合并胆石症。妊娠期间无产科并发症，胎儿正常发育。由于阴道纵隔且患者感到压力，患者在足月时通过剖宫产终止妊娠。我们得出结论，双子宫可能无症状，导致早期诊断困难。该妊娠属于高危妊娠，应更加关注此类病例。应考虑剖宫产，特别是存在阴道纵隔的情况下。
