Incidental finding of didelphys uterus with twin pregnancy in each cavity; A rare case report.

INTRODUCTION AND IMPORTANCE

Uterine didelphys is a Müllerian duct anomaly with two uteri and cervices, with or without a vaginal septum. A di-cavitary twin pregnancy in a uterus didelphys is an infrequent occurrence.

CASE PRESENTATION

A 27-year-old woman, gravida 3, para 2, at a gestational age of 37 weeks and 4 days, presented with pushing-down pain. A primary lower uterine segment cesarean section was performed due to fetal bradycardia, and incidentally, a second gravid uterus was discovered, necessitating another lower uterine segment cesarean section. Post-operative reevaluation revealed a double cervix but no vaginal septum.

CLINICAL DISCUSSION

Uterine didelphys is a rare Müllerian duct anomaly with two uteri and cervices, often leading to complications during pregnancy. This anomaly develops from the failure of the Müllerian ducts to fuse, constituting approximately 5-11 % of all Müllerian duct anomalies. Pregnancies in women with didelphys uterus face increased risks, particularly with twin gestations, which occur at a rate of about 1 in 1,000,000. Management strategies must be individualized, considering factors such as fetal presentation and maternal preferences, with vaginal delivery being an option when possible. Early detection through appropriate imaging techniques is crucial.

CONCLUSION

Routine follow-ups should actively search for any uterine anomalies. The management of such cases requires individualized care tailored to each specific situation.