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双子宫患者成功妊娠三例:病例报告

Three successful pregnancies in a patient with uterine didelphys: A case report.

作者信息

Mwagobele Lusajo, Ntiyakunze Gregory, Mulji Ronak, Fidaali Zainab, Moshi Lynn

机构信息

Department of Obstetrics and Gynaecology, Aga Khan Hospital, Dar es Salaam, Tanzania.

Department of Obstetrics and Gynaecology, Aga Khan Hospital, Dar es Salaam, Tanzania.

出版信息

Int J Surg Case Rep. 2025 May 6;131:111396. doi: 10.1016/j.ijscr.2025.111396.

DOI:10.1016/j.ijscr.2025.111396
PMID:40334442
Abstract

INTRODUCTION

Uterus didelphys is a congenital Müllerian anomaly characterized by the presence of two separate uteri and two cervixes. It is associated with an increased risk of pregnancy complications, including miscarriage, malpresentation, and labor dystocia.

CASE PRESENTATION

A 39-year-old gravida 3, para 2, living 2, at 39 weeks of gestation with two previous cesarean sections, presented in labor before her planned elective cesarean delivery. She was incidentally diagnosed with uterus didelphys during her first pregnancy after experiencing poor labor progression, leading to an emergency cesarean section. In this pregnancy, she initiated antenatal care at 12 weeks and attended seven routine visits, all of which were unremarkable. She underwent an emergency cesarean section and delivered a live male neonate weighing 3.26 kg with good Apgar scores. Her postoperative course was uneventful, and she was discharged in stable condition after 72 h of observation.

DISCUSSION

Uterus didelphys is associated with an increased risk of adverse pregnancy outcomes, including recurrent pregnancy loss, fetal malpresentation, and the need for cesarean delivery. The successful maternal and neonatal outcomes highlight the importance of early diagnosis, close antenatal monitoring, and timely delivery planning in patients with congenital uterine anomalies.

CONCLUSION

This case underscores the significance of early diagnosis and meticulous antenatal surveillance in women with congenital uterine anomalies. Although a didelphic uterus presents challenges in pregnancy management, appropriate obstetric care and timely surgical intervention can lead to favorable maternal and neonatal outcomes.

摘要

引言

双子宫是一种先天性苗勒管异常,其特征为存在两个独立的子宫和两个宫颈。它与妊娠并发症风险增加相关,包括流产、胎位异常和产程难产。

病例报告

一名39岁孕妇,孕3产2,育有2个子女,妊娠39周,既往有两次剖宫产史,在计划择期剖宫产分娩前临产。她在首次妊娠时因产程进展不佳,最终行急诊剖宫产,期间偶然被诊断为双子宫。本次妊娠,她在孕12周开始产前检查,共进行了7次常规产检,均无异常。她接受了急诊剖宫产,分娩出一名体重3.26千克的活男婴,阿氏评分良好。术后恢复顺利,观察72小时后病情稳定出院。

讨论

双子宫与不良妊娠结局风险增加相关,包括复发性流产、胎儿胎位异常以及剖宫产需求。母婴的成功结局凸显了先天性子宫异常患者早期诊断、密切产前监测及及时分娩计划的重要性。

结论

本病例强调了先天性子宫异常女性早期诊断及细致产前监测的重要性。尽管双子宫在妊娠管理中存在挑战,但适当的产科护理和及时的手术干预可带来良好的母婴结局。

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