Unilateral twin pregnancy in Uterus didelphys of multigravida woman concomitant with placenta previa: A Case Report

Unilateral twin pregnancy in Uterus didelphys

Abstract

Background: Uterus didelphys, also known as a double uterus is a rare Müllerian duct anomaly (MDA). This case report presents a unique instance of uterus didelphys in a multigravida woman who also had placenta previa. Remarkably, she carried her twin pregnancy to full term and delivered via Cesarean section.

Case: A 32-year-old woman, gravida VII, para V, abortion I with a gestational age of 40 weeks and five days based on a reliable last normal menstrual period (LNMP) presented to Salale University Comprehensive Specialized Hospital.

She reported experiencing vaginal bleeding and a pushing-down sensation for the past two hours. An obstetric ultrasound revealed a live twin intrauterine pregnancy. Both twins were in cephalic presentation, and the placenta was posterior, completely covering the internal cervical os (placenta previa). A Pfannenstiel incision was performed, revealing an intact, gravid uterus on the left side with a well-formed lower uterine segment, and a separate, empty uterus on the right side. Each uterus had a single fallopian tube and ovary. The uterine cavities were distinct, each with its own cervix, which both opened into a single vaginal canal. A lower uterine segment transverse cesarean section was performed, resulting in the delivery of two female twins weighing 1600g and 1700g, respectively. The postoperative period was smooth.

Conclusion: This case report contributes to the existing literature on the management of a very rare obstetric condition. Timely identification of uterus didelphys is crucial for providing comprehensive care throughout pregnancy and delivery, thereby mitigating potential adverse outcomes. Consequently, prioritizing the availability of obstetric ultrasound at health centers is essential for identifying the various types and anatomical variations of uterus didelphys during antenatal care (ANC) follow-up. This will enable healthcare providers to effectively prepare and advise pregnant women.