Uterus didelphys with pregnancy and its different maternal and perinatal outcomes

Abstract

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. These abnormalities can include failure of development, fusion, canalization, or reabsorption, which normally occurs between 6 and 22 weeks in utero. Most sources estimate an incidence of these abnormalities to be from 0.5 to 5.0% in the general population. It is an observational study of cases of uterine didelphys with pregnancy over a period of 2 years. Uterus didelphys with pregnancy has variable maternal and perinatal outcome. First case presents an uneventful course in pregnancy which was terminated with caesarian section with a healthy baby. Second case presented to us with retained placenta with perforation of left horn which was managed by obstetric hysterectomy. The third case presents a didelphys uterus with a congenitally abnormal fetus with Hydrops fetalis with IUFD at 7th month of gestation terminated by caesarian section due to associated vertical vaginal septum. Pregnancy in a uterus Didelphys deserves early diagnosis of the anomaly, and meticulous care in pregnancy and delivery to avert the associated adverse outcomes.