Didelphys Uterus: A Reason for Recurrent Breech Presentation and Operative Abdominal Delivery View PDF

^*Tafese Dejene Jidha
Department Of Obstetrics And Gynecology, Jimma University Medical Center, Jimma University, Jimma, Ethiopia

^*Corresponding Author:

Tafese Dejene Jidha
Department Of Obstetrics And Gynecology, Jimma University Medical Center, Jimma University, Jimma, Ethiopia
Email:dejtafese@gmail.com

Published on: 2020-12-07

Abstract

Background: A didelphys uterus results from failed fusion of the paired Mullerian ducts characterized by the presence of two uteri, two cervixes, with or without a longitudinal vaginal septum. Pregnancies develop in one of the two horns, and of the major uterine malformations, the didelphys uterus has the best reproductive prognosis. Pregnancy is associated with an increased risk of malpresentations and premature labor, although many patients will have no reproductive difficulties.
Case presentation: Here we report a case of a 24 years gravida 4 para 3 who presented at gestational age (GA) of 38 weeks with compliance of urge to bear down of one-hour duration. She had three previous cesarean scars which were done all for breech presentation. The current pregnancy was also breech presentation. Emergency cesarean section (CS) was done to effect female alive neonate weighing 2600 grams with good Apgar score.
Conclusion: Didelphys uterus is one of the major uterine malformations which has best reproductive prognosis.

Keywords

Breech; Previous Caesarean Section; Uterus Didelphys; Longitudinal Vaginal Septum

Introduction

Uterus didelphys, also known as duplicated uterus, is an embryological abnormality resulting from failure of fusion of Mullerian ducts, causing full uterine development to erroneously occur bilaterally [1]. Most women with a didelphys uterus are asymptomatic, but some present with dyspareunia or dysmenorrhea in the presence of a varying degree of longitudinal vaginal septum [2]. Rarely, genital neoplasms, hematocolpos or hematocolpometra, and renal anomalies are reported in association with didelphys uterus. Regarding the outcome of pregnancy in patients with didelphic uterus, Heinonen reported a 30% of miscarriage, 43% of malpresentation, and 82% of cesarean section and 11% of small for gestational age [3]. Patients with uterus didelphys had a preterm birth risk of 3.58 times higher, with a 3.7-fold increase in malpresentation [4]. Despite some of these complications, there are many cases of women with a didelphys uterus that did not exhibit any reproductive or gestational challenges. In this case report, we discuss a rare case of didelphys uterus in a woman who had three previous cesarean sections which was done for breech presentations, current pregnancy which was also breech and was delivered by cesarean section without any complications.