A CASE OF A VERY DIFFICULT UNSUSPECTED PREGNANCY

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A CASE OF A VERY DIFFICULT UNSUSPECTED PREGNANCY


35 year Jane who struggled to fall pregnant, had multiple miscarriages. She was known to have a left asbcent kidney. She had pain with intercourse and struggled in her relationships as a result.

She came for an abdominal and gynecological sonar examination. The findings were surprising. Janes uterus was different. Her uterus was separated by a deep cleft, and two separate cavities. In one of the uterine cavities she had a viable pregnancy.

The second uterus was empty.

The diagnosis was uterine didelphys with a pregnancy.

An amazing but rare finding.

Uterus didelphys is a type of Müllerian duct anomaly (class III) where there is a complete duplication of uterine horns as well as duplication of the cervix, with no communication between them.  

 8% of women may that have uterine didelphys have painful sex (dysparenia) due to a vaginal septum. 

 The chances of a good outcome to this pregnancy are dismal. Only 20% or 1/5 patients can have a complete pregnancy. A third of pregnancies end in abortion and over half in premature deliveries. Only 40% of pregnancies have living children.

 After the pregnancy a HSG further screening was performed.


There were two separate endocervical canals that open into separate endometrial cavities, with no communication between the two horns of the uterus. 

 Each of the separate endometrial cavities ended with a solitary fallopian tube.

 We screened her for endometriosis, a common complication associated with uterine didelphys.

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    Caution must be taken whilst appearing a hysterosalpingogram to save you the inadvertent exposure of a pregnant uterus.

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