Case Report: Incidental finding of didelphys uterus in a multigravida woman at Caesarean delivery

Abstract

Didelphys uterus is one of the rarest Müllerian duct anomalies (MDA) of the female genital tract. Many remain undiagnosed due to possibilities of successful pregnancies and vaginal deliveries in those without or with mild forms of associated cervical and/or vaginal anomalies.  Due to this, data on didelphys uterus in pregnancy are rare, with most cases seen during routine ultrasound in pregnancies’ Caesarean section for other obstetric indications. This case was a 36-year-old G4P1+2 female who had successful vaginal delivery in her preceding pregnancy; in index pregnancy, she presented with fetal footling breech in labour and had an emergency caesarean section during which uterine didelphys was diagnosed. Many pregnant women with didelphys uterus will deliver vaginally and, as such, remain undiagnosed.  Its presence is one of the possible reasons for persistent abnormal presentations like fetal breech presentation, especially in women with prior successful vaginal deliveries. Early recognition and availability of facilities for management of such incidentally found cases of uterine didelphys will prevent many of the complications associated with pregnancy with them.