Materiały źródłowe

• #1 Successful Vaginal Delivery of Naturally Conceived Dicavitary Twin in Didelphys Uterus: A Rare Reported Case

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5591991/

  Didelphys uterus, or double uterus, is an embryological developmental malformation of the mllerian ducts with the incidence of approximately 8.3% of all mllerian duct abnormalities (MDAs). […] The failure of fusion of the mllerian ducts results in uterus didelphys. It is a developmental abnormality of mllerian ducts comprised the double uterus with completely developed independent horns including endometrium, myometrium, and serosal layers; two cervices; and longitudinal or transverse vaginal septum. […] Didelphys uterus accompanying naturally conceived twin pregnancy with each fetus in the separate cavity is a rare entity. […] The exact incidence of the condition is unknown. The overall incidence of dicavitary twin gestation conceived either spontaneous or by the artificial reproductive technique is estimated approximately 1 in 1,000,000.

• #2 Uterus Didelphys: Causes, Symptoms, Diagnosis & Treatment

  https://risaaivf.com/uterus-didelphys-causes-symptoms-diagnosis-treatment/

  Uterus Didelphys is also known as double uterus. It is a rare condition where a woman has two uteruses instead of one. Each uterus may have its own cervix and, in some cases, a double vagina. This happens when the uterus does not form properly before birth. It affects around 0.1% to 0.5% of women. Some women have no symptoms, while others may face painful periods, miscarriages, or trouble getting pregnant. […] A double uterus develops before birth due to an issue in fetal development. Normally, two small tubes called Mllerian ducts fuse to form a single uterus. However, in some cases, these ducts do not join completely, leading to two separate uteruses. The exact cause of this condition is unknown, but it is believed to be linked to genetic factors. […] Since this condition forms before birth, there are no known ways to prevent it. However, early diagnosis can help in managing any related symptoms or complications.

• #3 Uterus didelphys | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/uterus-didelphys?lang=us

  Uterus didelphys is a type of Mllerian 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. […] Didelphys results from failure of normal Mllerian duct fusion that occurs between the 12th and 16th week of pregnancy and is characterized by two symmetric, widely divergent uterine horns and two separate cervices. The uterine volume in each duplicated segment is reduced.

• #4 Uterine Didelphys: Causes, Symptoms, and Treatment

  https://www.webmd.com/women/uterine-didelphys-double-uterus

  Uterine didelphys is a rare condition that happens when you grow two uteruses instead of one. This happens when you are a developing baby. […] While developing as babies, girls typically grow a uterus from two channels called the Mullerian ducts. These channels join together and make one hollow organ called the uterus. In uterine didelphys, the channels dont properly join together. Each tube can turn into a uterus, causing you to develop two. […] Sex organs develop when a baby is between 6 weeks to 22 weeks during pregnancy, and a double uterus forms because of failure for the tubes to join. Its not exactly clear why some babies develop two uteruses, but it might be linked with some genetic conditions. […] The exact cause is unknown. […] Women with a double uterus can usually get pregnant. Its possible to carry your baby to full term, but with uterine didelphys, you have a greater risk of pregnancy complications. […] Uterine didelphys is a sexual organ irregularity that happens before birth. It can cause problems with pregnancy and delivery, and pain and heavy bleeding during menstruation, but lots of women never have any symptoms.

• #5 Uterus didelphys – wikidoc

  https://www.wikidoc.org/index.php/Uterus_didelphys

  Uterus didelphys represents a uterine malformation where the uterus is present as a paired organ as the embryogenetic fusion of the mullerian ducts failed to occur. As a result there is a double uterus. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. […] The uterus is formed during embryogenesis by the fusion of the two mullerian ducts. This process usually fuses the two mullerian ducts into a single uterine body but fails to take place in these affected women who maintain their double mullerian systems. A didelphic uterus will have a double cervix and is usually associated with a double vagina. Causes for the failure to fuse are not known. […] Patients with an double uterus may need special attention during pregnancy as premature birth and malpresentation are common.

• #6 Uterus didelphys – Wikipedia

  https://en.wikipedia.org/wiki/Uterus_didelphys

  Uterus didelphys represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Mllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. […] The uterus is formed during embryogenesis by the fusion of the two paramesonephric ducts (also called Mllerian ducts). This process usually fuses the two Mllerian ducts into a single uterine body but fails to take place in these affected women who maintain their double Mllerian systems. A didelphic uterus will have a double cervix and is usually associated with a double vagina. The cause of the fusion failure is not known. […] Uterus didelphys, in certain studies, has also been found associated with higher rate of infertility, miscarriage, intrauterine growth retardation, and postpartum bleed.

• #7 Pregnancy and Childbirth in Uterus Didelphys: A Report of Three Cases

  https://www.mdpi.com/1648-9144/56/4/198

  Uterus didelphys is a rare form of congenital anomaly of the Müllerian ducts. […] The ASRM classification defines uterus didelphys, or didelphic uterus, as a reproductive tract anomaly representing a complete duplication of the uterus and cervix. It occurs as a result of a failure of Müllerian duct fusion in 8 weeks’ gestation. […] Generally, this anomaly is presented by two uterine cervixes and two uteri, each linked to a fallopian tube. A longitudinal vaginal septum is present in 75% of the cases. […] The ability to conceive is not typically impaired, but pregnancy in uterus didelphys is often associated with reproductive failure. […] A meta-analysis of 25 studies involving more than 160,000 women, of which 3766 with congenital uterine anomalies, shows that uterus didelphys was not associated with decreased natural or assisted fertility and an increased frequency of spontaneous abortions.

• #8 Successful Vaginal Delivery of Naturally Conceived Dicavitary Twin in Didelphys Uterus: A Rare Reported Case

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5591991/

  Didelphys uterus, or double uterus, is an embryological developmental malformation of the mllerian ducts with the incidence of approximately 8.3% of all mllerian duct abnormalities (MDAs). […] The failure of fusion of the mllerian ducts results in uterus didelphys. It is a developmental abnormality of mllerian ducts comprised the double uterus with completely developed independent horns including endometrium, myometrium, and serosal layers; two cervices; and longitudinal or transverse vaginal septum. […] Didelphys uterus accompanying naturally conceived twin pregnancy with each fetus in the separate cavity is a rare entity. […] The exact incidence of the condition is unknown. The overall incidence of dicavitary twin gestation conceived either spontaneous or by the artificial reproductive technique is estimated approximately 1 in 1,000,000.

• #9 Painful Periods and a Double Uterus: A Teen’s Struggle With Mullerian Anomalies > News > Yale Medicine

  https://www.yalemedicine.org/news/mullerian-anomalies-ohvira

  However, if Emily had been diagnosed with OHVIRA earlier, she could have been spared the pain and psychological distress she endured once her period started. […] It remains unclear what causes OHVIRA and other types of Mullerian anomalies. But Dr. Vash-Margita and several doctors and researchers have established an international consortium dedicated to investigating the genetic and environmental causes of these conditions. […] The team is running a clinical trial in which they are conducting whole genome sequencing in patients who have Mullerian anomalies. We test their mothers and fathers, too, with the hope that we find the genes that are causative or at least associated with this condition, Dr. Vash-Margita says.

• #10 Uterus didelphys | Pathology Learning Centre

  https://health.uct.ac.za/pathology-learning-centre/disease-themes-when-things-go-wrong-congenital-anomalies/uterus-didelphys

  The anomaly is also known as uterus bicornis bicollis. […] Uterus didelphys is due to failure of midline fusion of the Mllerian ducts to form a single uterus body and cervix. […] The cause of most Mllerian duct anomalies is unknown and probably multifactorial.

• #11 :: JKSR :: Journal of the Korean Society of Radiology

  https://jksronline.org/DOIx.php?id=10.3348/jksr.2010.62.4.383

  Herlyn-Werner-Wunderlich syndrome is a rare Mullerian ductal anomaly that is characterized by the presence of a hemivaginal septum, a didelphic uterus and ipsilateral renal agenesis. […] The precise etiology and pathogenesis of HWW syndrome is still unknown. It has been considered to represent anomalous Mullerian (paramesonephric) and Wolffian (mesonephric) duct development. […] A range of uterine anomalies can occur as a consequence of the non-development or failure of fusion of the distal segments of the Mullerian ducts, such as hypoplasia/agenesis, unicornuate, didelphys, bicornuate, septate and arcuate uterus. […] Therefore, a developmental anomaly of the caudal portion of one of the Wolffian ducts may be the cause of the unilateral renal agenesis associated with imperforate hemivagina.

• #12 A case of didelphic uterus and blind hemivagina with renal dysplasia and ectopic ureter presenting with vulvodynia and recurrent fever | Gynecological Surgery | Full Text

  https://gynecolsurg.springeropen.com/articles/10.1007/s10397-009-0469-3

  Didelphic uterus with blind hemivagina and ipsilateral renal anomaly is a rare congenital malformation. The pathogenesis of this syndrome and its embryologic origin are still the subject of discussion. […] Didelphic uterus with blind hemivagina is a rare congenital malformation that is ascribed to a failure in the fusion process of the two Mllerian ducts. It almost invariably coexists with anomalies of the ipsilateral mesonephric derivates (kidney and ureter) because of their close embryological relationship. […] Most uterine anomalies result from a defect in the reformation or fusion of the paired Mllerian ducts during embryogenesis. Complete failure of fusion of the paired Mllerian ducts results in duplication of the uterine corpus and cervix, known as uterus didelphys. […] Although controversy exists concerning the embryogenesis of this malformation, the primum movens seems to be damage to the caudal portion of a mesonephric duct.

• #13 Painful Periods and a Double Uterus: A Teen’s Struggle With Mullerian Anomalies > News > Yale Medicine

  https://www.yalemedicine.org/news/mullerian-anomalies-ohvira

  At her first appointment with Dr. Vash-Margita, Emily was told she had a complex condition called OHVIRA (Obstructed Hemi-Vagina with Ipsilateral Renal Agenesis). OHVIRA is a congenital, or present at birth, condition; it occurs when a girl has a double uterus, a missing kidney, and a wall of tissue that divides the vagina. […] This division blocks menstrual blood from fully flowing out of the body, which causes the blood to collect in the uterus as seen on Emily’s imaging studies and leads to pain. […] OHVIRA stems from a problem with the Mullerian ducts, the embryonic structure that develops into the female reproductive tract. […] But sometimes, the tubes don’t join as they should and instead two separate structures or uteruses form. This is called uterine didelphys. […] OHVIRA is a type of Mullerian anomaly, and there are a wide variety of them, says Dr. Vash-Margita, adding that it was not surprising that Emily was not diagnosed with OHVIRA when she was found to have one kidney at age 4.

• #14 Herlyn-Werner-Wunderlich syndrome with double hematocolpos in one side hemivagina

  https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906141/htm

  Herlyn-Werner-Wunderlich syndrome (HWWS) is an extremely rare Mullerian anomaly consisting of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis. […] It is important to understand the pathogenesis and clinical features of these anomalies for diagnosis. […] HWWS is an extremely rare congenital female reproductive malformation syndrome that is characterized by a triad of uterine didelphys, blind hemivagina, and ipsilateral renal agenesis also known as obstructed hemivagina and ipsilateral renal anomaly; OHVIRA. […] This extremely rare case, HWWS with double hematocolpos on one side of the hemivagina, was successfully treated with surgery. It is important to understand the pathogenesis and clinical features of these anomalies for diagnosis.

• #15

  https://www.omjournal.org/articleDetails.aspx?coType=1&aId=176

  Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA Syndrome) is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. […] Duplication of the uterus results from the lack of fusion of the paramesonephric ducts in a local area or throughout their normal line of fusion. In uterus didelphys, individual horns are fully developed, normal in size with two cervices inevitably present. Each hemiuteri is associated with one fallopian tube. Ovarian malposition may also be present. A longitudinal or transverse vaginal septum may be noted. […] Ipsilateral renal agenesis with partial vaginal septum on the same side and didelphys uterus is explained by embryologic arrest at the 8th week of gestation affecting simultaneously the mullerian and metanephric ducts.

• #16 Uterus didelphys: the first case report on molecular profiling of endometrial tissue from both uterine cavities | Reproductive Biology and Endocrinology | Full Text

  https://rbej.biomedcentral.com/articles/10.1186/s12958-024-01330-7

  A didelphic uterus represents a unique and infrequent congenital condition in which a woman possesses two distinct uteri, each with its own cervix. This anomaly arises due to partial or incomplete merging of the Mllerian ducts during the developmental stages in the womb. […] The physical separation of two uterine cavities in the uterus didelphys seems to participate in the differentiation in terms of the microenvironmental composition demonstrated by immunological factor MUM1 and microbiome. […] Our study revealed that physical separation, among other factors in uterus didelphys, affects the endometrial microbiome, metabolome, and inflammatory state, with significant microbiome variation observed between the uteri, although similar endometrial receptivity patterns were noted. […] The clear changes in the microbiome, with nearly 90% and 50% abundance of lactobacilli in left- and right-sided uteri, respectively, along with differences in the cervical microbiome and the presence of CE-associated microbes in the right-sided uterus, were associated with the CE diagnosis.

• #17 Uterus didelphys: the first case report on molecular profiling of endometrial tissue from both uterine cavities | Reproductive Biology and Endocrinology | Full Text

  https://rbej.biomedcentral.com/articles/10.1186/s12958-024-01330-7

  The left uterus, exhibiting more favourable microenvironment, showed high levels of metabolites involved in lipid metabolism, especially in fatty acid -oxidation. To the contrary, the right-sided uterus, with less favourable microenvironment, presented metabolic patterns associated with carbohydrate metabolism and a shift in energy production known as the Warburg effect.

• #18 Successful Vaginal Delivery of Naturally Conceived Dicavitary Twin in Didelphys Uterus: A Rare Reported Case

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5591991/

  The contractions of both uteri may not begin simultaneously. […] In didelphys uterus as the uterine horns are individually functioning so the initiation of labour could be local rather than systemic control. […] Didelphys uterus is associated with varieties of obstetric complications including early and late miscarriages, malpresentation, intrauterine growth restriction, preterm delivery, and preterm rupture of membrane. […] The overall obstetric outcome of uterus didelphys is poor but still better than the other MDAs like the septate or bicornuate uterus. […] The successful pregnancy rate with didelphys uterus is 57%, and the fetal survival rate is documented around 64%. […] If both fetal presentations are cephalic and there are no other associated risk factors, then vaginal delivery can be considered as the mode of delivery.

• #19 Twin pregnancy in each half of a didelphys uterus with delayed delivery and review of literature – ScienceOpen

  https://www.scienceopen.com/hosted-document?doi=10.14293/S2199-1006.1.SOR-MED.ASNJHF.v1

  Didelphys uterus results from an incomplete fusion of mullerian ducts and corresponds to the class III of mullerian abnormalities of the American Fertility Society. […] Didelphys uterus results from a complete failure of fusion of the two mullerian ducts in the female genital tract formation during the embryonic development. […] Didelphys uterus corresponds to the class III of mullerian abnormalities from the American Fertility Society classification from 1988. It results from a complete failure of fusion on the median line of the two paramesonephric ducts or mullerian ducts during the embryonic development. […] These complications are explained by three mechanisms: decreased muscle mass, abnormal uterine blood flow, and cervical insufficiency. […] Spontaneous labor of only one hemi-uterus and delayed delivery of the two twins corroborate with the hypothesis that the initiation of labor is a local phenomenon, with a role of the fetus and placenta, and not a general phenomenon.

• #20 The Impact of Uterus Didelphys on Fertility and Pregnancy

  https://www.mdpi.com/1660-4601/19/17/10571

  The most widely used classification of uterine malformations is the American Society for Reproductive Medicine (ASRM) classification, which outlines nine main types of uterine anomalies. […] Uterine malformations are most often detected in patients of reproductive age due to fertility problems (previously no symptoms), as many as 2–8% of infertile women have a uterine malformation and 5–30% have a history of miscarriage. […] The presence of a uterine defect may be a stress factor for the patients. […] The proper function of the placenta is essential for the adequate progression of the pregnancy until its termination and also translates into perinatal outcome. […] Pregnancy with uterus didelphys has an increased risk of preterm birth, so more attention should be paid to these cases. […] Uterus didelphys as an isolated anomaly is not an indication for either surgical treatment or termination of pregnancy by cesarean section. […] The decision to perform a cesarean section in this case requires taking into account many factors.

• #21 Pregnancy and Childbirth in Uterus Didelphys: A Report of Three Cases

  https://www.mdpi.com/1648-9144/56/4/198

  More than 80% of the pregnancies and childbirths in women with uterus didelphys end with a caesarean section but without immediate indication for it, research literature shows. […] The main reason for performing CS in a patient with uterine didelphys is the breech presentation or dystocia as a result of the obstruction of the pelvic entrance by the non-pregnant uterine cavity. […] Notwithstanding that labor dystocia in women with uterus didelphys may result from mechanical impediment, the question arises as to whether abnormal embryonic development of the reproductive organs is not a cause for the impaired function of the myometrium. […] A more complex analysis of the accumulated scientific data is needed to determine the optimal mode of delivery for this anomaly and to assess the risk of natural childbirth for the fetus or the mother.

• #22 Twin pregnancy in each half of a didelphys uterus with delayed delivery and review of literature – ScienceOpen

  https://www.scienceopen.com/hosted-document?doi=10.14293/S2199-1006.1.SOR-MED.ASNJHF.v1

  The pregnancy continuation after the birth of the first twin in the case of a double uterus allows the delayed delivery of the second twin and so increases his chances by reducing the impact of prematurity. […] In our case, the 2-week interval allowed us to do a complete lung maturation for the second twin and come through the very premature birth period.

• #23

  https://journals.lww.com/nimj/fulltext/2009/50020/superfetation_in_a_double_uterus___a_case_report.7.aspx

  Superfetation is not usually a human phenomenon, except in rare cases of double uterus and continuous menstruation during pregnancy. This report describes the condition in the presence of a double uterus. […] The case presented occurred in a double uterus. The argument for superfetation in this case is the fact that there is at least a difference of Sixteen weeks between the two fetuses taking into consideration the collapse and autolysis in the dead fetus, also the occurrence of the pregnancies in separate uteri and their differential size. Superfetation occurring in pseudodidelphys uterus has been reported. […] The cause of the second ovulation is not known, probably caused by the fallen levels of the hormones due to the death of the first fetus or it may have occurred before the fetal demise, because of the available space in the second uteri.

• #24 Double the uterus, double the babies, double the birthdays: Alabama mom delivers rare twins at UAB – UAB News

  https://www.uab.edu/news/health-medicine/double-the-uterus-double-the-babies-double-the-birthdays-alabama-mom-delivers-rare-twins-at-uab

  Kelsey Hatcher has a rare double uterus also known as uterus didelphys a rare congenital anomaly that occurs in 0.3 percent of women. […] The condition occurs when the Mllerian ducts fail to fuse together and subsequently form two uterine cavities, often referred to as horns. Each uterus has one fallopian tube and one ovary. In Kelseys case, she also has two cervices. […] Kelseys obstetrician, Shweta Patel, M.D., assistant professor in the UAB Department of Obstetrics and Gynecology, was in disbelief of the discovery until she was able to look at the scans herself. While it is not as uncommon for women with a double uterus to have a pregnancy with one baby in one uterus, as Kelsey had carried three times before, having a baby in both also known as a dicavitary pregnancy is an estimated one-in-a-million chance.

• #25 Double the uterus, double the babies, double the birthdays: Alabama mom delivers rare twins at UAB – UAB News

  https://www.uab.edu/news/health-medicine/double-the-uterus-double-the-babies-double-the-birthdays-alabama-mom-delivers-rare-twins-at-uab

  Due to the rareness of dicavitary twins, Patel and Davis had only a handful of case reports to study and use to guide a plan for delivery. […] It goes to show that the field of obstetrics is always changing and unpredictable, and you dont always have clear-cut answers, Patel said. It takes a team of experts from obstetricians to amazing nurses and a skilled anesthesia team to take care of such a rare pregnancy.

• #26 Dicavitary Di-Di Twin in Uterine Didelphys: A Case Report

  https://clinmedjournals.org/articles/ogcr/obstetrics-and-gynaecology-cases-reviews-ogcr-11-255.php?jid=ogcr

  Review of available literature regarding pregnancy outcomes in patients with uterine anomalies suggests increased risk of adverse pregnancy outcomes. However, data regarding twin pregnancies in these patients, particularly in patients with uterine didelphys, has been limited to case reports. […] Review of these reports suggests that it is difficult to assess whether the elevated risk of adverse pregnancy outcomes is primarily due to the presence of the uterine anomaly or due to the nature of a twin gestation.

• #27

  https://www.omjournal.org/articleDetails.aspx?coType=1&aId=176

  Uterus didelphys with obstructed hemivagina is an obstructive mullerian anomaly caused by the lateral nonfusion of the mullerian ducts with asymmetrical obstruction. Renal agenesis most commonly occurs in association with uterine didelphys than with any other type of mullerian anomaly. The reported incidence of renal anomalies in this group is 20%. […] OHVIRA syndrome represents obstructed hemivagina with ipsilateral renal anomaly and is classically associated with uterus didelphys. […] Obstructed unilateral vagina in patients with uterus didelphys is frequently associated with ipsilateral renal and ureter agenesis. […] Resection of the vaginal septum is the treatment of choice for obstructed hemivagina for symptom relief and preservation of reproductive capabilities. […] Didelphic uteri have the highest association with transverse vaginal septum.

• #28

  https://www.omjournal.org/articleDetails.aspx?coType=1&aId=176

  The role of imaging is to help detect, diagnose and distinguish surgically correctable forms of mullerian malformations from inoperable forms. […] Uterus didelphys has been associated with higher rate of infertility, spontaneous abortion, intrauterine growth retardation, preterm labor and postpartum bleed. […] The diagnosis of this rare mullerian anomaly, also known as Herlyn-Werner-Wunderlich Syndrome (HWWS) should be suspected in women who have ipsilateral renal agenesis with a pelvic mass. […] Early diagnosis of this condition with appropriate surgical intervention decreases the long term morbidity.

• #29 Didelphys Uterus: A Case Report and Review of the Literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4576003/

  A didelphys uterus is characterized by complete failure of the Mullerian ducts to fuse leading to separate uterine cavities and two cervices. […] Most women with a didelphys uterus are asymptomatic, but may present with dyspareunia or dysmenorrhea in the presence of a thick, sometimes obstructing, vaginal septum. […] The fertility of women with untreated didelphys uterus has been shown by some sources to be better than those with other Mullerian duct abnormalities but still less than women with normal uterine anatomy. […] A didelphys uterus has been shown in many case reports to occur as a part of a syndrome, more specifically called, Herlyn-Werner-Wunderlich (HWW) syndrome, also known as obstructed hemivagina and ipsilateral renal anomaly (OHVIRA). […] The ability to conceive remains a debatable issue as well. […] Overall, the literature available on the didelphys uterus is quite limited at the present time. Therefore more studies are needed in order to better determine the reproductive and gestational outcomes, so that clinicians can adequately advise and care for their patients.

• #30 The Impact of Uterus Didelphys on Fertility and Pregnancy

  https://www.mdpi.com/1660-4601/19/17/10571

  Uterus didelphys occurs as a result of abnormal fusion of the paramesonephric ducts and is characterized by complete duplication of uterine horns, cervix, and very often also the vagina or presence of longitudinal vaginal septum. […] Uterus didelphys arises from incomplete fusion of Mϋller’s ducts between 12 and 16 weeks of fetal life, followed by a dilation of the uterine horns, cervix and, very often, the vagina. […] The presence of a uterine defect increases the risk of obstetric complications, indicating the need for frequent checks during pregnancy. […] The diagnosis is made on the basis of imaging studies—ultrasound, HSG, and MRI. […] Diagnosis of uterine malformations is usually problematic and lengthy, due to the asymptomatic course of uterine anomalies. […] If there are no coexisting symptoms, treatment is waived.

• #31 Uterine Didelphys | Intimate Wellness Institute

  https://iwiva.com/home-page/womens-speciality-care/advanced-gynecology/congenital-abnormalities/uterine-didelphys/

  Uterus didelphys occurs when two ducts (the Mullerian ducts) dont fuse properly during development. These ducts usually join to create one uterus. If you have a double uterus, the ducts didnt join and each duct turned into its own uterus. Some people will also have two vaginas and two cervixes. Healthcare providers arent entirely sure why Mullerian ducts fail to fuse in some people. […] Uterus didelphys can cause infertility in some people. In most cases, the shape of your uterus doesnt prevent you from conceiving or getting pregnant. However, it does increase your risk for miscarriage. […] You will not have a miscarriage just because you have a double uterus. However, your chance of miscarriage is slightly higher. This is because your uterus is smaller, which restricts the growth of the fetus. The atypical shape can also affect the placenta and the blood flow within your uterus. If you have repeat late second trimester miscarriages, your healthcare provider may suggest surgery to fix your double uterus. Surgical treatment can increase your chances for a full-term pregnancy. […] You are at greater risk for pregnancy complications if you have a double uterus. The pregnancy complications associated with a double uterus are: Miscarriage, Early labor, Breech babies, Cesarean birth, Low birth weight, Growth restriction, Torn vaginal septum at the time of vaginal delivery.

• #32 Uterus didelphys (double uterus): Symptoms and more

  https://www.medicalnewstoday.com/articles/uterus-didelphys

  Uterus didelphys, or double uterus, is a rare condition where a person is born with two uteruses. It can affect menstruation and pregnancy. In some cases, it may require surgery. […] Researchers think uterus didelphys occurs when the Mllerian tubes fail to fuse during development in the womb. […] However, the exact cause of this developmental anomaly is unknown. […] Uterus didelphys can negatively affect pregnancy outcomes. However, some people with a double uterus can carry a pregnancy to full term with no issues. […] Possible complications include: increased risk of ectopic pregnancy, low birth weight, pregnancy loss, preterm labor and birth. […] A person with uterus didelphys may experience disruptions to their menstrual cycle. This may include atypical bleeding. […] Once doctors discover it, they may not do anything to treat the condition. Instead, they may monitor and help treat pregnancy-related complications to give a person the best chance of a successful pregnancy.

• #33 One successful intrauterine device into a uterus didelphys: a case report and literature review

  https://www.clinical-medicine.panafrican-med-journal.com/content/article/6/38/full/

  Uterus didelphys represents a uterus malformation where the uterus is present as a double organ due to embryonic fusion failure of the mullerian ducts. […] When fusion does not occur it leads to a uterus didelphys. […] Little is known about the pathogenesis of recurrent pregnancy loss in Mullerian duct abnormalities. […] Anatomical uterine disorder is a category 4 WHO medical eligibility for IUDs use, meaning a condition which represents an unacceptable health risk if the contraceptive method is used. […] This is to prevent or to avoid complications due to their insertion into the uterus including IUDs expulsion, IUDs malposition in the uterus, uterine perforation and migration of IUDs into the abdominal cavity and viscera. […] However this contraindication has been controversial for some authors suggesting that IUDs can still be inserted in selective and known patients with such a condition; and have successfully inserted them into the uterus didelphys.

• #34 One successful intrauterine device into a uterus didelphys: a case report and literature review

  https://www.clinical-medicine.panafrican-med-journal.com/content/article/6/38/full/

  LNG-IUD is a long acting high effective and reversible form of contraception. […] It works by thickening the cervical mucus, thinning the endometrium lining and stromal decidualization without affecting ovulation. […] Considering this mechanism and high LNG concentration in the pelvis, we thought using only one LNG-IUD might be sufficient to achieve an effective contraception for two uteri, inversely to other authors we read through using a LNG-device in each uterus. […] We think only one Cu T 380 cant be enough to protect against pregnancy in two uteri unless two Cu T 380 IUDs are inserted at once, one in each uterus.

• #35 Uterus Didelphys(Double Uterus): Causes and Symptoms

  https://www.prepladder.com/neet-pg-study-material/obstetrics-and-gynaecology/uterus-didelphysdouble-uterus-causes-symptoms-diagnosis-treatment-and-complications

  A rare disorder known as a double uterus affects some women from birth. The uterus first develops as two tiny tubes in a female fetus. The tubes usually connect to form a single, bigger, hollow organ as the fetus develops. The uterus is that organ. […] The specific cause of some fetuses developing a second uterus is unknown to medical professionals. It’s possible that genetics will come into play. This is due to the fact that this uncommon illness occasionally runs in families. […] A double uterus typically has no symptoms. The problem is likely to be discovered during a basic pelvic examination. Alternatively, imaging tests may be used to find the cause of recurrent miscarriages. […] If you don’t have any symptoms or other issues, treatment for a double uterus is frequently unnecessary. It is uncommon to have a double uterus surgically joined. […] Many women who have a second uterus have active sex lives. They might also experience regular pregnancies and successful births. However, occasionally having a second uterus along with other uterine conditions might result in: Infertility, Miscarriage, Premature Birth, Problems with the kidneys.

• #36 Bicornuate uterus, double uterus or uterus didelphys: what is it? How can it affect fertility and pregnancy?

  https://www.institutobernabeu.com/en/blog/bicornuate-uterus-double-uterus-or-uterus-didelphys-what-is-it-how-can-it-affect-fertility-and-pregnancy/

  A so-called double uterus or uterus didelphys is currently known as a complete bicornuate uterus based on the most recent categorisation developed by the European Society of Human Reproduction and Embryology (ESHRE) in 2013. It is produced by a defect in the fusion of the paramesonephric ducts. According to the ESHRE nomenclature, it is a Class U2b and anomalies in the cervix can also be present. There may be a double cervix or double vagina and a longitudinal septum separating them in two. […] Diagnosis must be performed by viewing a dip in the external uterine contour that completely divides the uterine as far as the cervix.

• #37 A Case Report on an 18-Year-Old Primigravida Patient With Uterine Didelphys | Narula | Journal of Clinical Gynecology and Obstetrics

  https://jcgo.org/index.php/jcgo/article/view/818/506

  Based on literature review, the best long-term outcome in such uterine anomalies is achieved with an early diagnosis, complete evaluation, clear understanding of the anomaly, mobilization of appropriate surgical resources, sufficient preoperative counseling, and planned surgical intervention if necessary. […] Full diagnosis and evaluation of the anomaly is necessary and important in order to plan for delivery appropriately.

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