The likelihood of a successful simultaneous twin pregnancy in two wombs in the congenital anomaly complete double uterus
Uterus didelphys is one of the congenital malformations of the uterus, which occurs due to incomplete fusion along the midline of Müller’s ducts, resulting in two separate uteri and a vaginal septum. This is a rare congenital abnormality, with a prevalence of 1/1000–1/30 000. Each uterus is connected to one fallopian tube and the ovary. A twin pregnancy with a fetus in each uterus in women with uterus didelphys is an extremely rare phenomenon, with a frequency of about 1/1 000 000. The data available in the literature on the problem of obstetric and perinatal outcomes of multiple pregnancy in women with complete double uterus (uterus didelphys) underwent systems analysis. The authors provide their own extremely rare case of spontaneous pregnancy with two fetuses in separate wombs in uterus didelphys, which has successfully resulted in the simultaneous birth of both fetuses via abdominal delivery, without any complications at 36 weeks of pregnancy. There are very few reports of multiple pregnancy in women with uterus didelphys. The authors give data from the review of foreign literature, as well their own extremely rare case of spontaneous twin pregnancy in a woman with uterus didelphys.Tskhay V.B., Bazina M.I., Lobanova T.T.
Keywords
double uterus (uterus didelphys)
multiple pregnancy
twin pregnancy
outcomes
References
1. Trad M., Palmer S. Müllerian duct anomalies and a case study of unicornuate uterus. Radiol. Technol. 2013; 84(6): 571-6.
2. Адамян Л.В., Богданова Е.А., Глыбина Т.М., Баран Н.М. Пороки развития матки и влагалища у девочек с синдромом МакКьюсика-Кауфмана. Проблемы репродукции. 2008; 14(1): 81-4.
3. Afrashtehfar C.D., Piña-García A., Afrashtehfar K.I. Müllerian anomalies. Obstructed hemivagina and ipsilateral renal anomaly syndrome (OHVIRA). Cir. Cir. 2014; 82(4): 460-71.
4. Nayak S., Pati T., Panda S.K., Sahu M.C., Padhy R.N. Uterus didelphys with cervical incompetence ─ A rare case report. Int. J. Pharm. Sci. Rev. Res. 2014; 28(1): 228-32.
5. Talebian Yazdi A., De Smet K., Ernst C., Desprechins B., de Mey J. Uterus didelphys with obstructed hemivagina and renal agenesis: MRI findings. JBR-BTR. 2011; 94(1): 16-8.
6. Dhar H., Razek Y.A., Hamdi I. Uterus didelphys with obstructed right hemivagina, ipsilateral renal agenesis and right pyocolpos: a case report. Oman Med. J. 2001; 26(6): 447-50.
7. Fukunaga T., Fujii S., Inoue C., Mukuda N., Murakami A., Tanabe Y. et al. The spectrum of imaging appearances of müllerian duct anomalies: focus on MR imaging. Jpn. J. Radiol. 2017; 35(12): 697-706.
8. Nohara M., Nakayama M., Masamoto H., Nakazato K., Sakumoto K.,Kanazawa K. Twin pregnancy in each half of a uterus didelphyswith a delivery interval of 66 days. BJOG. 2003; 110(3): 331-2.
9. Al Yaqoubi H.N., Fatema N. Successful vaginal delivery of naturally conceived dicavitary twin in didelphys uterus: A rare reported case. Case Rep. Obstet. Gynecol. 2017; 2017: 7279548.
10. Ozyuncu O., Turgal M., Yazicioglu A., Ozek A. Spontaneous twin gestation in each horn of uterus didelphys complicated with unilateral preterm labor. Case Rep. Perinat. Med. 2014; 3(1): 53-6.
11. Yang M., Tseng J., Chen C., Li H. Delivery of double singleton pregnancies in a woman with a double uterus, double cervix, and complete septate vagina. J. Chin. Med. Assoc. 2015; 78(12): 746-8.
12. Allegrezza D.M. Uterus didelphys and dicavitary twin pregnancy. J. Diagn. Med. Sonogr. 2016; 23(5): 286-9.
13. Olpin J.D., Heilbrun M. Imaging of Müllerian duct anomalies. Clin. Obstet. Gynecol. 2009; 52(1): 40-56.
14. Arora M., Gupta N., Neelam N., Jindal S. Unique case of successful twin pregnancy after spontaneous conception in a patient with uterus bicornis unicollis. Arch. Gynecol. Obstet. 2007; 276(2): 193-5.
15. Maki Y., Furukawa S., Sameshima H., Ikenoue T. Independent uterine contractions in simultaneous twin pregnancy in each horn of the uterus didelphys. J. Obstet. Gynaecol. Res. 2014; 40(3): 836-9.
16. Slavchev S., Yordanov A., Donkov V., Vasileva P., Malkodanski I. A rare case of undeveloped multiple pregnancy in uterus didelphys. Open Access J. Surg. 2017; 6(3): 555695.
17. Green Q.L., Schanck G.P., Smith J.R. Normal, living twins in uterus didelphys with 38 day interval between deliveries. Am. J. Obstet. Gynecol. 1961; 82: 340-2.
18. Jackson J.R., Williams B., Thorp J. Spontaneous triplets carried in a uterus didelphys. Case Rep. Women’s Health. 2014; 3(C): 1-2.
19. Díaz-García C., Subirá Nadal J.P., Urgal Ayala A., Cazorla Amorós E., Borrás Suñer D., Perales Marín A. Spontaneous triplet pregnancy complicated by uterus didelphys: a case report. Fetal Diagn. Ther. 2010; 27(4): 227-30.
20. Mashiach S., Ben-Rafael Z., Dor J., Serr D.M. Triplet pregnancy in uterus didelphys with delivery interval of 72 days. Obstet. Gynecol. 1981; 58(4): 519-21.
21. Cruceyra M., Iglesias C., la Calle M., Ssncha M., Magallon S.L., Gonzáles S. Successful delivery of a twin pregnancy in a bicornuate uterus (uterus bicornis unicollis) by bilateral Caesarean section. J. Obstet. Gynaecol. Can. 2011; 33(2): 142-4.
22. Doruk A., Gozukara I., Burkaş G., Bilik E., Dilek T.U. Spontaneous twin pregnancy in uterus bicornis unicollis. Case Rep. Obstet. Gynecol. 2013; 2013: 834952.
23. Rezai S., Bisram P., Lora Alcantara I., Upadhyay R., Lara C., Elmadjian M. Didelphys uterus: a case report and review of the literature. Case Rep. Obstet. Gynecol. 2015; 2015: 865821.
24. Garg R., Kwatra A., Bangal V. A rare case of uterus didelphys with full term pregnancy in each horn. Pravara Med. Rev. 2010; 2(4): 22-4.
25. Acién P., Acién P. Diagnostic imaging and cataloguing of female genital malformations. Insights Imaging. 2016; 7(5): 713-26.
26. Li Y., Phelps A., Zapala M.A., MacKenzie J.D., MacKenzie T.C., Courtier J. Magnetic resonance imaging of Müllerian duct anomalies in children. Pediatr. Radiol. 2016; 46(6): 796-805.
27. Yoo R.E., Cho J.Y., Kim S.Y., Kim S.H. A systematic approach to the magnetic resonance imaging-based differential diagnosis of congenital Müllerian duct anomalies and their mimics. Abdom. Imaging. 2015;40(1): 192-206.
28. Crane J., Scott H., Stewart A., Chandra S., Whittle W., Hutchens D. Transvaginal ultrasonography to predict preterm birth in women with bicornuate or didelphus uterus. J. Matern. Fetal Neonatal Med. 2012; 25(10):1960-4.
29. Ong C.L. The current status of three-dimensional ultrasonography in gynaecology. Ultrasonography. 2016; 35(1): 13-24.
Received 02.02.2018
Accepted 02.03.2018
About the Authors
Tskhay, Vitaly B., MD, Professor, Head of perinatology, obstetrics and gynecology department, Krasnoyarsk State Medical University namedafter prof. V.F. Voino-Yasenetsky, 660022 Russia, Krasnoyarsk, Str. P. Geleznyaka 1. Tel.+79232872134. E-mail: tchai@yandex.ru
Bazina, Marina I., MD, Docent, Head of obstetrics and gynecology department, Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky,
660022 Russia, Krasnoyarsk, Str. P. Geleznyaka 1. Tel.:+ 79029929770. E-mail: sonja189@mail.ru
Lobanova, Tatyana T., The heard of ultrasound diagnostic department, Krasnoyarsk Regional Clinical Center of Mother and Сhild Health,
660074, Russia, Krasnoyarsk , Akad. Kirenskogo str. 2a. Tel.: +79131974868. E-mail: oufd_pc@pericentr.ru
For citations: Tskhay V.B., Bazina M.I., Lobanova T.T. The likelihood of a successful simultaneous twin pregnancy in two wombs in the congenital anomaly complete double uterus. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 166-70. (in Russian)
https://dx.doi.org/10.18565/aig.2018.11.166-170
Similar Articles
