Abstract

Uterus didelphys is a rare congenital uterine abnormality in which the embryogenetic fusion of the Mullerian ducts fails to occur. It will lead to the formation of a double uterus with two separate cervices and most often a double vagina with a longitudinal septum as well. Here, we present two different cases of uterus didelphys with varied presentations. The first case is a nulliparous woman presented with post-coital bleeding. On examination, two cervical openings with a longitudinal complete vaginal septum were found, conservative management was done. Findings of didelphys uterus were confirmed on USG. The patient was counseled and discharged. The second case is a multiparous woman with previous cesarean delivery, rupture of membranes, and meconium in this pregnancy with term pregnancy taken up for emergency cesarean section. Dense adhesions and a mass on the right side of uterus were found intraoperatively, which on further inspection confirmed to be patent right horn of uterus. Diagnosis of uterus didelphys was made after doing per speculum and per vaginal examination post-cesarean.

Highlights

  • During embryogenesis, the uterus is formed by the fusion of the two paramesonephric ducts (Mullerian ducts), which normally fuse to form the single uterine body

  • Case 1 A 28-year-old nulliparous recently married woman came at night in emergency at PGIMS, Rohtak, with complaints of excessive bleeding per vaginum after coitus

  • Case 2 A 26-year-old female gravida 4 para 1 with no live issue and two abortions with one previous cesarean section presented in our emergency at term gestation with complaints of leaking per vaginum

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Summary

INTRODUCTION

The uterus is formed by the fusion of the two paramesonephric ducts (Mullerian ducts), which normally fuse to form the single uterine body. Case 1 A 28-year-old nulliparous recently married woman came at night in emergency at PGIMS, Rohtak, with complaints of excessive bleeding per vaginum after coitus She went to a nearby government hospital where she received some injectables to stop blood and some pain killers (according to patient) and referred to our institute for further management. Case 2 A 26-year-old female gravida 4 para 1 with no live issue and two abortions with one previous cesarean section presented in our emergency at term gestation with complaints of leaking per vaginum. She was conscious and her vitals were normal. Post-operative period was uneventful and the patient was told about her uterus and discharged with stable vitals

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