Uterus didelphys

Case contributed by Dr Kapil Sakinala

Presentation

25 year female with one live child, being evaluated for secondary infertility.

Patient Data

Age: 25
Gender: Female

Transabdominal

Modality: Ultrasound

Separate divergent uterine horns with a large fundal cleft. Endometrial cavities are uniformly separate, with no evidence of communication.

HSG

Modality: Fluoroscopy

Image showing two separate endocervical canals that open into separate fusiform endometrial cavities, with no communication between the two horns. Each endometrial cavity ends in a solitary fallopian tube.

Case Discussion

From the Radiopaedia uterine didelphys article:

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

It results from failed ductal fusion that occurs between the 12th and 16th week of pregnancy and is characterized by two symmetric, widely divergent uterine horns and two cervixes. The uterine volume in each duplicated segment is reduced. As with most uterine anatomical anomalies, there is an increased incidence of fertility issues, and Müllarian abnormalities in general are over represented in infertile women. The chance of seeing a pregnancy to term is significantly reduced, down to only 20%, with a third of pregnancies ending in abortion and over half in premature deliveries. Only 40% of pregnancies resulted in living children

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Case Information

rID: 25351
Case created: 21st Oct 2013
Last edited: 12th Nov 2015
System: Gynaecology
Inclusion in quiz mode: Included

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