UTERUS DIDELPHYS - DOUBLE UTERUS

Uterus didelphys  is a uterine malformation where the uterus is present as a paired organ due to failure of embryogenetic fusion of the mullerian ducts. As a result there is a double uterus with two separate cervices, and often a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary.

Another condition known as uterus duplex bicollis occurs when a woman has two uterus and two cervix, but only one vagina. If there is doubling of the uterus but only one cervix and vagina, the condition is termed bicornuate uterus. It is also possible to have abnormal development in only one of the two Mullerian ducts, which can lead to an abnormality called unicornuate uterus , with only one normal Fallopian tube.

Because the external genitalia generally appears normal in these cases, the conditions may not be diagnosed at birth. Also because the external genitalia are normal, many cases of reproductive tract duplication or fusion are likely never diagnosed. For this reason, it is difficult to predict exactly how often these abnormalities occur.

Duplication of the reproductive tract does not interfere with a woman's ability to become pregnant. However, the anatomical abnormalities may lead to complications of pregnancy such as incompetent cervix, breech or other abnormal fetal positions, and an increased incidence of miscarriage.Abnormalities in development of the reproductive tract can also be associated with congenital malformations of the kidneys and urinary system.

Helpful techniques to investigate the uterine structure are transvaginal ultrasonography and sonohysterography, hysterosalpingography, MRI, and hysteroscopy. 

A number of twin gestations have occurred where each uterus carried its pregnancy separately. A recent example occurred on February 26, 2009, when Sarah Reinfelder of Sault Ste. Marie, Michigan delivered two healthy, although seven weeks premature, infants by cesarean section at Marquette General Hospital.^[6] It is possible that the deliveries occur at different times, thus the delivery interval could be days or even weeks.

Sarah Reinfelder and twins

Triplets

A UK woman with a double uterus gave birth to triplets in 2006. 

Hannah Kersey, of Northam in Devon, gave birth to a pair of identical twins from an egg that implanted into one womb and then divided, and to an infant from a single egg that implanted into the other womb. This was the first known birth of viable triplets in a woman with a double uterus. It is estimated that the possibility of such a birth is about 1 in 25 million.

 A triplet pregnancy in a woman with uterus didelphys was reported from Israel in 1981; one baby died in utero, and of the remaining babies, one was delivered at 27 weeks gestation and the other 72 days later.

Hanna Kersey and triplets