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Dec 8, 2025Keywords:
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Uterine didelphys: A rare anomaly unveiled at repeat caesarean section in a multiparous woman at term
Abstract
Background: Uterine didelphys (UD) is an unusual congenital Mullerian duct anomaly with significant obstetric and gynaecological implications.
Case Presentation: We present the case of a 32-year-old gravida 4 para 2 plus 1 (1 alive) multiparous woman, who underwent repeat elective caesarean section for breech presentation at 37 weeks of gestation. Despite a prior ultrasound suggesting uterine didelphys during her first confinement (the diagnosis was missed intraoperatively), and no findings on subsequent scans during the index pregnancy, the anomaly was definitively diagnosed during the current caesarean section.
The fetus was successfully delivered via breech extraction from one hemi-uterus, and a separate second hemi-uterus with its cervix was identified intraoperatively. The patient's immediate postoperative course was uneventful.
Conclusion: This case highlights the diagnostic challenges of uterine didelphys, underscoring the importance of a high index of suspicion and thorough intraoperative exploration to accurately identify such rare anomalies, even in multiparous women with a history of uterine surgery.
