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Uterus Didelphys

Definition:
In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus. Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate cavity. This condition is called double uterus (uterus didelphys).

Each cavity in a double uterus often leads to its own cervix. Some women with a double uterus also have a duplicate or divided vagina.

Double uterus is rare — and sometimes not even diagnosed. According to one estimate, double uterus occurs in 2 percent to 4 percent of women who have normal pregnancies. The percentage may be higher in women with a history of miscarriage or premature birth.

Treatment is needed only if a double uterus causes symptoms or complications, such as pelvic pain or repeated miscarriages.

Causes:
Researchers don't know what causes double uterus. The condition is associated with kidney abnormalities, which suggests that something may influence the development of these related tubes before birth.

Symptoms:
Some women have a double uterus and never realize it — even during pregnancy and childbirth. Possible signs and symptoms may include:
  • A mass in the pelvis
  • Unusual pain before or during a menstrual period
  • Abnormal bleeding during a period, such as blood flow despite the use of a tampon

Dignosis:
A double uterus is often diagnosed during a routine pelvic exam when the doctor observes a double cervix or an unusually shaped uterus. If the doctor suspects an abnormality, he or she may recommend any of the following tests:
  • Magnetic resonance imaging (MRI). This test uses a strong magnetic field to create cross-sectional images of the inside of your body.
  • Ultrasound. This test uses high-frequency sound waves to create images of the inside of your body.
  • Hysterosalpingography. With this test, a special dye is injected into your uterus through your cervix. Then X-rays are taken to determine the shape and size of your uterus.
  • Hysteroscopy. With this procedure, the doctor inserts a tiny tube with a light into your vagina and through your cervix. This allows the doctor to examine the inside of your uterus.
  • Laparoscopy. With this surgical procedure, the surgeon makes a small incision beneath your navel and inserts a laparoscope — an illuminated, fiber-optic device — into your abdomen to examine your uterus. Laparoscopy requires general anesthesia.
Complication:
Many women with a double uterus have normal sex lives, pregnancies and deliveries. In fact, the more complete the duplication, the less likely complications are to arise. But sometimes a double uterus leads to infertility or miscarriage. A double uterus may also cause premature birth or unusual positions of the baby in the uterus, such as bottom down (breech presentation).

Treatment:
If you have a double uterus but no signs or symptoms, treatment is rarely needed. Surgery to unite a double uterus is rarely done — although other surgical procedures may help if you have a partial division within your uterus.

If you're pregnant and have a double uterus, share any concerns you may have about childbirth with your doctor. He or she may suggest ways to help prevent preterm delivery or manage labor.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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