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Uterus didelphys (sometimes also uterus didelphis) represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. 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. In non human species (e.g. nematodes), a didelphic genital tract may be normal rather than a malformation. Such species are described as didelphic, as opposed to monodelphic, with a single tract. Some women have a double uterus and never realize it — even during pregnancy and childbirth. 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. Possible signs and symptoms may include: Unusual pressure or cramping pain before or during a menstrual period. Abnormal bleeding during a period, such as blood flow despite the use of a tampon. When to consult a doctor If you have signs and symptoms of a double uterus, make an appointment with your doctor. An early diagnosis is especially important if you plan to become pregnant or if you've had repeated miscarriages. Your doctor can recommend treatment options to improve your chances of getting pregnant, staying pregnant and having a safe delivery. If you've been diagnosed with a double uterus and are considering pregnancy, talk with your doctor first. Together you can make a plan for optimal care during pregnancy and delivery.
Women with the condition may be asymptomatic and unaware of having a double uterus. However, a study by Heinonen showed that certain conditions are more common. In his study of 26 women with a double uterus gynecological complaints included dysmenorrhea and dyspareunia. All patients displayed a double vagina. The fetal survival rate in 18 patients who delivered was 67.5%. Breech presentation was present in 43% and premature delivery common (21%).
If you have a double uterus but you don't have signs or symptoms, treatment is rarely needed. Surgery to unite a double uterus is rarely done. Surgery may help you sustain a pregnancy if you have a partial division within your uterus and no other medical explanation for a previous pregnancy loss. If you're pregnant and have a double uterus, your risk of pregnancy complications may be higher due to the smaller size of your uterine cavity. This factor may lead to early delivery, often by C-section. Share any concerns you may have about childbirth with your doctor because he or she may suggest ways to help prevent preterm delivery or manage labor.