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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 structure. This condition is called double uterus (uterus didelphys). A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. There may even be two vaginas.
The prevalence all over the world was described by Grimbizis et al which was about 4.3% for the general population and/or fertile women, about 3.5% in infertile women, and about 13% in women with recurrent pregnancy losses. The prevalence of müllerian duct anomalies also varies significantly, with reports ranging from 0.16-10%. When these data are obtained in women with recurrent pregnancy loss who are undergoing hysterosalpingography (HSG), the prevalence of müllerian anomalies is 8-10%. This rate contrasts with a prevalence of 2-3% in women undergoing elective hysteroscopy, a population thought to better reflect the general population than the former group.
Double uterus is rare and sometimes never diagnosed. The percentage of women with a double uterus is likely higher in those with a history of miscarriage or premature birth. The cause of double uterus is unknown. This condition may be associated with kidney abnormalities, which suggests that something may influence the development of these related structures before birth. Surgery to unite a double uterus is rarely done although 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. Patients with a double uterus may need special attention during pregnancy as premature birth and malpresentation are common.