A unique case of successful twin pregnancy reaching term in a patient with uterus bicornis unicollis

Ahluwalia, Simran; Kamble, Vidya; Patil, Shaifali; Boricha, B. G.

doi:10.5455/2320-1770.ijrcog20141245

Cited by 4 publications

(4 citation statements)

References 7 publications

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“… 15 Similarly, Ahluwalia et al had noted in 2014 that there are no specific guidelines for management and so recommended maintenance of a worldwide register to report cases and consistently improve pregnancy outcomes and foetal survival rates. 16 It is in response to these concerted calls that we report the above case. To the best of our knowledge, this is the first case that has been reported in Kenya, a Lower Middle-Income Country (LMIC).…”

Section: Discussionmentioning

confidence: 92%

Twin pregnancy in a bicornuate uterus in rural Kenya: A case report for accidental discovery and successful delivery

Elias

Amisi

2020

Afr. j. prim. health care fam. med.

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Introduction: Uterine anomalies are often identified during pregnancy, during infertility evaluation or pregnancy miscarriage and have been associated with an increased risk of adverse pregnancy outcomes. Although some studies have documented the rare occurrence of spontaneous twin pregnancy in each horn of a bicornuate uterus, this is the first time this is being documented in Kenya, to the best of our knowledge. This is a rare occurrence and reporting of this case adds to the documentation of such cases.Patient presentation: This is a case report for a 30-year-old female, para 2+0 at 34 weeks 4 days by dates, who presented with features of labour. Upon examination, she had normal vital signs and a fundal height of 38 weeks with multiple foetal parts both in cephalic presentation and two foetal heart rates within normal range. Her antenatal profile was non-contributory and had undergone two ultrasounds that confirmed twin gestation with no other notable findings.Management and outcome: The patient had a spontaneous vertex delivery of the first twin with a good outcome. There was a delay in the delivery of the second twin and a caesarean section was done with an indication of non-reassuring foetal status and low-lying placenta. The bicornuate uterus was accidentally identified during the surgery. The outcome was good, with an APGAR score of 6 in the first minute and 9 at 10 min.Conclusion: Although this is a rare occurrence, we would like to sensitise healthcare workers in rural low- to middle-income countries that this can occur, and they should attempt to increase antenatal diagnosis as it can influence the mode of delivery.

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Section: Discussionmentioning

confidence: 92%

Twin pregnancy in a bicornuate uterus in rural Kenya: A case report for accidental discovery and successful delivery

Elias

Amisi

2020

Afr. j. prim. health care fam. med.

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“…Some researchers have recently called for the continuous publication of case reports pertaining to the management of twin gestation in uterine malformations to broaden the data available on such rare presentations [ 9 ]. Others have also recommended the maintenance of a global register of such cases in order to improve pregnancy outcomes and fetal survival [ 10 ]. It is in response to these concerted calls that we report this case.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed uterus didelphys with unicavitary twin gestation in a district hospital in Ghana: a case report

Effah¹,

Manu²,

Udofia³

et al. 2023

Pan Afr Med J

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Uterus didelphys is a congenital anomaly of the female reproductive tract which arises from the abnormal fusion of the Mullerian ducts. We present, the first case to the best of our knowledge, of uterus didelphys with a unicavitary twin gestation to be documented in Ghana, a low-middle income country. A 24-year-old woman, gravida 3, para 0+2 miscarriages, was seen and admitted to our maternity ward due to elevated blood pressure with ++ proteinuria at 36 weeks of gestation. She attended an antenatal clinic regularly during the pregnancy but was mainly seen by midwives. Apart from multiple pregnancy, two 2D ultrasound examinations (one at 25 weeks gestation and another during admission) did not reveal any uterine malformations. At 37 weeks+2 days, she underwent emergency cesarean section on account of pre-eclampsia and a twin pregnancy with the leading twin in breech presentation. After delivering both babies and the placenta, the uterus was exteriorized and inspected, during which a non-gravid bulky left uterus was first found. Each uterus had a normal ovary and fallopian tube on its lateral end. Further postoperative examination revealed a normal-looking vulva, two vaginas, and two cervices. Both babies weighed 1.9 kg, each below the fifth percentile of weight for age. The elevated blood settled postoperatively and the postoperative period was uneventful. The patient and twins were found in a stable condition on review two weeks after delivery and the twins were healthy at 5 years. Despite being a rare presentation, we wish to create awareness among health workers in rural and low-resource settings of such cases and highlight the need to improve prenatal diagnostic capabilities, as this is key to determining the mode of delivery and achieving favorable maternal and fetal outcomes.

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“…7 The mode of delivery could be via caesarean section or vaginal delivery. 9 Challenges to vaginal delivery may include cervical dystocia, malpresentation and possible risk of uterine rupture. 10 Almost all cases of twin pregnancy in a bicornuate uterus reported in literature were delivered through caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Retained second twin secondary to an undiagnosed bicornuate uterus in a poorly supervised labour: A case report

Enebe

Omeke

Emeka

2020

Proceedings of Singapore Healthcare

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Congenital anomalies of the uterus may result from maldevelopment, abnormal fusion or failure of recanalisation of the paramesonephric (Müllerian) ducts. They are uncommon and are associated with various fertility and pregnancy outcomes. Uterine anomalies have been associated with infertility and pregnancy-related complications. Some cases of successful pregnancies among women with a bicornuate uterus have been reported. However, successful twin pregnancy in a bicornuate uterus is very rare. We report the case of a 24-year-old primigravida who presented with a retained second twin secondary to an undiagnosed bicornuate uterus. An abdominal examination revealed an enlarged abdomen with the uterus tilted to the right and also a palpable firm mass on the left iliac fossa. The retained foetus was presenting cephalic, and the foetal heart rate was 118 bpm. A diagnosis of a retained second twin secondary to a suspected uterine anomaly and suspected foetal distress was made. An emergency caesarean section revealed two horns of the uterus, each having a fallopian tube, an ovary and a cervix. Both cervices opened into one vagina. A 3.0 kg live male baby was successfully delivered through a transverse incision on the lower segment of the right horn of the uterus. The client had an uneventful recovery and was discharged home together with her babies after 4 days. In conclusion, congenital anomalies of the uterus should be considered in cases of a retained second twin. A prompt and accurate diagnosis followed by appropriate management will go a long way in ensuring a good outcome, as was had in this case.

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A unique case of successful twin pregnancy reaching term in a patient with uterus bicornis unicollis

Cited by 4 publications

References 7 publications

Twin pregnancy in a bicornuate uterus in rural Kenya: A case report for accidental discovery and successful delivery

Twin pregnancy in a bicornuate uterus in rural Kenya: A case report for accidental discovery and successful delivery

Undiagnosed uterus didelphys with unicavitary twin gestation in a district hospital in Ghana: a case report

Retained second twin secondary to an undiagnosed bicornuate uterus in a poorly supervised labour: A case report

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