Uterine didelphys: An accidental finding at emergency caesarean section

Background: A didelphic uterus is a rare uterine anomaly. This malformation is usually asymptomatic in the absence of other associated malformations, making its diagnosis incidental during radiological or surgical examination. The authors report a case of an undiagnosed didelphic uterus discovered incidentally during an emergency caesarean section. Objective: To report on the obstetric prognosis of fertile women with a didelphic uterus. Clinical case: Ms KO, aged 26, was referred to us for the onset of labour in a nulliparous woman with a breech presentation at full term. Speculum examination revealed a double cervix. Vaginal examination confirmed two cervices, one of which was centred and dilated to 3 centimetres with an intact amniotic sac and a fœtus in breech presentation. The second cervix was off-centre to the right with a closed os. An emergency caesarean section was indicated, allowing the delivery of a live newborn weighing 3100 grams. After the extraction of the foetus, the examination revealed two distinct hemi-uteri, each with homolateral adnexa. Each hemi-uterus was connected to a cervix. The left hemi-uterus, which had previously been pregnant, had a well-formed lower segment. The second, on the right, was slightly enlarged. The postoperative course was uneventful for both the mother and the newborn. Conclusion: A didelphic uterus is a rare uterine anomaly. A pregnancy in a didelphic uterus can be carried to term without symptoms. However, caesarean section is more common due to the higher risk of fœtal presentation abnormalities. Keywords: didelphic uterus, incidental finding, caesarean section.