Delayed-interval-delivery of twins in didelphys uterus complicated with chorioamnionitis: a case report and a brief review of literature

Dicavitary twin pregnancy in patient with bicornuate bicollis uterine anomaly

“…Successful VBAC has been described in cases of singleton pregnancies where the subsequent pregnancy presents in the opposite cavity 30 or in the same uterine cavity 31 . In cases of twin pregnancies cesarean of the first followed by vaginal delivery of the second twin during the same pregnancy has also been described 13,28 …”

“…In the absence of contraindication to vaginal delivery, successful vaginal delivery for both twins have been reported 6,11,15,17,20,22 . In rare cases, a cesarean may be required for delivery of one twin, while the other is able to be delivered via the vaginal route, and vice versa 5,13,18,23,26,28 …”

“…However, a dicavitary gestation is not itself a contraindication for vaginal birth unless the birth canal is incomplete or obstructed. The most common indications for cesarean section in the literature include malpresentation, [7][8][9]12,27,28 fetal distress, 13,18,26 labor dystocia, 5,10 and concern for obstruction of the birth canal. 21,24 In the case of our patient, a second cervix was never palpated or visualized on exam during the antepartum period, despite visualization of a second cervical canal on ultrasound.…”

Uterus didelphys with double vagina diagnosed during third cesarean section: A case report

“…There are cases where uterine anomalies were missed during laparotomy. 18,23 Undiagnosed uterus didelphys risks uterine rupture in future if a trial of vaginal birth is planned. As reported in the literature, pregnancy in one horn of the uterus may be confused with cornual ectopic pregnancy, 7 and it might mimic ovarian tumor.…”

“…19 Similar to our case, there are case reports of successful term singleton as well as twin pregnancies elsewhere. 3,[20][21][22][23] Uterine anomaly is detected during infertility work up, 22 during second vaginal delivery which was missed in first vaginal birth, 20 and cases of delayed-interval-delivery of twins complicated with chorioamnionitis in uterus didelphys. 23 Our case is unique and special one: The uterine anomaly and vaginal septum were not diagnosed prior to conception or antenatal ultrasound scan; she had three term pregnancies without any antenatal complications; and uterine anomaly and vaginal septum were diagnosed during third CS only.…”