Dicavitary Uteri with Twin Gestation: A Case Following Clomiphene Citrate Therapy and Review of Obstetric Outcomes

Abstract

We report the first case of dicavitary twin pregnancy, following clomiphene citrate therapy, in a patient with uterus bicornis bicollis and anovulation. A review of the literature is presented, and obstetric outcomes and management of these rare pregnancies are discussed.

Dicavitary twin pregnancy in patient with bicornuate bicollis uterine anomaly

“…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 …”

“…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.…”

Independent uterine contractions in simultaneous twin pregnancy in each horn of the uterus didelphys

“…The incidence of twin pregnancy in each cavity in a uterus didelphys is extremely rare, roughly 1/1 million . We are aware of only 17 documented cases in the English‐language published work (Table ) . Of these cases, seven women delivered both infants vaginally.…”

“…1 We are aware of only 17 documented cases in the English-language published work ( Table 2). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Of these cases, seven women delivered both infants vaginally. In four cases, uterine contractions of both horns were documented by manual palpation; two cases reported synchronous UC 1,3 and the other two cases reported independent UC.…”