Successful term delivery of spontaneous twin pregnancy in a woman with bicorporeal septate uterus: A case report

Abstract

Herein, we report the first case of successful term delivery of twins in a patient with bicorporeal septate uterus via natural conception. The patient had been diagnosed with complete septate, didelphys and bicornuate uterus during different phases of her three pregnancies. Based on follow-up data at six weeks and then six months post-partum of the last pregnancy, we found that the abnormalities presented in our case did not fit the criteria of any categories following American Fertility Society and European Society of Human Reproduction and Embryology-European Society for Gynaecological Endoscopy classification systems. After comprehensive review of the uterine morphologic characteristics, embryology and pregnancy outcome, we considered 'bicorporeal septate uterus' the most appropriate diagnosis. This case emphasized the atypical changes of uterine shape as twin pregnancy advances and its influence on productive performance and pregnancy outcome in uterine malformation. It also raised concern regarding the usability and comprehensiveness of the two most popular classification systems.

Dicavitary twin pregnancy in patient with bicornuate bicollis uterine anomaly

“…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. Given this concern and breech presentation of both twins at term, a cesarean was scheduled for 37 weeks gestation.…”

“…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, 7–9,12,27,28 fetal distress, 13,18,26 labor dystocia, 5,10 and concern for obstruction of the birth canal 21,24 …”

“…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 …”

The impact of congenital uterine abnormalities on pregnancy and fertility: a literature review

“…Nevertheless, pregnancy may be possible after surgical corrections through natural or artificial insemination ( Table 2 ). In a rare case, Li et al . (2016) reported a successful full-term twin pregnancy in each cavity of a bicorporeal septate uterus of a patient with two cervices and a longitudinal vaginal septum via natural insemination.…”

“…Nevertheless, pregnancy may be possible after surgical corrections through natural or artificial insemination (Table 2). In a rare case, Li et al (2016) reported a successful full-term twin pregnancy in each cavity of a bicorporeal septate uterus of a patient with two cervices and a longitudinal vaginal septum via natural insemination. Furthermore, a women with bicornuate unicollis uterus with twins successfully delivered at 35 weeks of gestation through a bilateral cesarean section (Doruk et al, 2013).…”