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What Is A Didelphic Uterus?

A didelphic uterus, also called uterus didelphys or a double uterus, is a congenital uterine malformation that causes a woman to end up with two separate uterine cavities. Each uterine cavity is connected to one fallopian tube. Simply put, women with this condition essentially have two smaller uteri, along with two cervices and sometimes two vaginas as well. 

Though the condition can have symptoms such as prolonged menstrual bleeding and pain during sex, many women are asymptomatic. In this case, the woman will not require any specific treatment while she is not pregnant or trying to conceive. Hormonal birth control or condoms will be preferred over intrauterine devices, which would have to be implanted in both uteri, something that isn't always possible.

A double uterus often won't cause you any difficulties until you are pregnant. It is quite possible not to know you have a double uterus until an ultrasound during pregnancy reveals it. Pregnancy can be a bit scary all by itself, so if you discover you have a didelphic uterus during this time, that is quite the shock, and you are bound to have a lot of questions. 

Is A Healthy Pregnancy With A Didelphic Uterus Possible?

In short, yes. A healthy pregnancy with a didelphic pregnancy is possible, but there are risk factors to consider.

Some studies show that a double uterus is associated with infertility, while there is a general scientific consensus that uterus didelphys poses a higher risk of preterm delivery and breech presentation, which in turn leads to a higher c-section rate. Women with a didelphic uterus likewise have an increased risk of miscarriage. 

However, the fact is that uterus didelphys is a rare condition, which makes it a subject that isn't as well studied as you would hope. The various studies conducted into the reproductive risks of a double uterus all come with a very small sample size. While one study found that women with a didelphic uterus had:

  • A live birth rate of 67.5 percent
  • A premature delivery rate of 21 percent
  • A breech presentation rate of 43 percent

Another found that the participating subjects had a live birth rate of 81 percent once those who elected to terminate their pregnancies had been eliminated. There are certainly case studies in which women with uterus didelphys gave birth at term, vaginally and without any significant complications, as well. The course of your pregnancy will partially depend on how developed the uterine cavity in which the pregnancy is developing is.

In Conclusion

Whether you have a didelphic uterus and are thinking about trying to conceive, currently trying, or already pregnant, it helps to have a doctor experience in the condition by your side. Your doctor will be able to assess your specific anatomy and follow your pregnancy to minimize risks. 

Because you are in an unusual position and it's your healthcare provider's job to focus on risk assessment, you may also want to connect with other women who have uterus didelphys and other uterine abnormalities during this time. The emotional support can be invaluable. 

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