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Uterus Didelphys: Diagnosis, Treatment, and Impact on Fertility and Reproduction

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Congenital Müllerian Anomalies


Uterus didelphys results from failure of fusion of the paired Müllerian ducts. Uterus didelphys is defined as this anomaly occurs in approximately 1 in 3000 women and accounts for 8–10 % of all Müllerian anomalies. A longitudinal septum is found in 75 % of cases of uterine didelphys. The majority of patients with uterus didelphys are asymptomatic. Fertility is not affected in women with uterus didelphys, but those who are pregnant are at risk for preterm delivery and malpresentation needing cesarean section for delivery.

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  1. Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7(2):161–74.

    Article  CAS  PubMed  Google Scholar 

  2. Heinonen PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand. 1982;61(2):157–62.

    Article  CAS  PubMed  Google Scholar 

  3. Buttram VC. Müllerian anomalies and their management. Fertil Steril. 1983;40(2):159–63.

    Article  PubMed  Google Scholar 

  4. Vercellini P, Daguati R, Somigliana E, Viganò P, Lanzani A, Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil Steril. 2007;87(4):719–24.

    Article  PubMed  Google Scholar 

  5. Lin PC. Reproductive outcomes in women with uterine anomalies. J Womens Health. 2004;13(1):33–9.

    Article  Google Scholar 

  6. Humphries PD, Simpson JC, Creighton SM, Hall-Craggs MA. MRI in the assessment of congenital vaginal anomalies. Clin Radiol. 2008;63(4):442–8.

    Article  CAS  PubMed  Google Scholar 

  7. Heinonen PK. Clinical implications of the didelphic uterus: long-term follow-up of 49 cases. Eur J Obstet Gynecol Reprod Biol. 2000;91(2):183–90.

    Article  CAS  PubMed  Google Scholar 

  8. Stassart JP, Nagel TC, Prem KA, Phipps WR. Uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis: the University of Minnesota experience. Fertil Steril. 1992;57(4):756–61.

    Article  CAS  PubMed  Google Scholar 

  9. Pellerito JS, McCarthy SM, Doyle MB, Glickman MG, DeCherney AH. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology. 1992;183(3):795–800.

    Article  CAS  PubMed  Google Scholar 

  10. Raga F, Bonilla-Musoles F, Blanes J, Osborne NG. Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound. Fertil Steril. 1996;65(3):523–8.

    Article  CAS  PubMed  Google Scholar 

  11. Deutch TD, Abuhamad AZ. The role of 3-dimensional ultrasonography and magnetic resonance imaging in the diagnosis of Müllerian duct anomalies: a review of the literature. J Ultrasound Med. 2008;27(3):412–23.

    Article  Google Scholar 

  12. Bermejo C, Ten Martínez P, Cantarero R, Diaz D, Pérez Pedregosa J, Barrón E, Labrador E, Ruiz López L. Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol. 2010;35:593–601.

    Article  CAS  PubMed  Google Scholar 

  13. Ghi T, Casdio P, Kuleva M, et al. Accuracy of three-dimensional ultrasound in diagnosis and classification of congenital uterine anomalies. Fertil Steril. 2009;92:808–13.

    Article  PubMed  Google Scholar 

  14. Bocca S, Oehinger S, Stadtmauer L, et al. A study of the cost, accuracy, and benefits of 3-dimensional sonography compared with hsyterosalpinography in women with uterine abnormalities. J Ultrasound Med. 2012;31:81–5.

    Article  PubMed  Google Scholar 

  15. Moini A, Mohammadi S, Hosseini R, Eslami B, Ahmadi F. Accuracy of 3-dimensional sonography for diagnosis and classification of congenital uterine anomalies. J Ultrasound Med. 2013;32(6):923–7.

    Article  PubMed  Google Scholar 

  16. Wu MH, HSU CC, Huang KE. Detection of congenital Müllerian duct anomalies using three-dimensional ultrasound. J Clin Ultrasound. 1997;25:487–92.

    Article  CAS  PubMed  Google Scholar 

  17. Steinberg W. Strassmann’s metroplasty in the management of bipartite uterus causing sterility or habitual abortion. Obstet Gynecol Surv. 1955;10:400–30.

    Article  CAS  PubMed  Google Scholar 

  18. Fedele L, Amberletti D, Alberton A, Vercellin P, Candiani G. Gestational aspects of uterus didelphys. J Reprod Med. 1988;33(4):353–5.

    CAS  PubMed  Google Scholar 

  19. Heinonen P. Uterus Didelphys: a report of 26 cases. Eur J Obstet Gynecol Reprod Biol. 1984;16(5):345–50.

    Article  Google Scholar 

  20. Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine-Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol. 2011;38:371–82.

    Article  CAS  PubMed  Google Scholar 

  21. Venetis CA, Papadopoulos SP, Campo R, Gordts S, Tarlatzis BC, Grimbizis GF. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod Biomed Online. 2014;29:665–83.

    Article  PubMed  Google Scholar 

  22. Hoffman B, Schorge J, Schaffer J, Halvorson L, Bradshaw K, Cunningham G. Anatomic disorders. 2nd ed. New York: McGraw-Hill; 2012.

    Google Scholar 

  23. Hua M, Odibo AO, Longman RE, Macones GA, Roehl KA, Cahill AG. Congenital uterine anomalies and adverse pregnancy outcomes. Am J Obstet Gynecol. 2011;205:558.e1–5.

    Article  Google Scholar 

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Correspondence to Joseph S. Sanfilippo MD, MBA .

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Sanfilippo, J.S., Peticca, K. (2016). Uterus Didelphys: Diagnosis, Treatment, and Impact on Fertility and Reproduction. In: Pfeifer, S. (eds) Congenital Müllerian Anomalies. Springer, Cham.

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