Uterine Didelphys Pregnancy Management | Chapter 10 | New Insights into Disease and Pathogen Research Vol. 2
Introduction:
Didelphys uterus is a rare Mullerian duct abnormality, which affects 1-3 in
3000 women worldwide. It is usually asymptomatic. There are many patients with
this condition in Saudi Arabia, and this compelled us to study this condition.
Aims: To describe the management and
outcomes of pregnant women diagnosed with uterus didelphys.
Study Design: This is a multicenter
prospective cohort study.
Place and Duration of Study: This
study was conducted in Saudi Arabia in 4 cities; 8 hospitals over a period of five
years.
Methodology: 286 patients were
enrolled in this study, all diagnosed previously to have didelphys uterus,
pregnant and willing to join, follow up and deliver in one of the research
hospitals. Patients consented to join the search and every 2 weeks follow up
and management was done accordingly.
Results: 15 (5.2%) patients aborted
during the first half of the pregnancy. 139 (48.6%) patients had cervical
cerclage done. 79 (27.6) patients had preterm labor which was managed
conservatively. 231 (80.8%) patients delivered by cesarean section and 17
(5.9%) delivered spontaneous vaginal delivery. Added to that, 38 (13.3%) had
operative vaginal delivery. 271 neonates delivered. Unfortunately, three (1.1%)
had intrauterine fetal death (IUFD) at 30-32 weeks of gestational age due to
multiple congenital anomalies. All remaining neonates were normal and healthy
except 25 (9.2%) who were admitted to NICU for various causes, but eventually
discharged in good condition.
Conclusion: Antenatal care in
patients with uterine didelphys is challenging, but given proper care, they can
compete pregnancy with good neonatal outcome. Preterm labor and operative
deliveries in the form of cesarean section and instrumental delivery were found
to be high though.
Author(s) Details
Dr. Mohammad Othman
Department of Obstetrics and
Gynecology, Faculty of Medicine, Al-Baha University, Saudi Arabia.
Comments
Post a Comment