Uterus Didelphus

Abstract

INTRODUCTION Uterus didelphus is a rare             disorder due to failure of lateral fusion of Mullerian ducts. The Mullerian ducts are ordinarily pulled together by subperitoneal fibromuscular tissue at 12th and 16th week of pregnancy, and it is suggested that a defect in this, is a cause of uterovaginal malformations. It may be associated with renal agenesis and transverse vaginal septum .CASE REPORT The American Fertility Society classifies the didelphic uterus as class iii  Mullerian anomaly. Various signs symptoms of uterus            didelphus depends on the age of presentation. It can be an incidental finding, hematocolpos in adolescence and during child bearing age as dysmennorhea, dyspaurenia,                hypertension, recurrent spontaneous abortions, and             malpresentations during labour. Here I am presenting a case ofdidelphic uterus with asymmetric obstruction of vagina with unilateral renal agenesis presented with haematocolpos in adolescence. Diagnostic methods include                          Hysterosalphingogram, ultrasound, ultrasound with                    transvaginal transducers. M.R.I is a useful complementary tool for assessing urogenital anomalies when ultrasonography is inconclusive. Ultrasonogram is the method of choice for screening uterovaginal anomalies, and diagnosis is to be confirmed by demonstrating two separate cervical              endometrial canals. CONCLUSION As congenital disorders of development are more common than previously reported because of the use of sophisticated instruments, and correct diagnosis can help to ally patients anxiety to conceive, and to

formulate appropriate therapeutic plan by the Gynecologist, like resection of vaginal septum, hysteroscopic or                      transabdominal metroplasty depending on the anatomic           features of the cervix and the uterine cavity.