A woman with uterus didelphys is born with two uteruses, two cervices, and two vaginas. This condition is very rare and can be a cause of infertility. It is possible for a woman with this type of uterine malformation to become pregnant and carry a baby to term, but there is an increased risk of complications. These can include miscarriage, incompetent cervix, premature birth, improper positioning of the baby, and uterine rupture. During pregnancy, a woman with uterus didelphys is typically closely monitored by her doctor.
Most women with this condition are not aware of it unless they have a problem carrying a baby to term. One of the most common pregnancy concerns when uterus didelphys is involved is miscarriage. Studies have estimated that women with double uteruses have miscarriage rates of 43% compared to a miscarriage rate of 25% in women without the condition.
As a pregnancy progresses, a woman with this condition may become concerned about the health of the cervix associated with the uterus carrying the fetus. An incompetent cervix dilates prematurely, which can lead to a miscarriage or pre-term labor. A doctor treating a woman with an incompetent cervix may recommend bed rest or placing a cerclage on the cervix to keep it closed.
The size and shape of the double uteruses make premature labor and birth a concern during pregnancy. The average gestational period of a baby born to a woman with this condition is 35 weeks, compared to the typical 40-week gestation of a normal pregnancy. Premature birth can lead to complications in the baby, so it is recommended that a woman with double uteruses give birth in a hospital with neo-natal intensive care facilities.
Another concern in regard to the size and shape of the uteruses is the position of the baby in utero. In a normal pregnancy, a baby is positioned with its head down shortly before birth. Pregnancies in which a woman has uterus didelphys have a high rate of fetal malpositioning. It is estimated that in 27% of these pregnancies, the fetus is in the breech position with the buttocks presenting first. Most doctors believe that the safest way to deliver a breech baby is via Cesarean section, which has its own set of risks and concerns.
While very rare, it is possible for the uterus to rupture during pregnancy. A uterine rupture is very serious and can be fatal to both the mother and the baby. This occurs at a slightly higher rate in a woman with uterine abnormalities, such as uterus didelphys. It is speculated that this may be due to the fact that abnormal uteruses tend to have thinner than normal walls as the pregnancy progresses.