What is the Didelphe uterus that can lead to cross pregnancies?

Several cases of women with crossover pregnancies have been reported in the scientific literature. You have an extremely rare deformity called a “double” uterus. What is the didelphic uterus?

An American woman gave birth to two babies in less than a year in 2021, reports The Body Optimist; In 2019, a 20-year-old Bangladeshi woman gave birth to twins a month after her first preterm birth, Le Figaro explains; As late as 2019 in the US, a woman had a twin pregnancy with two babies, each in one womb, Le Monde illustrates. All these women have one thing in common: a uterus divided into two cavities that can alternately or simultaneously house babies. This extremely rare malformation is called the didelphic uterus. It has several names, we also speak of a complete bicornuate uterus. Explanations.

Where does the didelphic uterus come from?

During the formation of the fetus, genital tracts, then called the Mullerian ducts, must converge to form a uterus with a single cavity connected to a vagina. But sometimes things don’t go as planned and paths don’t lead together. Fact, The uterus forms in two parts with a separation between the cavities. These two pathways can be connected to a single vagina, but there can also be two vaginas and a single cervix.

The prevalence of this malformation is difficult to establish, but it is estimated to affect between 0.3% and 2.9% of women who consult for difficulties conceiving.

pregnancy risks

The uterus is didelphea often associated with a infertility problem, it makes pregnancy more difficult, the chances of carrying the pregnancy to term are “significantly reduced”, according to Orphanet. The risk of giving birth to a premature or stunted baby is greater.

That means pregnancy is possible. The rarest is a twin pregnancy in one uterus and a singleton pregnancy in the other, there are 5 in all medical literature. According to the blog Réalité biomédicale du Monde, twin pregnancies do not exceed 20 cases. In any case, pregnancies with a didelphic uterus require careful monitoring.

How do you recognize it?

A didelphic uterus can go undetected for a long time because most women do not have symptoms when they are young or when they are alive. The signs that can alert and enable investigations are menstrual pain significant or intense bleeding. The pain could be explained by the presence of endometriosis, which can be associated with it, explains Belen Moliner, a doctor specializing in reproductive medicine at the Instituto Bernabeu. To find out, we can practice a three-dimensional ultrasound or MRI.

Some publications indicate that it can be treated that the two parts of the uterus can be reunited through surgery, i.e. a “complete resorption of the vaginal septum, which allows the continuous drainage of menstrual retention,” explains The Pan African Medical Log . But the gynecologist from the Instituto Bernabeu specifies: “There is currently no indication for this operation.because no meta-analysis or well-designed study has shown that it improves the clinical condition of the patient compared to use without treatment.”

Sources : Le Figaro, Biomedical reality Le Monde, Orpahnet, Instituto Bernabeu, The Pan African Medical Journal, The Body Optimist.

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