Successful delivery of a twin pregnancy in a patient with a rare genital malformation
- Autores: Sukhanov A.A.1,2, Obryadov M.A.2, Dikke G.B.3, Kukarskaya I.I.1,2
-
Afiliações:
- Perinatal Medical Center
- Tyumen State Medical University, Ministry of Health of Russia
- F.I. Inozemtsev Academy of Medical Education
- Edição: Nº 11 (2023)
- Páginas: 205-210
- Seção: Clinical Notes
- URL: https://journals.eco-vector.com/0300-9092/article/view/626148
- DOI: https://doi.org/10.18565/aig.2023.246
- ID: 626148
Citar
Texto integral
Acesso aberto
Acesso está concedido
Acesso é pago ou somente para assinantes
Resumo
Background: Pregnancy in patients with uterine malformations such as complete intrauterine septum with duplicated cervix is rare and it is associated with the risk of complications. There is no unified guidance on the management and delivery.
Case report: A 35-year-old female patient with a complete intrauterine septum and duplicated cervix had her third twin pregnancy (in each uterus) with the help of assisted reproductive technologies (ART). The woman had a previous history of two miscarriages and secondary infertility. There was a threat of miscarriage at 14–15 weeks gestation, the pregnancy was prolonged to 34 weeks 4 days. A cesarean section was performed after premature rupture of the membranes. The woman gave birth to live premature babies: a female with a weight of 2172 g and height of 46 cm long, and a male with a weight of 2416 g and height of 50 cm; they were both in a satisfactory condition.
Conclusion: This is an extremely rare clinical case when a woman with a complete intrauterine septum, duplicated cervix, and a history of habitual miscarriage becomes pregnant with twins after ART. The favorable outcome of this pregnancy is determined by accurate interpretation of the ultrasound image and the correct sequence of actions during pregnancy for prolongation and delivery.
Texto integral
Sobre autores
Anton Sukhanov
Perinatal Medical Center; Tyumen State Medical University, Ministry of Health of Russia
Autor responsável pela correspondência
Email: such-anton@yandex.ru
ORCID ID: 0000-0001-9092-9136
PhD, Head of the Department of Gynecology, Perinatal Center, Associate Professor, Department of Obstetrics and Gynecology
Rússia, 1 Daudelnaya str., Tyumen, 625002; 54, Odesskaya str., Tyumen, 625023Mikhail Obryadov
Tyumen State Medical University, Ministry of Health of Russia
Email: mikhail-obryadov@mail.ru
ORCID ID: 0009-0009-8518-1800
student of the Pediatric Faculty
Rússia, 54, Odesskaya str., Tyumen, 625023Galina Dikke
F.I. Inozemtsev Academy of Medical Education
Email: galadikke@yandex.ru
ORCID ID: 0000-0001-9524-8962
Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology with a Course of Reproductive Medicine
Rússia, 22 liter M, Moskovsky Prospect, St. Petersburg, 190013Irina Kukarskaya
Perinatal Medical Center; Tyumen State Medical University, Ministry of Health of Russia
Email: such-anton@yandex.ru
ORCID ID: 0000-0002-8275-3553
Dr. Med. Sci., Associate Professor, Head of the Department of Obstetrics, Gynecology and Perinatology, Institute of Maternity and Childhood, Chief Specialist in Obstetrics and Gynecology, Department of Health of the Tyumen Region
Rússia, 1 Daudelnaya str., Tyumen, 625002; 54, Odesskaya str., Tyumen, 625023Bibliografia
- Nappi L., Meccariello G., Cazzato L., Barone I., Greco P. Spontaneous dichorionic diamniotic twin pregnancy in bicornis unicollis uterus. Eur. J. Obstet. Gynecol. Reprod Biol. 2015; 191: 142-3. https://dx.doi.org/10.1016/j.ejogrb.2015.05.001.
- King A.L., Pixton S., Lanzarone V. Uterine didelphys with dicavitary twin gestation: a case report. Case Rep. Womens Health. 2020; 27: e00199. https://dx.doi:/10.1016/j.crwh.2020.e00199.
- Kaur K.K., Allahbadia G., Singh M. An update on the advances in classification as well as reproductive surgeries in Mullerian anomalies - a systematic review. Am. J. Surg. Tech. Case Rep. 2020;1(1):1002.
- Al Yaqoubi H.N., Fatema N. Successful vaginal delivery of naturally conceived dicavitary twin in didelphys uterus: a rare, reported case. Case Rep. Obstet. Gynecol. 2017; 2017: 7279548. https://dx.doi.org/10.1155/2017/7279548.
- Makiyan Z. Systematization for female genital anatomic variations. Clin. Anat. 2021; 34(3): 420-30. https://dx.doi.org/10.1002/ca.23668.
- Chemlal C., El Amouri I., Tanouti S., Taheri H., Saadi H., Mimouni A. Spontaneous twin pregnancy in uterus bicornis unicollis complicated with preeclampsia: а case report. Int. J. Surg. Case Rep. 2022; 92:106899. https://dx.doi.org/10.1016/j.ijscr.2022.106899.
- Bhagavath B., Ellie G., Griffiths K.M., Winter T., Alur-Gupta S., Richardson C., Lindheim S.R. Uterine malformations: аn update of diagnosis, management, and outcomes. Obstet. Gynecol. Surv. 2017; 72(6): 377-92. https://dx.doi.org/10.1097/OGX.0000000000000444.
- Ani E.O., Ugwa E.A., Taiye A.B., Agbor I.E., Suleiman I.S. Simultaneous pregnancy in each uterine cavity of a double uterus in a young Nigerian multipara who presented with a retained second twin following an unsupervised preterm labor at home; case report. Int. J. Surg. Case Rep. 2018; 42: 224-6. https://dx.doi.org/10.1016/j.ijscr.2017.11.068.
- Karunaratne M., Melber D.J., Su H.I., Ramos G.A. Dicavitary twin pregnancy in patient with bicornuate bicollis uterine anomaly. Clin. Case Rep. 2023; 11: e7440. https://dx.doi.org/10.1002/ ccr3.7440.
- Arora M., Gupta N., Neelam N., Jindal S. Unique case of successful twin pregnancy after spontaneous conception in a patient with uterus bicornis unicollis. Arch. Gynecol. Obstet. 2007; 276(2): 193-5. https://dx.doi.org/10.1007/s00404-007-0323-7.
- Doruk A., Gozukara I., Burkaş G., Bilik E., Dilek T.U. Spontaneous twin pregnancy in uterus bicornis unicollis. Case Rep. Obstet. Gynecol. 2013; 2013: 834952. https://dx.doi.org/10.1155/2013/834952.
- Шибельгут Н.М., Батина Н.А., Елгина С.И., Мозес В.Г., Рудаева Е.В., Железная А.А. Течение беременности и родов при аномалии развития половых органов (двурогой матке). Мать и Дитя в Кузбассе. 2022; 2(89): 56-61. [Shibelgut N.M., Batina N.A., Elgina S.I., Mozes V.G., Rudaeva E.V., Zheleznaya A.A. The course of pregnancy and childbirth with abnormal development of the genitals (two-horned uterus). Mother and Child in Kuzbass. 2022; 2(89): 56-61 (in Russian)]. https://dx.doi.org/10.24412/2686-7338-2022-2-56-61.
- Chan Y.Y., Jayaprakasan K., Zamora J., Thornton J.G., Raine-Fenning N., Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum. Reprod. Update. 2011; 17(6): 761-71. https://dx.doi.org/10.1093/humupd/ dmr028.
- Tsukuda L.K., Lorenzon A.R., Bonetti T.C., Serafini P.C., Motta E., Pereira R.M., Domingues T.S. Two successful spontaneous pregnancies, single and twin, in uterus bicornis unicollis after deep infiltration endometriosis surgery. JBRA Assist. Reprod. 2020; 24(3): 387-90. https://dx.doi.org/10.5935/ 1518-0557.20200019.
- Adeyemi A.S., Atanda O.O., Adekunle A.D. Successful pregnancy in one horn of a bicornuate uterus. Ann. Afr. Med. 2013; 12(4): 252-4. https://dx.doi.org/10.4103/1596-3519.122696.
- Han J.H., Lee Y.S., Im Y.J., Kim S.W., Lee M.J., Han S.W. Clinical implications of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome in the prepubertal age group. PLoS One. 2016; 11(11): e0166776. https://dx.doi.org/10.1371/journal. pone.0166776.
- Reichman D.E., Laufer M.R. Congenital uterine anomalies affecting reproduction. Best Pract. Res. Clin. Obstet. Gynaecol. 2010; 24(2): 193-208. https://dx.doi.org/10.1016/j.bpobgyn.2009.09.006.
- Цхай В.Б., Базина М.И., Лобанова Т.Т. Вероятность успешного течения двухплодной беременности одновременно в двух матках при врожденной аномалии – полном удвоении матки. Акушерство и гинекология. 2018; 11: 166-70. [Tskhay V.B., Bazina M.I., Lobanova T.T. The likelihood of a successful simultaneous twin pregnancy in two wombs in the congenital anomaly complete double uterus. Obstetrics and Gynecology. 2018;(11):166-70 (in Russian)]. https://dx.doi.org/10.18565/aig.2018.11.166-170.
Arquivos suplementares
