Didelphic uterus

Uterus didelphys (sometimes also uterus didelphis) represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Uterus didelphys (sometimes also uterus didelphis) represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. Most non-human mammals do not have a single uterus with no separation of horns. Marsupials and rodents have a double uterus (uterus duplex). In other animals (e.g. nematodes), the term 'didelphic' refers to a double genital tract, as opposed to monodelphic, with a single tract. Persons with the condition may be asymptomatic and unaware of having a double uterus. However, a study by Heinonen showed that certain conditions are more common. In his study of 26 women with a double uterus gynecological complaints included dysmenorrhea and dyspareunia. All patients displayed a double vagina. The fetal survival rate in 18 patients who delivered was 67.5%. Premature delivery occurred in 21% of the pregnancies. Breech presentation occurred in 43% of women and cesarean section was performed in 82% of the cases. The uterus is formed during embryogenesis by the fusion of the two paramesonephric ducts (also called Müllerian ducts). This process usually fuses the two Müllerian ducts into a single uterine body but fails to take place in these affected women who maintain their double Müllerian systems. A didelphic uterus will have a double cervix and is usually associated with a double vagina. The cause of the fusion failure is not known. Associated defects may affect the vagina, the renal system and, less commonly, the skeleton. The condition is less common than these other uterine malformations: arcuate uterus, septate uterus, and bicornuate uterus. It has been estimated to occur in 1/3,000 women. A specific association of uterus didelphys (double uterus), unilateral hematocolpos (inadequate draining of menstrual blood) and ipsilateral renal agenesis (having only one kidney) has been described.