Uterus Didelphys

Overview

What is uterus didelphys?

Uterus didelphys is a rare condition where a person develops two uteruses. It’s also called a double uterus. A double uterus is a congenital abnormality that you are born with. Your two uterine cavities are narrower than the cavity of a typical uterus. Each uterus has its own fallopian tube and ovary.

A uterus starts as two ducts. As an unborn baby (fetus) develops, these ducts join together to create the uterus. Your uterus is one hollow organ and looks like an upside-down pear. If you have uterus didelphys, the two ducts don’t join together. Instead, each duct creates its own uterus, which means you have two. Some people with a double uterus may also have two cervixes and two vaginal canals. Instead of having a pear-shaped uterus, if you have uterus didelphys, your uteruses resemble bananas.

How common is uterus didelphys?

Uterus didelphys is rare and only affects about 0.3% of the population. It’s one of the least common uterine abnormalities.

What is the difference between bicornuate uterus and uterus didelphys?

A bicornuate uterus is a heart-shaped uterus. You still have one uterus, but instead of being pear-shaped, it’s shaped like a heart. If you have uterus didelphys, there are two separate uteruses. A bicornuate uterus is more common than uterus didelphys. Like uterus didelphys, a bicornuate uterus is congenital, meaning you are born with it. Both conditions can cause complications during pregnancy.

Does uterus didelphys affect pregnancy?

Yes, uterus didelphys can impact your pregnancy. People with a double uterus are at increased risk for miscarriage and preterm birth but can have healthy pregnancies.

Symptoms and Causes

What are the symptoms of uterus didelphys?

Most people don’t know they have uterus didelphys because it doesn’t cause any symptoms. Instead, it’s discovered during a routine pelvic exam or during investigation for recurrent miscarriages or severe menstrual pain.

If you’re experiencing symptoms from uterus didelphys, you might have:

  • Pain during sex.
  • Painful cramping before and during your period.
  • Heavy bleeding during your period.
  • Leaking blood when using a tampon (tampon is only in one uterus and not the other).
  • Frequent miscarriages.
  • Preterm labor.

What causes a uterus didelphys?

Uterus didelphys occurs when two ducts (the Mullerian ducts) don’t fuse properly during development. These ducts usually join to create one uterus. If you have a double uterus, the ducts didn’t join and each duct turned into its own uterus. Some people will also have two vaginas and two cervixes. Healthcare providers aren’t entirely sure why Mullerian ducts fail to fuse in some people.

How does uterus didelphys affect periods?

Your period can be affected by uterus didelphys in one or all of the following ways:

  • Very heavy or abnormal bleeding during menstruation.
  • Painful periods.
  • Pelvic cramping and pressure.
  • Difficulty using tampons.

Diagnosis and Tests

How is uterus didelphys diagnosed?

Your healthcare provider may diagnose a double uterus during a routine pelvic exam after feeling two cervixes or two vaginas. They’ll likely order additional imaging tests to confirm uterus didelphys.

What tests will be done to diagnose uterus didelphys?

Imaging tests will be used to further examine the size and shape of your double uterus and confirm the diagnosis. Some tests your healthcare provider will recommend are:

  • Ultrasound. Your healthcare provider will get images of your uterus with an abdominal or transvaginal ultrasound. A transvaginal ultrasound is when a wand is inserted into your vagina.
  • Magnetic resonance imaging (MRI). MRI scanners produce high-quality images of your uterus using a magnetic field and radio waves.
  • Sonohysterogram. Your provider inserts a thin catheter into each uterus and injects saline into the cavity. Then, they perform a transvaginal ultrasound to get images of the cavity as the fluid travels through your cervix and into your uterus.
  • Hysterosalpingography. A special dye is inserted into each uterus. Then, your provider uses X-ray to get images as the dye moves through your cervix and into your uterus.

Management and Treatment

Can a uterus didelphys be fixed?

Yes, uterus didelphys can be fixed. Most healthcare providers don’t recommend treating a double uterus unless you experience symptoms like repeat late pregnancy loss. Surgery to merge the uteruses can weaken your remaining uterus. If you have painful intercourse, the associated longitudinal vaginal septum (resulting in two vaginas) can be removed surgically.

Care at Cleveland Clinic

Prevention

How can I prevent uterus didelphys?

You can’t prevent uterus didelphys because it’s congenital, which means it formed during development in the womb. Healthcare providers do not know why uterine abnormalities happen or if it’s hereditary.

Outlook / Prognosis

Can uterus didelphys cause infertility?

Uterus didelphys can cause infertility in some people. In most cases, the shape of your uterus doesn’t prevent you from conceiving or getting pregnant. However, it does increase your risk for miscarriage.

Will I have a miscarriage if I have uterus didelphys?

You will not have a miscarriage just because you have a double uterus. However, your chance of miscarriage is slightly higher. This is because your uterus is smaller, which restricts the growth of the fetus. The atypical shape can also affect the placenta and the blood flow within your uterus. If you have repeat late second trimester miscarriages, your healthcare provider may suggest surgery to fix your double uterus. Surgical treatment may increase your chances for a full-term pregnancy.

Can a woman with two uteruses get pregnant?

Yes, you can get pregnant if you have uterus didelphys. Your healthcare provider will monitor your pregnancy closely to ensure you and your baby are healthy. You’re at an increased risk for several pregnancy complications.

What are the pregnancy complications of a uterus didelphys?

You are at greater risk for pregnancy complications if you have a double uterus.

The pregnancy complications associated with a double uterus are:

  • Miscarriage.
  • Early labor.
  • Breech babies.
  • Cesarean birth.
  • Low birth weight.
  • Growth restriction.
  • Torn vaginal septum at the time of vaginal delivery.

Many people with a double uterus carry healthy babies to term. Talk to your healthcare provider about any concerns you have to make sure you receive the care you need.

Living With

Are there health risks associated with uterus didelphys?

Most people who have a double uterus lead healthy lives and don’t have any significant health complications. The following risks are associated with a double uterus:

  • Complications during pregnancy including miscarriage and premature birth.
  • Increased risk for cesarean section due to because your baby isn’t well positioned for birth.
  • Heavy menstrual bleeding.
  • Mispositioned or missing kidney.

What questions should I ask my doctor about uterus didelphys?

If you’re diagnosed with a double uterus, some questions you might ask are:

  • What is the cause of my double uterus?
  • What treatment do you recommend?
  • Can I still have a healthy pregnancy?
  • What can I do to increase my chances of a successful pregnancy?
  • Should I have surgery before I get pregnant?
  • Are there any other health concerns I should be aware of?

A note from Cleveland Clinic

Uterus didelphys is a condition that happens before you’re born and isn’t caused by anything you did wrong. If you’re pregnant or wish to become pregnant, talk to your healthcare provider about your condition to make sure you can have a safe pregnancy. They may recommend treating your double uterus. Many people with this condition have healthy pregnancies and babies.

Last reviewed by a Cleveland Clinic medical professional on 06/19/2022.

References

  • Boehnke M, et al. Uterine didelphys with concomitant renal anomalies in both mother and fetus. Journal of Pediatric Surgery Case Reports. 2016;14:19-21. Accessed 6/19/2022.
  • Pui MH. Imaging diagnosis of congenital uterine malformation. Computerized Medical Imaging and Graphics. 2004:28(7):425-433. Accessed 6/19/2022.
  • Rezai S, et al. Didelphys uterus: A case report and review of the literature. (https://www.hindawi.com/journals/criog/2015/865821/) Accessed 6/19/2022.
  • Slavchev S, Kostov S, Yordanov A. Pregnancy and Childbirth in Uterus Didelphys: A Report of Three Cases. Medicina (Kaunas). 2020;56(4):198. Accessed 6/19/2022.

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