A Case Report on an 18-Year-Old Primigravida Patient With Uterine Didelphys

Abstract

We present a case of an 18-year-old primigravida who presented to labor and delivery at 41 weeks and 3 days, admitted for induction of labor at late term. During her antepartum course, the patient was suspected to have a uterine anomaly, bicornuate vs. uterine didelphys, given the findings during her first trimester ultrasound. The patient was eventually taken for primary cesarean section for category 2 fetal heart tracings after being admitted for induction of labor. After delivery of the fetus and closure of the hysterotomy, patient was noted to have severe uterine atony, requiring massive transfusion protocol and cesarean hysterectomy with a total estimated blood loss of 6,680 cc. This was an interesting case due to the confirmation of the Mullerian anomaly found intraoperatively, and the adverse outcome for the young patient who required a hysterectomy for life-saving measures. Based on literature review, and in consideration of this case, we suggest if suspicion of a Mullerian anomaly in the antepartum period, a full evaluation of the anomaly be performed along with a plan for delivery.