Abstract
Müllerian duct anomalies (MDAs) are congenital uterine abnormalities resulting from incorrectly developed Müllerian ducts. Uterus didelphys is an uncommon MDA linked to fetal growth restriction, dysmenorrhea, dyspareunia, and higher rates of infertility. We present an unusual case of a 21-year-old woman who presented at the emergency room with no previous history of medical illness. An ultrasound report showed her uterus with an irregular shape. An official departmental scan indicated an anteverted, bicornuate uterus harboring a normal-looking intrauterine gestational sac and a 2.5 cm cervical length. Because of this borderline cervical length and the associated anomaly, the patient was scheduled for an elective cervical cerclage. Before starting the procedure, the patient was found to have a thick longitudinal vaginal septum and the cervix could not be evaluated for which the procedure was halted and the patient kept on progesterone. Elective cesarean surgery (LSCS, lower-section cesarean surgery) at 37 weeks of gestation was arranged due to the previous findings and breech presentation. During the LSCS, the examination revealed the presence of two non-communicating uteri, two cervical canals, and two separate vaginas dividing the introitus into two distinct openings. Diagnostic modalities such as magnetic resonance imaging (MRI), hysteroscopy, laparoscopy, hysterosalpingogram, and ultrasound (USG) are necessary for precise diagnosis of uterine didelphys. This case highlights that with careful prenatal and intrapartum supervision good pregnancy outcomes can be achieved in a uterine didelphic condition.