Abstract
INTRODUCTION: Uterus didelphys is a congenital Müllerian anomaly characterized by the presence of two separate uteri and two cervixes. It is associated with an increased risk of pregnancy complications, including miscarriage, malpresentation, and labor dystocia. CASE PRESENTATION: A 39-year-old gravida 3, para 2, living 2, at 39 weeks of gestation with two previous cesarean sections, presented in labor before her planned elective cesarean delivery. She was incidentally diagnosed with uterus didelphys during her first pregnancy after experiencing poor labor progression, leading to an emergency cesarean section. In this pregnancy, she initiated antenatal care at 12 weeks and attended seven routine visits, all of which were unremarkable. She underwent an emergency cesarean section and delivered a live male neonate weighing 3.26 kg with good Apgar scores. Her postoperative course was uneventful, and she was discharged in stable condition after 72 h of observation. DISCUSSION: Uterus didelphys is associated with an increased risk of adverse pregnancy outcomes, including recurrent pregnancy loss, fetal malpresentation, and the need for cesarean delivery. The successful maternal and neonatal outcomes highlight the importance of early diagnosis, close antenatal monitoring, and timely delivery planning in patients with congenital uterine anomalies. CONCLUSION: This case underscores the significance of early diagnosis and meticulous antenatal surveillance in women with congenital uterine anomalies. Although a didelphic uterus presents challenges in pregnancy management, appropriate obstetric care and timely surgical intervention can lead to favorable maternal and neonatal outcomes.