A CASE OF PREGNANCY AND SPONTANEOUS VAGINAL DELIVERY IN A PATIENT WITH UTERUS DIDELPHYS AND INTRAUTERINE DEVICE IN SITU
DOI:
https://doi.org/10.67214/gtc9bw07Keywords:
Müllerian duct anomaly and pregnancy, pregnancy and IUDAbstract
Uterus didelphys, a rare congenital Müllerian duct anomaly, presents unique challenges for reproductive management, especially when long-acting reversible contraceptives, such as in- trauterine devices (IUDs), are used. Uterus didelphys is characterized by two separate uterine cavities, which may decrease IUD efficacy and elevate the risk of unintended pregnancy. This case report details a patient with a uterus didelphys and an IUD in situ who achieved a full-term, spontaneous vaginal delivery. The anomaly was discovered only after the patient presented with pregnancy, underscoring the importance of pre-insertion imaging for women with a clinical history suggestive of uterine anomalies. The advanced imaging modalities, such as ultrasound, saline infusion sonography (SIS) and three-dimensional ultrasound, are essential for accurately identifying Müllerian anomalies to guide appropriate contraceptive counseling and reproduc- tive care. This case highlights the need for individualized approaches in the management of pregnancies with Müllerian duct anomalies and the potential for favorable outcomes. Given the scarcity of reports on pregnancies with uterus didelphys and concurrent IUD use, our findings contribute valuable insights into the effective management of reproductive anomalies and em- phasize the critical role of comprehensive imaging before IUD placement.
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