حاملگی موفق در رحم دی‌دلفیس: گزارش موردی

نوع مقاله : گزارش مورد

نویسندگان

1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دستیار زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: رحم دی‌دلفیس از جمله موارد نادر ناهنجاری‌های مولرین می‌باشد که در اغلب موارد تا زمان بارداری و زایمان بدون علامت باقی می‌ماند. در بیماران با ناهنجاری‌های مولرین، بارداری و زایمان با عوارض بیشتری نظیر زایمان زودرس همراهی دارد که نیازمند نظارت بیشتر بر این بارداری‌ها می‌باشد. بیشتر موارد بارداری در رحم دی‌دلفیس در رحم سمت چپ گزارش شده است. از روش‌های سونوگرافی و MRI می­توان برای تشخیص آن استفاده کرد.
معرفی بیمار: بیمار، خانمی 21 ساله با سابقه دیسپارونی و یک نوبت سقط خود‌به‌خود و با بارداری کنونی 38 هفته بود که به‌دلیل آبریزش و درد زایمان به زایشگاه مراجعه نموده بود و در معاینه واژینال سپتوم طولی واژن تشخیص داده شد. بیمار به‌دلیل مایع آمنیوتیک مکونیال غلیظ دور از زایمان سزارین شد و نوزاد سالم و ترم متولد شد. رحم دی‌دلفیس و جنین در حفره راست بود.
نتیجه‌گیری: علی‌رغم زیاد بودن عوارض بارداری در حاملگی‌های همراه با ناهنجاری مولرین، گاهی این حاملگی‌ها بدون عارضه تا ترم ادامه می‌یابد.
کلمات کلیدی: بارداری، رحم دی‌دلفیس، ناهنجاری‌های مولرین

کلیدواژه‌ها

عنوان مقاله [English]

Successful pregnancy in Didelphys uterus: a case report

نویسندگان [English]

  • Laya Shirinzadeh 1
  • Maliheh Rakhshanifar 2
1 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
چکیده [English]

Introduction: Didelphys uterus is one of the rare cases of mullerian anomalies that in most cases, remains asymptomatic until pregnancy and delivery. In women with mullerian anomalies, pregnancy and delivery are associated with more complications such as preterm labor that requires more attention to such pregnancies. Most cases of pregnancies in Didelphys uterus are reported in the left cavity. Ultrasound and MRI can be used to diagnose it.
Case presentation: The patient was a 21 year old female with history of dyspareunia and one spontaneous abortion at 38 weeks of pregnancy who referred to the maternity complaining of amniotic fluid leakage and labor pain. Longitudinal vaginal septum was diagnosed during the vaginal examination. The patient underwent a cesarean section due to thick meconium-stained amniotic fluid far from delivery and a healthy term baby was born. Didelphys uterus was seen and the fetus was in the right cavity.
Conclusion: Despite the high incidence of pregnancy complications in pregnancies with mullerian anomalies, sometimes these pregnancies continue without complications until term.

کلیدواژه‌ها [English]

  • Didelphys uterine
  • Mullerian anomalies
  • Pregnancy

مراجع

  1. Rezai S, Bisram P, Lora Alcantara I, Upadhyay R, Lara C, Elmadjian M. Didelphys uterus: a case report and review of the literature. Case Rep Obstet Gynecol 2015; 2015.
  2. Patil B, Nagaraju RM. Uterine didelphys with obstructed hemivagina and ipsilateral renal anomaly - OHVIRA syndrome: a rare congenital anomaly. Int J Reprod Contracept Obstet Gyneco 2015; 4(3):889-92.
  3. Ng'ang'a N, Ratzersdorfer J, Abdelhak Y. Vaginal birth after two previous caesarean deliveries in a patient with uterus didelphys and an interuterine septal defect. BMJ Case Rep 2017; 2017:bcr2016219149.
  4. Cunningham FG, Kenneth J, Bloom SL, Spong CY, Dash JS, Hoffman BL, et al. Williams obstetrics. 25nd ed. New York: McGraw-Hill; 2018.
  5. Bhoil R, Ahluwalia A, Chauhan N. Herlyn werner wunderlich syndrome with hematocolpos: an unusual case report of full diagnostic approach and treatment. International Journal of Fertility & Sterility 2016; 10(1):136-40.
  6. Vercellini P, Daguati R, Somigliana E, Viganò P, Lanzani A, Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertility and sterility 2007; 87(4):719-24.
  7. Ani EO, Ugwa EA, Taiye AB, Agbor IE, Suleiman IS. Simultaneous pregnancy in each uterine cavity of a double uterus in a young Nigerian multipara who presented with a retained second twin following an unsupervised preterm labor at home; Case report. International journal of surgery case reports 2018; 42:224-6.
  8. Jena L, Puhan JN, Swain S, Kanungo S. Uterine didelphys: a rare case report. Int J Reprod Contracept Obstet Gynecol 2015; 4(5):1613-1614.
  9. Lewis P, Zarariya A, Daver RG, Choudhary S, Kale K. An interesting case report on Herlyn-Werner-Wunderlich syndrome with hematoclopos and communicating blind duplex ureters. International Journal of Interdisciplinary and Multidisciplinary Studies (IJIMS) 2015; 2(6):163-67.
  10. Aranke M, Nguyen KL, Wagner RD, Kauffman RP. Haematometrocolpos and acute pelvic pain associated with cyclic uterine bleeding: OHVIRA syndrome. Case Reports 2018; 2018.
  11. Valdespino VE, Ramon HM, Cordova GM, Gomez VV, Torres PF, Hernandez PB. Didelphys Uterus and Cervical Cancer: A Case Report and Review of Literature Clin Surg 2018; 3:1964.
  12. Algeri P, Rota SM, Nicoli E, Caruso O, Spinetti G, Stagnati V. A uterus didelphys with a spontaneous labor at term of pregnancy: a rare case and a review of the literature. Case Reports in Perinatal Medicine 2018; 7(2).
  13. Ghaednia Jahromy M, Ansari I, Ghaednia Jahromy M, Rezagholizamenjany M, Mirzadeh SM, Rasekh Jahromi A. Double Uterus with Single Cervix: A Case Report. Annals of Military and Health Sciences Research 2017; 15(3).
  14. Rao S, Anitha GS. Chandralekh, a P. Pregnancy in Uterus Didelphys Delivered by Caesarean Delivery: Case Report. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2016; 5:2434-7.
  15. Hamidi H, Haidary N. Late presentation, MR imaging features and surgical treatment of Herlyn-Werner-Wunderlich syndrome (classification 2.2); a case report. BMC women's health 2018; 18(1):161.
  16. Singh SS, Roplekar P, Sudmani S. Herlyn-Werner-Wunderlich syndrome with endometriosis of ovary and fallopian tube- a rare case report. Indian J Appl Res 2017; 7(10).
  17. Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine‐Fenning NJ. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound in Obstetrics & Gynecology 2011; 38(4):371-82.
  18. Hua M, Odibo AO, Longman RE, Macones GA, Roehl KA, Cahill AG. Congenital uterine anomalies and adverse pregnancy outcomes. Am J Obstet Gynecol 2011; 205(6):558-e1.
  19. Gudu W, Barsenga M. Uterus Didelphys with Term Pregnancy Diagnosed in Labor as a Cause of Dystocia: Case Report. Ethiopian Journal of Reproductive Health 2020; 12(1):55-59.
  20. del Socorro Conde-Gutiérrez Y, Cruz-López N, Carmín Jiménez-Ibáñez L. Útero didelfo como causa de ruptura uterina espontánea. Reporte de un caso. Ginecologia y Obstetricia de Mexico 2020; 88(6):407-11.
  21. King AL, Pixton S, Lanzarone V. Uterine didelphys with dicavitary twin gestation: A case report. Case Reports in Women's Health 2020: e00199.
مجله زنان، مامایی و نازایی ایران
دوره 23، شماره 12
اسفند 1399
صفحه 102-107

فایل ها

هم رسانی

ارجاع به این مقاله

آمار