In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus. Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate structure. This condition is called double uterus (uterus didelphys). A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. There may even be two vaginas.
Double uterus is rare — and sometimes never diagnosed. The percentage of women with a double uterus is likely higher in those with a history of miscarriage or premature birth.
Treatment is needed only if a double uterus causes symptoms or complications, such as pelvic pain, repeated miscarriages or preterm labor.
Some women have a double uterus and never realize it — even during pregnancy and childbirth. Each cavity in a double uterus often leads to its own cervix. Some women with a double uterus also have a duplicate or divided vagina.
Possible signs and symptoms may include:
When to see a doctor
If you've been diagnosed with a double uterus and are considering pregnancy, talk with your doctor first. Together you can make a plan for optimal care during pregnancy and delivery.
Researchers don't know what causes a double uterus. This condition may be associated with kidney abnormalities, which suggests that something may influence the development of these related structures before birth.
Many women with a double uterus have normal sex lives, pregnancies and deliveries. But sometimes a double uterus and other abnormalities of uterine development lead to infertility or miscarriage. A double uterus may also cause premature birth or unusual positions of the baby in the uterus, such as bottom down (breech presentation).
Preparing for your appointment
You're likely to start by seeing your primary care provider. However, in some cases when you call to set up an appointment, you may be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist) or a doctor who specializes in reproductive hormones and optimizing fertility (reproductive endocrinologist).
What you can do
Some basic questions to ask your doctor include:
Don't hesitate to ask questions any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
A double uterus may be diagnosed during a routine pelvic exam when your doctor observes a double cervix or feels an abnormally shaped uterus. If your doctor suspects an abnormality, he or she may recommend any of the following tests:
Treatments and drugs
If you have a double uterus but you don't have signs or symptoms, treatment is rarely needed. Surgery to unite a double uterus is rarely done — although surgery may help you sustain a pregnancy if you have a partial division within your uterus and no other medical explanation for a previous pregnancy loss.
If you're pregnant and have a double uterus, your risk of pregnancy complications may be higher due to the smaller size of your uterine cavity. This factor may lead to early delivery, often by C-section. Share any concerns you may have about childbirth with your doctor because he or she may suggest ways to help prevent preterm delivery or manage labor.
Last Updated: 2013-04-02
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