Challenges in Diagnosing and Managing Uterus Didelphys: A Case Report

Sebastian Giovanni, Kang Heji Dian Pertiwi, Syamsu Rijal
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Abstract

Background: This medical case report provides an insightful examination of a 22-year-old pregnant woman with uterus didelphys, a rare congenital anomaly of the Müllerian ducts. The introduction section sets the stage by discussing the embryological origins of congenital uterine anomalies and their varied clinical manifestations. It emphasizes the challenges in detecting these conditions due to their often asymptomatic nature and highlights their significant impact on reproductive health, including increased risks of miscarriage, preterm labor, and perinatal mortality. Case presentation: The case report segment details the patient’s clinical presentation, initially misdiagnosed as an ectopic pregnancy, later revealed to be an intrauterine pregnancy coexisting with uterus didelphys. The diagnosis was substantiated by her history of irregular menstruation, lower abdominal pain since menarche, and a previously diagnosed ovarian cyst, illustrating the critical role of a thorough medical history in guiding diagnosis. The discussion section delves into the implications of uterus didelphys on fertility and pregnancy outcomes, advocating for individualized management strategies and highlighting the psychological impact of such congenital anomalies. It underscores the necessity of a multidisciplinary approach to care involving obstetricians, radiologists, and reproductive specialists. Conclusion: The conclusion emphasizes the importance of clinical awareness, meticulous history-taking, and personalized care in the management of uterus didelphys. It calls for further research to enhance understanding and improve outcomes in reproductive medicine, stressing the complexity of diagnosing and managing pregnancies in women with Müllerian anomalies and the need to consider congenital uterine anomalies in differential diagnoses, particularly in young women with atypical gynecological histories.
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诊断和治疗双子宫的挑战:病例报告
背景:本医学病例报告对一名患有子宫发育不良(一种罕见的先天性穆勒氏管畸形)的 22 岁孕妇进行了深入的研究。导言部分通过讨论先天性子宫畸形的胚胎学起源及其不同的临床表现为该报告奠定了基础。该部分强调了由于先天性子宫畸形通常无症状,因此在发现这些病症时面临的挑战,并着重介绍了这些病症对生殖健康的重大影响,包括增加流产、早产和围产期死亡的风险。病例介绍:病例报告部分详细介绍了患者的临床表现,起初被误诊为宫外孕,后来发现是宫内妊娠并发子宫异位症。其月经不调史、月经初潮后的下腹疼痛史以及之前诊断出的卵巢囊肿证实了这一诊断,说明详尽的病史在指导诊断方面起着至关重要的作用。讨论部分深入探讨了子宫发育不良对生育和妊娠结果的影响,主张采取个性化的管理策略,并强调了这种先天性异常对患者心理的影响。它强调了产科医生、放射科医生和生殖专家共同参与的多学科治疗方法的必要性。结论:该结论强调了临床意识、细致的病史采集和个性化护理在子宫二叠症治疗中的重要性。它呼吁进一步开展研究,以加深对生殖医学的理解并改善结果,同时强调诊断和管理穆勒氏管畸形妇女妊娠的复杂性,以及在鉴别诊断中考虑先天性子宫畸形的必要性,尤其是对有非典型妇科病史的年轻妇女。
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