Dil Sahi Roka, Priyanka Gharti Magar, Jie Hou, Lijing Liu
Uterus didelphys is a rare congenital Müllerian duct anomaly defined by the presence of two uteri, typically with two cervices and occasionally with a vaginal septum. Although in many cases it is asymptomatic, it is linked to several complications, including miscarriage, premature birth, malpresentation, and an increased rate of cesarean section. We report a 19-year-old primigravida incidentally diagnosed with uterus didelphys at emergency cesarean section for fetal distress at 38 weeks. Uterus didelphys is one of the rare Müllerian duct anomalies and is often missed on routine antenatal ultrasonography. Intraoperatively, a non-gravid right uterine horn and a gravid left uterine horn were noted. A healthy male infant of 2.7 kg was delivered. The postoperative period was uneventful and highlights the importance of careful antenatal evaluation, proper counseling, and multidisciplinary team involvement in future pregnancies.