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Schubert M, Tihon A, Andresen K, Ruchay Z, Farrokh A, Maass N, Elischer P, Longardt AC, Tesch K, Lebenatus A, Krüger M, Alkatout I. Peripartal management of dichorial twin pregnancy in a bicornuate bicollis uterus: a case report and review of the literature. J Med Case Rep 2024; 18:196. [PMID: 38643176 PMCID: PMC11032606 DOI: 10.1186/s13256-024-04506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/12/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION The management of a pregnancy in a bicornuate uterus is particularly challenging. A bicornuate uterus is a rare occurrence and a twin pregnancy in a bicornuate uterus even more rare. These pregnancies call for intensive diagnostic investigation and interdisciplinary care. CASE PRESENTATION We report on a 27-year-old European woman patient (gravida I, para 0) with a simultaneous pregnancy in each cavity of a bicornuate bicollis uterus after embryo transfer. The condition was confirmed by hysteroscopy and laparoscopy. Several unsuccessful in vitro fertilization (IVF) attempts had been performed earlier before embryo transfer in each cornus. After a physiological course of pregnancy with differential screening at 12 + 6 weeks and 22 + 0 weeks of gestation, the patient presented with therapy-resistant contractions at 27 + 2 weeks. This culminated in the uncomplicated spontaneous delivery of the leading fetus and delayed spontaneous delivery of the second fetus. DISCUSSION Only 16 cases of twin pregnancy in a bicornuate unicollis uterus have been reported worldwide and only 6 in a bicornuate bicollis uterus. The principal risks in such pregnancies are preterm labor, intrauterine growth restriction, malpresentation and preeclampsia. These typical risk factors of a twin pregnancy are greatly potentiated in the above mentioned setting. CONCLUSION A twin pregnancy in the presence of a uterine malformation is rare and difficult to manage. These rare cases must be collected and reported in order to work out algorithms of monitoring and therapy as well as issue appropriate recommendations for their management.
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Affiliation(s)
- Melanie Schubert
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany.
| | - Anastasia Tihon
- Department of Obstetrics and Gynecology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Kristin Andresen
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Zino Ruchay
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - André Farrokh
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Philipp Elischer
- Department for Pediatrics and Adolescent Medicine I, Neonatology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Ann Carolin Longardt
- Department for Pediatrics and Adolescent Medicine I, Neonatology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Karolin Tesch
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Annett Lebenatus
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Magret Krüger
- Center for Operative Gynecology, Park Clinic, 24116, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany.
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Chemlal C, El Amouri I, Tanouti S, Taheri H, Saadi H, Mimouni A. Spontaneous twin pregnancy in uterus bicornis unicollis complicated with preeclampsia: A case report. Int J Surg Case Rep 2022; 92:106899. [PMID: 35278983 PMCID: PMC8914195 DOI: 10.1016/j.ijscr.2022.106899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Chaymae Chemlal
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.
| | - Imane El Amouri
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Saloua Tanouti
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Hafsa Taheri
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Hanane Saadi
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Ahmed Mimouni
- Gynecology and Obstetrics Department, Mohammed VI University Hospital of Oujda, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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