Case Report: Effective Pregnancy Management in Uterus Didelphys

Munawar Adhar Lubis, Edy Fakhrizal


Abstract


Introduction: Uterus didelphys is a rare congenital anomaly resulting from incomplete fusion of the Müllerian ducts, accounting for 10% of such anomalies. It often goes unnoticed until reproductive age, sometimes causing dyspareunia or dysmenorrhea. This anomaly is associated with increased obstetric risks, including higher rates of miscarriages, preterm births, breech presentations, and lower live birth rates. Diagnosis is typically achieved through imaging techniques such as ultrasound, hysterosalpingography, or magnetic resonance imaging.
Case Report: This case study involves a 37-year-old primigravida at 34 weeks gestation presenting with premature contractions. Ultrasound revealed a singleton foetus in the breech position, and speculum examination identified two cervical os. The patient had a history of primary infertility and was diagnosed with uterus didelphysis during fertility assessments. Despite the complexities associated with this condition, she successfully conceived through artificial insemination. Her pregnancy was closely monitored, and due to the presence of labour signs and uterus didelphys condition, a planned Caesarean section was performed, resulting in the delivery of a healthy infant.
Conclusion: This case underscores the importance of individualised care and continuous monitoring in managing pregnancies complicated by uterine anomalies to mitigate associated risks and improve maternal and foetal outcomes.

Laporan Kasus: Managemen Efektif Kehamilan Pada Uterus Didelphys

Abstrak
Pendahuluan: Uterus didelphys merupakan anomali kongenital langka yang disebabkan oleh fusi duktus Müllerian yang tidak sempurna, yang mencakup 10% dari anomali tersebut. Kondisi ini sering tidak disadari hingga usia reproduksi, terkadang menyebabkan dispareunia atau dismenore. Anomali ini dikaitkan dengan peningkatan risiko obstetrik, termasuk tingkat keguguran yang lebih tinggi, kelahiran prematur, presentasi bokong, dan tingkat kelahiran hidup yang lebih rendah. Diagnosis biasanya dicapai melalui teknik pencitraan seperti Ultrasonografi, histerosalpingografi, atau pencitraan resonansi magnetik.
Laporan Kasus: Studi kasus ini melibatkan seorang primigravida berusia 37 tahun dengan usia kehamilan 34 minggu yang mengalami kontraksi prematur. Ultrasonografi menunjukkan janin tunggal dalam presentasi bokong dan pemeriksaan spekulum mengidentifikasi dua ostium serviks. Pasien memiliki riwayat infertilitas primer dan didiagnosis dengan uterus didelphysis selama penilaian kesuburan. Meskipun kondisi ini rumit, ia berhasil hamil melalui inseminasi buatan. Kondisi kehamilan pasien dipantau secara ketat, namun karena adanya tanda-tanda persalinan disertai kondisi uterus didelphys, maka diputuskan untuk dilakukan operasi caesar. Pasca operasi kondisi ibu dan bayi sehat.
Kesimpulan: Kasus ini menggarisbawahi pentingnya perawatan individual dan pemantauan berkelanjutan dalam mengelola kehamilan yang rumit karena anomali uterus untuk mengurangi risiko dan menjaga keselamatan ibu dan bayi.

Kata kunci: uterus didelphys, anomali uterus kongenital, risiko obstetrik, operasi caesar


Keywords


terus didelphys, congenital uterine anomaly, obstetric risks, caesarean section

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DOI: http://dx.doi.org/10.24198/obgynia.v7i3.738

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