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Esa Lestary
Universitas Muslim Indonesia
Religion Arts Humanities Computer Science & IT Engineering Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Library & Information Science Mathematics Nursing Physics Social Sciences Veterinary Other

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Uterus Didelphys With Intrauterine Fetal Demise: Diagnostic Challenges And Future Reproductive Prognosis Dian Permatajaya Rimi; Nasrudin Andi Mappaware; Esa Lestary; Wahyuni Saddang; Nur Rakhmah; Abadi Aman
Jurnal Sipakatau: Inovasi Pengabdian Masyarakat Vol. 3 No. 5 (2026): August
Publisher : PT. Global Research Collaboration

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66314/sipakatau.v3i5.1338

Abstract

Uterus didelphys is an uncommon Müllerian duct anomaly that may be overlooked when one hemiuterus is gravid and the contralateral hemiuterus is mistaken for a leiomyoma. We report a 25-year-old G5P2A2 woman who presented with one week of vaginal bleeding, reduced fetal movement, lower abdominal pain, and absent fetal heart activity. A prior two-dimensional ultrasound had described a uterine myoma, and no three-dimensional ultrasound or magnetic resonance imaging had been performed. At emergency cesarean delivery, two distinct uterine bodies were identified, confirming uterus didelphys; the clinical record also documented cervical duplication. A 1300-g female fetus was delivered without signs of life, and no corrective metroplasty was performed. This case emphasizes that two-dimensional ultrasonography may be insufficient when uterine contour is atypical and that definitive characterization requires assessment of both the internal cavity and external fundal contour, preferably with three-dimensional transvaginal ultrasound or magnetic resonance imaging. Although uterus didelphys does not necessarily reduce fertility, it is associated with higher risks of preterm birth, malpresentation, cesarean delivery, and other adverse perinatal outcomes. Preconception anatomical confirmation, early pregnancy surveillance, and individualized counseling are therefore essential in subsequent pregnancies.
Preoperative Ultrasonography Versus Intraoperative Findings In An Ovarian Cyst With Uterus Didelphys: A Case Report Faridhah Ulfah; Irwan; Trika Irianta; Abadi Aman; Fery Wijaya; Esa Lestary
Jurnal Sipakatau: Inovasi Pengabdian Masyarakat Vol. 3 No. 5 (2026): August
Publisher : PT. Global Research Collaboration

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66314/sipakatau.v3i5.1339

Abstract

Background: Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome typically involves Müllerian duct agenesis, whereas its coexistence with fusion anomalies such as uterus didelphys, vaginal agenesis, and cervical atresia is exceptionally rare. This case highlights the diagnostic challenge created by discordance between preoperative ultrasonography and intraoperative findings in a complex Müllerian anomaly. Case: A 26-year-old woman presented with acute-on-chronic lower abdominal pain and primary amenorrhea. Examination showed a normal vulva and a blind vaginal pouch without a visible cervix or external cervical os. Ultrasonography suggested a complex left adnexal cyst and a hypoplastic uterus, whereas magnetic resonance imaging showed a 5-cm left dermoid cyst and a retroverted uterus. Cyclic molimina suggested functional but obstructed endometrium. Intraoperative exploration revealed uterus didelphys with vaginal agenesis and total cervical atresia. A left salpingo-oophorectomy was performed for the dermoid cyst. Discussion: The case demonstrates the limitations of ultrasonography for detailed mapping of complex Müllerian duct anomalies, particularly when adnexal masses obscure pelvic anatomy. The combination of a blind vaginal pouch and cyclic pain indicates complete outflow tract obstruction and creates major reproductive and reconstructive challenges. Conclusion: Careful physical examination, advanced imaging, and intraoperative confirmation are essential when imaging findings are discordant with clinical symptoms. Precise anatomical mapping is critical for fertility counseling and planning future reconstructive treatment.
Co-Authors Abadi Aman Dian Permatajaya Rimi Faridhah Ulfah Fery Wijaya Irwan Nasrudin Andi Mappaware Nur Rakhmah Trika Irianta Wahyuni Saddang