Dr Dulcy on problem pregnancies

DOUBLE UTERUS: PROBLEMS CONCEIVING CAN BE PICKED UP AND SOLVED IN MANY WAYS

Consult doctor if you have a menstrual flow despite the insertion of a tampon.

The inability of a woman to conceive and to carry a pregnancy successfully can be because of structural abnormalities of the uterus. Some women have an abnormally developed uterus from birth (congenital) while others may develop a uterine problem due to infection or surgery (acquired).

A variety of uterine factors can play a significant role in reproductive failure.

These factors may contribute to infertility and also to recurrent miscarriage.

Even when uterine factors are diagnosed, all other potential factors which might contribute to infertility should be aggressively evaluated and treated. Only when the entire picture is clearly understood and alternatives, risks, and benefits have been thoroughly discussed should a surgical approach be considered.

Uterine didelphys, which means a double uterus, is a rare congenital abnormality. In a female foetus, the uterus starts out as two small tubes. As the foetus develops, the tubes normally join to create one larger hollow organ, the uterus. Sometimes, however, the tubes do not join completely. Instead, each one develops into a separate structure. A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix.

In many cases, a thin wall of tissue runs down the length of the vagina, dividing it into two separate openings. Women who have a double uterus often have successful pregnancies. But the condition can increase the risk of miscarriage or premature birth.

It is not clear why some foetuses develop a double uterus and others don’t. A genetic component may be a factor because this rare condition sometimes runs in families.

It is advisable that you consult your doctor if you have a menstrual flow despite the insertion of a tampon, or if you have severe pain with menstruation or experience repeated miscarriages.

If a woman with repeated miscarriages has a double uterus, it is often assumed that the congenital uterine anomaly is the cause of the problem. However, it is important to exclude any other factor contributing to miscarriage before initiating treatment. Surgical repair should only be considered after a thorough evaluation.

SYMPTOMS

Often a double uterus has no symptoms. The condition may be discovered incidentally during a regular pelvic exam or during imaging tests to determine the cause of repeated miscarriages.

Women who have a double vagina along with a double uterus may initially consult a doctor for menstrual bleeding that is not stopped by a tampon. In these situations, the woman has placed a tampon in one vagina, but blood is still escaping from the second uterus and vagina.