Overview
A double uterus is a rare abnormality that develops when a baby girl is in her mother’s womb. Every uterus starts out as two small tubes called Mullerian ducts. As they begin to develop, they usually fuse together to form one uterus. But in rare cases, the tubes remain separate and become two uteri.
Sometimes there is only one cervix for both wombs, other times each womb has a cervix. Often the vagina in women with a double uterus is divided into two separate openings by a thin membrane.
It’s entirely possible for women with a double uterus to carry a baby to term. However, the condition does come with an increased risk of miscarriage or premature labor.
You may also hear a double uterus referred to as uterus didelphys. It’s sometimes confused for a septate uterus (a divided uterus) or a bicornuate (heart-shaped) uterus.
It’s quite common for a woman with a double uterus to experience no symptoms whatsoever. A doctor may discover the condition during a routine pelvic exam. Otherwise, it’s usually found when investigating the cause of recurrent miscarriages.
If a woman has a double vagina with a double uterus, then she may experience menstrual bleeding even after she’s inserted a tampon. This is because she has placed the tampon inside one of her vaginas but is still bleeding from the other vagina.
The condition is a congenital abnormality. This means it occurs during development as a fetus, and affected baby girls are born with the condition.
We know that the condition occurs when two small tubes fail to merge into one and instead develop into a uterus each. However, it’s not known exactly what causes this to happen. It could be that there is a genetic link, as the condition has been known to run in families.
During a routine pelvic exam, your doctor may feel that you have a double cervix, or that your uterus is shaped differently than normal. If they do, they may recommend some tests to find out what might be going on. These tests might also be recommended if you have experienced recurrent miscarriages. In either scenario, the tests you may be offered are the same.
Ultrasound
High-frequency sound waves are used to create images of the inside of your body. The sonographer will put some cool jelly on the end of a device called a transducer and apply it to your abdomen so that they can see how your uterus looks. If they want a clearer image of the inside of the uterus, they might suggest a transvaginal ultrasound, in which the transducer is inserted into the vagina.
Sonohysterogram
This is another ultrasound, but in a sonohysterogram the images are taken after a fluid is inserted into the uterus through a thin tube that is put into the vagina. This allows the doctor to see any abnormalities in the shape of the uterus that may be present.
MRI scan
Magnetic fields and radio waves are used to generate cross-sectional images of the body. For this test, a woman needs to lie completely still in a machine that looks like a large tunnel. It can feel unnerving, but it’s completely painless.
Hysterosalpingography (HSG)
During this test, a dye is inserted into the uterus via the cervix. As the dye travels through, X-rays allow a doctor to see the size and shape of your uterus.
Surgery is possible to correct a double uterus, but it’s rarely needed. For women who have a double uterus but are experiencing no symptoms, there is no need to treat the condition. Those who experience recurrent miscarriages that have no other medical explanation may be offered the surgery. It’s possible that the surgery will help them to sustain a successful pregnancy.
Women with a double vagina and a double uterus may benefit from surgery to remove the dividing membrane in their vagina. This can make childbirth easier for them.
Having a double uterus doesn’t usually cause a woman any problems for actually getting pregnant. Sometimes the shape of the uterus that the fetus has implanted in leads to miscarriage. As well, women with a double uterus generally have smaller uteri, which can lead to preterm labor.
If you have a double uterus and are pregnant, your doctors will want to monitor your pregnancy very closely to ensure that all is well with your baby. They may suggest early delivery via cesarean delivery (C-section) if the baby shows signs that they’re not doing well.
If you’ve had recurrent miscarriages, you may be offered surgery, which can increase your chances of carrying to term.
Women with a double uterus often find they have a heavy menstrual flow. They may need to seek assistance from their doctor should it become unmanageable.
Abnormalities of the Mullerian duct can affect another duct that develops in the fetus, called the Wolffian duct. Malformations of the Wolffian duct can cause kidney issues. This complication occurs in 15 to 30 percent of women with a double uterus.
In a very small number of cases, women with a double uterus find they are unable to get pregnant.
It’s important to remember that this is an extremely rare condition, and in many cases it’s never detected because it causes no problems at all. If you’re one of the few women who do experience pregnancy loss as a result of this condition, there is a surgery available to you that may help.
If your condition was detected only after you became pregnant, then talk to your doctor about receiving the very best of care and monitoring to ensure the best possible outcome for you and your baby.
Q:
Is there a higher chance of carrying multiples if you have a double uterus?
A:
No. A review of the literature suggests that while it’s possible to carry multiples with a double uterus, fertility rates are still lower than those of women with a normal uterus. There is an increased risk of miscarriage, poor growth in the womb, and prematurity. Research shows that the chances of having a premature birth increase by up to 45 percent for women with a double uterus.
Valinda Riggins Nwadike, MD, MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.