Independent uterine contractions in simultaneous twin pregnancy in each horn of the uterus didelphys

The mechanism of synchronizing uterine contractions is not fully understood. We present a case of twin pregnancy in a uterus didelphys and objectively analyze the synchrony of bilateral uterine contractions. A 32‐year‐old woman, with a history of vaginal septal resection during her previous vaginal...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2014-03, Vol.40 (3), p.836-839
Main Authors: Maki, Yohei, Furukawa, Seishi, Sameshima, Hiroshi, Ikenoue, Tsuyomu
Format: Article
Language:English
Subjects:
Adult
Biological Clocks
Cesarean Section
Deceleration
Female
Humans
Live Birth
Models, Biological
Myometrium - physiology
Myometrium - physiopathology
Obstetric Labor Complications - physiopathology
Obstetric Labor Complications - therapy
Pregnancy
Pregnancy, Twin
synchrony
Treatment Outcome
twin
Urogenital Abnormalities - physiopathology
Urogenital Abnormalities - therapy
Uterine Contraction
Uterus - abnormalities
Uterus - physiopathology
uterus didelphys
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Summary:The mechanism of synchronizing uterine contractions is not fully understood. We present a case of twin pregnancy in a uterus didelphys and objectively analyze the synchrony of bilateral uterine contractions. A 32‐year‐old woman, with a history of vaginal septal resection during her previous vaginal delivery, became pregnant with twins in a uterus didelphys in which each uterine horn had one fetus. At 37 weeks and 6 days, the first baby was delivered vaginally. The second baby was delivered by cesarean section due to recurrent late decelerations. Operative findings confirmed the didelphys uterus. We retrospectively reviewed the timing of contractions of both uteruses. The timing was determined by visual analysis as synchronous if both uteruses contracted within 5 s. Otherwise, contractions were considered solitary. Both uterine horns contracted independently in 90% of the incidence throughout labor and delivery. From this rare case of an ‘experiment by nature’, we speculated that the myometrium must be histologically connected in order to synchronize uterine contractions.
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.12219