- Uterus didelphys constitutes approximately 5% of müllerian duct anomalies.
- Result of nearly complete failure of fusion of the müllerian ducts. Each müllerian duct develops its own hemiuterus and cervix and demonstrates normal zonal anatomy with a minor degree of fusion at the level of the cervices. No communication is present between the duplicated endometrial cavities.
- A longitudinal vaginal septum is associated in 75% of these anomalies.
- Spontaneous abortion rates are reported to range from 32% to 52% (pooled data, 45%).
- Premature birth rates range from 20% to 45% (pooled data, 38%).
 Imaging Findings
- HSG demonstrates two separate endocervical canals that open into separate fusiform endometrial cavities, with no communication between the two horns.
- Each endometrial cavity ends in a solitary fallopian tube.
- If the anomaly is associated with an obstructed longitudinal vaginal septum, only one cervical os may be depicted, and it may be cannulated with the endometrial configuration mimicking a unicornuate uterus.
- Separate divergent uterine horns are identified with a large fundal cleft.
- Endometrial cavities are uniformly separate, with no evidence of communication.
- Two separate cervices need to be documented.
- MR imaging demonstrates two separate uteri with widely divergent apices, two separate cervices, and usually an upper vaginal longitudinal septum.
- In each uterus, normal uterine zonal anatomy is preserved.
Patient #1: Uterus didelphys with a leiomyoma in the right horn
 See Also
- Mullerian duct anomalies classification system
- Arcuate uterus
- Bicornuate uterus
- Septate uterus
- Unicornuate uterus
 External Links
- Robert N. Troiano, and Shirley M. McCarthy. Müllerian Duct Anomalies: Imaging and Clinical Issues. Radiology 2004 233: 19-34.