BMJ Case Reports 2017; doi:10.1136/bcr-2016-219149
  • Unusual presentation of more common disease/injury

Vaginal birth after two previous caesarean deliveries in a patient with uterus didelphys and an interuterine septal defect

  1. Yaakov Abdelhak1,2
  1. 1 Department of Obstetrics & Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
  2. 2 Maternal Resources, Hackensack, New Jersey, USA
  1. Correspondence to Dr Njoki Ng'ang'a, njoki.nganga{at}
  • Accepted 27 April 2017
  • Published 5 June 2017


Uterus didelphys is a congenital abnormality characterised by double uteri, double cervices and a double or single vagina that affects 0.3% to 11% of the general female population. A 23-year-old woman, gravida 3 para 3003, with uterus didelphys, acquired an iatrogenic interuterine septal defect during an otherwise routine primary caesarean delivery for fetal malpresentation. The defect was repaired but noted to have dehisced during her second pregnancy. A repeat caesarean section was performed due to fetal malpresentation after an unsuccessful external cephalic version. The dehisced defect was left unrepaired. During her third pregnancy, the placenta implanted in the right uterus, but the fetus migrated to the left uterus at approximately 28 weeks gestation. The umbilical cord traversed the interuterine septal defect. With the fetus in the vertex presentation at term gestation, the patient underwent a vaginal birth after two previous caesarean deliveries without any major perinatal complications.


  • Contributors NN, JR and YA provided direct care to the patient. NN, JR and YA conceived the paper. NN drafted the manuscript. NN, JR and YA revised the manuscript and approved the final version submitted for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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