July 18, 2024

Rare Case: Woman with Double Uterus Gives Birth to Healthy Twins

In a truly extraordinary event, Kelsey Hatcher, a woman with a rare double uterus, successfully gave birth to healthy twins at the University of Alabama at Birmingham (UAB). Hatcher was pregnant with one baby in each of her uteruses, a condition known as uterus didelphys. After a 20-hour labor, she delivered Baby A on December 19 and Baby B on December 20.

Hatcher, in a news release from UAB, expressed her amazement at the unique birth, saying, “Never in our wildest dreams could we have planned a pregnancy and birth like this, but bringing our two healthy baby girls into this world safely was always the goal, and UAB helped us accomplish that. It seems appropriate that they had two birthdays, though. They both had their own ‘houses’ and now both have their own unique birth stories.”

Dr. Shweta Patel, an assistant professor of obstetrics and gynecology at UAB, had been aware of Hatcher’s double uterus since her third pregnancy. However, the revelation of two babies in two uteruses came as a true medical surprise. Hatcher had learned about her condition at the age of 17 when she discovered that her Müllerian ducts had failed to fuse, resulting in two separate uterine cavities, each with one fallopian tube, one ovary, and two cervixes.

During the pregnancy, Hatcher experienced some bleeding, prompting her to schedule an ultrasound. While the first baby was doing well, Patel decided to check the second uterus for any potential complications. To everyone’s surprise, another baby was discovered.

While it is not uncommon for women with a double uterus to be pregnant with one baby in one uterus, the likelihood of having a baby in both uteruses, known as a dicavitary pregnancy, is extremely rare, occurring in just one in a million cases. Patel immediately sought assistance from UAB colleagues specializing in high-risk and unique pregnancies.

Throughout the following months, Hatcher underwent regular checkups and ultrasounds, alternating between her obstetrics and maternal-fetal medicine teams. Despite the higher number of appointments, the pregnancies progressed smoothly. Dr. Richard Davis, a professor of maternal-fetal medicine at UAB and co-leader of Hatcher’s medical team, explained that in typical twin pregnancies, the twins share one womb, leading to limited space and a higher likelihood of preterm birth. However, in Hatcher’s case, each baby had their own womb, sac, placenta, and umbilical cord, allowing for more space for growth and development.

Given the rarity of dicavitary twins, Patel and Davis had limited case studies to refer to. As a result, they prepared for three possible delivery scenarios: both babies delivered vaginally, one delivered vaginally and the other via cesarean section, or both babies delivered via cesarean section. While cesarean sections are often favored in high-risk cases like Hatcher’s, the doctors took into account her successful history of vaginal deliveries from both uteruses.

They also took Hatcher’s wishes into consideration. She desired a similar birth experience for the twins as her previous children, as long as it was safe and possible. The doctors hoped that Hatcher would go into labor naturally. However, when she did not at 39 weeks, she was induced. One cervix was already dilated to 4 centimeters, while the other was dilated to 3 centimeters. To ensure optimal care, the medical team assigned two nurses, one for each uterus and baby.

The contractions Hatcher experienced were unique. They did not occur consistently together but were within seconds of each other. Hatcher felt contractions on different sides of her body, corresponding to each uterus. Her right uterus, which had been pregnant twice before, started contracting faster than the left, and since the baby’s head was lower, the team broke her water on that side. Eventually, Baby A, named Roxi, weighing 7 pounds, 7 ounces, was delivered vaginally.

Despite Baby A’s birth, Hatcher was still in labor with Baby B in her left uterus while simultaneously undergoing the postpartum process on the right side. After continued induction on the left, it became apparent that Baby B was not descending. Just over 10 hours after her sister’s birth, Baby B, named Rebel, weighing 7 pounds, 3.5 ounces, was delivered via cesarean section on December 20. The sisters finally met as Roxi’s bassinet was brought nearby.

Dr. Patel and Dr. Davis, with nearly 60 years of combined experience, had not encountered a dicavitary twin case before. Patel expressed the ever-changing and unpredictable nature of the field of obstetrics and the importance of a team of experts, including obstetricians, nurses, and anesthesia teams, to ensure the best care for such a rare pregnancy.

While technically not identical twins, as they were each from a different uterus, the medical team referred to them as fraternal twins. Dr. Davis stated, “At the end of the day, it was two babies in one belly at the same time. They just had different apartments.”

Source: Coherent Market Insights, Public sources, Desk research
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