Incidental Finding of Bicornuate Uterus at Repeat Caesarean Section in a Woman with Recurrent Abnormal Presentation

A Case Report

Abstract

The bicornuate uterus is one of the most common uterine anomalies and is often associated with adverse pregnancy outcomes. It is asymptomatic in some cases; but can cause abnormal lie and presentation in advanced pregnancy.

This patient was an unbooked 39-year-old G7P2+4(1A) woman with two previous caesarean sections and a poor obstetric history. The previous surgeries were due to breech presentations. She presented at a gestational age of 33 weeks and 6 days with preterm drainage of liquor and developed labour pain with the baby in transverse lie. She subsequently had an emergency caesarean section with incidental findings of a bicornuate uterus, which was not previously identified in her previous deliveries. She delivered a live male neonate with a birth weight of 2.3kg and an APGAR score of 6 in one minute and 9 at the fifth minute of life. Her post-operative state was satisfactory until discharge and at the postnatal clinic review.

Uterine anomalies are associated with various abnormal obstetric conditions; as seen in the case presentation. Therefore, recurrent abnormal presentation requires a high index of suspicion for uterine anomalies for which the uterus should be meticulously examined at or after delivery.