Pregnancy complications in women with uterine duplication abnormalities

Patients with duplication anomalies have a higher incidence of infertility, repeated first trimester spontaneous abortions, fetal intrauterine growth restriction, fetal malposition, preterm labor, and retained placenta. The role of imaging is not only to detect and diagnose müllerian anomalies but also to help distinguish surgically correctable forms of müllerian duct anomalies from nonsurgical forms. Imaging is also important to identify the location of the pregnancy, because ultrasound guidance may be needed after miscarriage or when pregnancies occur in an ectopic location. Attention to the position of the fetus within a normal-appearing uterus, with normal thickness surrounding myometrium, is important for recognizing an otherwise unsuspected uterine duplication abnormality. In this article, we review and illustrate the imaging features and complications of uterine duplication anomalies in pregnancy and identify potential mimics of duplication anomalies.