Pyometra and Pregnancy with Herlyn-Werner-Wunderlich Syndrome

Area of Science:

• Reproductive Medicine
• Gynecology
• Medical Case Reports

Background:

• Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital anomaly characterized by the triad of uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis.
• Patients with HWWS often experience symptoms such as dysmenorrhea, pelvic pain, and infertility, posing significant challenges in reproductive management.

Observation:

• This report details a case of HWWS in a patient with a history of infertility who spontaneously conceived.
• The patient developed a pyometra in the contralateral, non-gravid uterus during gestation, persisting despite antibiotic therapy.
• The pregnancy was high-risk due to the uterine anomaly and risk of infection and preterm labor.

Findings:

• The presence of a partial horizontal vaginal septum potentially contributed to cervical closure of the gravid uterus.
• This anatomical configuration may have protected the pregnancy from ascending infection and preterm delivery.
• The patient experienced an uneventful vaginal delivery, successfully carrying the pregnancy to term.

Implications:

• This case highlights a unique presentation of HWWS with a successful pregnancy outcome despite complications.
• It suggests a potential protective role of vaginal septum in maintaining pregnancy in cases of uterine didelphys with contralateral pyometra.
• Further research into the anatomical and physiological mechanisms influencing pregnancy outcomes in HWWS is warranted.