Favorable Pregnancy Outcome in a Dicavitary Twin Gestation: A Case Report and Literature Review

Congenital Müllerian anomalies pose unique risks for complications in pregnancy, particularly in the setting of multifetal gestation. Uterine didelphys with dicavitary twin gestation remains a rare entity with fewer than 10 cases reported in the medical literature. Currently, there are no established guidelines for the management or delivery of dicavitary twin gestations. We report a case of naturally conceived dicavitary twins in the setting of uterine didelphys with two functional cervices and a prior vaginal septum excised in childhood. Delivery occurred in the 35th week of gestation via cesarean section with two low vertical hysterotomy incisions. Late-preterm delivery was recommended for maternal indications, specifically superimposed preeclampsia with severe features. Cesarean delivery was recommended due to malpresentation, with both fetuses in a double-footling breech position. The patient and twins were discharged home in good condition on Postpartum Day 3 (Day of Life 4). This case contributes to the literature on the management of a rare obstetric condition with favorable outcomes for the mother and infants, including a nuanced surgical technique.