# Undiagnosed Uterine Didelphys, Concomitant Right Renal Agenesis, and Left Nephrolithiasis in a Primigravida With Breech Pregnancy: A Case Report

## TL;DR

A 24-year-old woman with undiagnosed uterine didelphys and kidney issues had a breech pregnancy requiring a C-section.

## Contribution

This case highlights the rare co-occurrence of uterine didelphys, renal agenesis, and nephrolithiasis in a pregnant woman.

## Key findings

- Uterine didelphys was diagnosed postnatally in a primigravida with a breech pregnancy.
- The patient had right renal agenesis and a left kidney stone.
- The case underscores the risks of undiagnosed Mullerian anomalies during pregnancy.

## Abstract

Mullerian duct anomalies are congenital abnormalities involving the female genital systems. A double uterus or uterine didelphys is one of the uterine duplication anomalies that result from impaired fusion with regard to the Mullerian ducts. The uterine didelphys can be diagnosed earlier in symptomatic patients. However, the diagnosis can be delayed or the patients may remain undiagnosed throughout their lifetime if asymptomatic. Pregnant women with uterine didelphys are at a greater risk for spontaneous miscarriage, malposition, premature labor, and cervical incompetence. Uterine didelphys are also associated with renal anomalies such as renal agenesis or duplex kidneys.

We present a case of a 24-year-old primigravida who had a spontaneous pregnancy and underwent a lower segment cesarean section (LSCS) after a failed external cephalic version for the breech fetal position. The uterine didelphys was diagnosed postnatally. Her condition was associated with right renal agenesis and concomitant left renal calculus.