# Cesarean Delivery of a Dichorionic Diamniotic Twin Pregnancy Complicated With a Complete Septate Uterus: A Case of Septum Perforation to Deliver the Trailing Twin

## TL;DR

A rare case of a complete septate uterus with a twin pregnancy is described, where the second twin's placenta was attached to the septum, leading to growth issues.

## Contribution

This case report highlights a rare uterine anomaly complicated by a twin pregnancy and septum perforation during delivery.

## Key findings

- The patient had a complete septate uterus with a dichorionic diamniotic twin pregnancy.
- The trailing twin's placenta was attached to the septum, causing growth restriction.
- The septum thinned during pregnancy and was perforated during cesarean delivery.

## Abstract

A complete septate uterus, resulting from the abnormal fusion of the Müllerian ducts, is a rare uterine anomaly in which the uterine cavity is divided by a septum, resulting in two separate uterine cavities. In this case, we encountered a patient with a complete septate uterus complicated by a dichorionic diamniotic twin pregnancy, with each fetus developing in separate uterine cavities. During the course of the pregnancy, the placenta of the trailing twin (Twin B) was attached to the septum. As the pregnancy progressed, the septum became progressively thinner, and Twin B exhibited growth restriction.