MRI of a twin pregnancy in a uterus bicornis unicollis

Abstract

A 30-year-old woman was seen at 24 weeks for a discrepancy between the symphysis-fundal height and the gestation by dates. Ultrasound examination revealed a twin pregnancy and showed the placentas to be implanted ‘back-to-back’ over what appeared to be a septum that extended from the uterine fundus to the cervix. A bicornuate unicollis uterus was confirmed on MRI and revealed two divergent uterine horns separated by a deep fundal cleft, surrounded by myometrial tissue, containing a fetus within each horn. A single cervix and vagina was visualised, in keeping with a Class IVA Müllerian duct abnormality. At 33 weeks, an emergency caesarean section delivery was performed via two separate classical incisions into each corpus.