Herlyn-Werner-Wunderlich Syndrome With Preterm Pregnancy The Presentation Of A Rare Case
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Background: Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Mullerian ducts and Wolffian structures, and characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain right before menarche, causing a delay in diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Mullerian Duct Anomalies (MDA) are infrequently encountered in a routine clinical setting. Case presentation: 19-years old female, primigravida with acute abdomen symptoms. Abdominal ectopic pregnancy was suspected by clinical examination. After that,laparatomy was performed and we found didelphys uterus with one part of them was being pregnant, ruptured at the cornu site and absence of her left kidney. Discussion: The reproductive outcome in cases of a didelphys uterus has been studied and compared with groups of uterine congenital anomalies. In the literature, didelphys uterus was found to give a good chance for a succesful pregnancy, better than other uterine anomalies. As we observed in the literature and our case, fertility in women with a didelphic uterus is not significantly impaired. The prognosis of pregnancies is comparatively good, with a high fetal survival rate, while an increased risk of preterm delivery. Conclusion: Herlyn-Werner-Wunderlich (HWW) syndrome is a rare syndrome of Mullerian and Wolffian duct abnormalities. Because of the rarity of this syndrome, it is frequently misdiagnosed or diagnosed late.