Potential Risks of Having a Double Uterus

Miscarriage Risk for Women With a Didelphic Uterus

Ultrasound image showing duplication of uterus corpus

Nevit / Wikimedia Commons / Creative Commons

A didelphic uterus is a “double” uterus. It is a type of congenital uterine malformation in which two uteri and sometimes two cervices form. Some women with the condition also have two vaginas.

In some women, this condition can increase the chance of miscarriage, but this condition is very rare. It is believed to be genetic, however, because double uteri tend to run in families. If you have the condition, you might want to ask your older family members if they know of other women among your relatives who've had the same diagnosis.


Doctors might detect a double uterus through a number of imaging studies, such as hysterosalpingogram, sonohysterogram, ultrasound or even MRI. The diagnosis might need to be confirmed by hysteroscopy or laparoscopy in order to differentiate a double uterus from a bicornuate uterus in some cases.

Before this diagnosis, a doctor might suspect that a woman has a double uterus if she has complaints of severe pelvic pain or has suffered repeat miscarriages. Most women with this condition, however, have no symptoms at all.

Women who have a double uterus, along with a double vagina, are at greater risk for heavy menstrual flow and may need to seek medical advice about how to manage their periods. They may also suffer from infertility, kidney problems, and premature birth.


Most women with a didelphic uterus do not need special treatment for the condition, but generally, women with this condition should make sure to work closely with a doctor during pregnancy to watch for signs of preterm labor or other risks to the baby. These women will likely need an obstetrician who specializes in high-risk pregnancies.

Before conceiving, a woman with a double uterus should discuss her plans to become pregnant with her physician. Doctors may perform surgery to unify the uterus or to remove an underdeveloped uterus if a woman is having health problems.

Surgery is rarely performed for the condition, though. It's usually reserved for women who've had repeated pregnancy problems. A physician may also help such women take additional steps to lower their risk of complications during pregnancy, labor, and delivery.

Risk of Pregnancy Loss

Women who have a didelphic uterus have a lot of variation in their ability to get pregnant and carry to term. Some women never have any problems because of the condition, and many who want to get pregnant go on to give birth successfully. Others may have recurrent miscarriages or may face preterm labor and increased risk of second-trimester pregnancy loss because of the condition.

In women who have two fully developed uteri, pregnancy might be completely normal and you might have even seen news articles about rare cases of women with didelphic uteri getting pregnant in both uteri with different due dates. In other women with a didelphic uterus, one uterus might be underdeveloped and have a higher risk of miscarriage, or if the cervix is underdeveloped, a higher risk of preterm labor.

2 Sources
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  1. Ridout AE, Ibeto LA, Ross GN, et al. Cervical length and quantitative fetal fibronectin in the prediction of spontaneous preterm birth in asymptomatic women with congenital uterine anomaly. Am J Obstet Gynecol. 2019;221(4):341.e1-341.e9. doi:10.1016/j.ajog.2019.05.032

  2. Rezai S, Bisram P, Lora alcantara I, Upadhyay R, Lara C, Elmadjian M. Didelphys Uterus: A Case Report and Review of the Literature. Case Rep Obstet Gynecol. 2015;2015:865821. doi:10.1155%2F2015%2F865821

Additional Reading
  • Cooney, Michael J., Carol B. Benson, and Peter M. Doubliet, "Outcome of pregnancies in women with uterine duplication anomalies." Journal of Clinical Ultrasound 6 Dec 1998.
  • Heinonen, Pentti K., "Clinical implications of the didelphic uterus: long-term follow-up of 49 cases." European Journal of Obstetrics & Gynecology and Reproductive Biology Aug 2000. 183-190. 

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.