Abstract:
Introduction: Uterine anomalies are often identified during pregnancy, during infertility
evaluation or pregnancy miscarriage and have been associated with an increased risk of
adverse pregnancy outcomes. Although some studies have documented the rare occurrence of
spontaneous twin pregnancy in each horn of a bicornuate uterus, this is the first time this is
being documented in Kenya, to the best of our knowledge. This is a rare occurrence and
reporting of this case adds to the documentation of such cases.
Patient presentation: This is a case report for a 30-year-old female, para 2+0 at 34 weeks 4 days
by dates, who presented with features of labour. Upon examination, she had normal vital signs
and a fundal height of 38 weeks with multiple foetal parts both in cephalic presentation and
two foetal heart rates within normal range. Her antenatal profile was non-contributory and
had undergone two ultrasounds that confirmed twin gestation with no other notable findings.
Management and outcome: The patient had a spontaneous vertex delivery of the first twin
with a good outcome. There was a delay in the delivery of the second twin and a caesarean
section was done with an indication of non-reassuring foetal status and low-lying placenta.
The bicornuate uterus was accidentally identified during the surgery. The outcome was good,
with an APGAR score of 6 in the first minute and 9 at 10 min.
Conclusion: Although this is a rare occurrence, we would like to sensitise healthcare workers
in rural low- to middle-income countries that this can occur, and they should attempt to
increase antenatal diagnosis as it can influence the mode of delivery
