Dr. Manny: 3 babies, 2 uteruses, 1 medical miracle

A British woman is being hailed as a true medical miracle after giving birth to triplets from two separate wombs in her body.

Hannah Kersey was diagnosed with a rare condition, called uterus didelphys, which is thought to affect just 0.1 to 0.5 percent of the population. Before becoming pregnant, she was told that it was highly unlikely she would carry children in each womb – a possibility with odds estimated at 5 million to one.

Now, the chances of a woman giving birth to three children from her two wombs are even more scarce – estimated at one in 25 million. But that’s exactly what Kersey did when she gave birth to three baby girls, conceived from two different eggs, one in each womb, that were simultaneously fertilized by two different sperm.

This is what I call a successful trifecta in obstetrics: 1 medical anomaly, 2 uteruses and 3 healthy babies. But for those of you wondering how this can happen, I’ll do my best to explain.

Some women who have this condition may have a complete separation of the left and right side of the uterus, cervix and vagina – meaning two of each. There are also mild variations of this condition where the two uteruses never fully separated, forming what’s called a double-horn uterus or a heart-shaped uterus. Or, you may simply have one cervix with two uteruses attached to it.

Why does this happen?
Simply put, it happens when embryological signals get a little out of control during development. This falls under the Mullerian classification of abnormalities. See, this embryonic plate transforms itself into the female reproductive organs during development, so there are a number of reproductive abnormalities that can occur when cellular multiplication happens at an uncontrollable rate. Many times, women who have these kinds of reproductive abnormalities also have kidney abnormalities since the whole area of the body is affected by the mixed signals.

How does a woman know that she has a double uterus?
Well, she usually doesn’t because there are no symptoms and most patients will maintain normal menstrual cycles. Often, it’s only when these women have miscarriages or a history of premature delivery that it’s discovered. Usually women who have this condition have a 20 percent chance of premature labor and a 30 percent chance of miscarriage, as compared to the general population, who have a less than 3 percent risk, depending upon their age.

How is the diagnosis made?
We start with a simple gynecological examination, but specific diagnostic studies can help make the diagnosis. First is a pelvic ultrasound followed by a pelvic MRI, and finally, a hysterosalpingogram – which is where we gently inject a contrast through the cervix and take an X-ray. On the X-ray, you can see flow of the contrast, through the cervix, into the endometrial cavity and out the fallopian tubes.

Should you treat this condition before having a baby?
Not necessarily. The most important thing for these patients to do is make sure their obstetrician is aware so they can monitor the patient as the risk for preterm labor is significant. In extreme cases, there are surgical corrections for mild to moderate forms of uterine abnormalities. One is called metroplasty in which the septal defect is wedged out of the uterus and the uterus re-stitched to create a normal contour.

The bottom line is that this woman was no doubt blessed by God, and her kids, years from now are going to be talking about their birth for a long time.