Unique case of successful twin pregnancy after spontaneous conception in a patient with uterus bicornis unicollis

Introduction: Abnormal fusion of the mullerian ducts or failure of absorption of the septum causes varying degrees of congenital uterine malformation. Twin gestation in a case of bicornuate uterus is extremely rare. We are reporting this case because of its extremely rare presentation, where twins have managed to reach term after spontaneous conception. Case report: A 28-year-old second gravida, para one was initially diagnosed to have diamniotic dichorionic twins on ultrasound. At term, she was referred to us with severe pre-eclamptic toxaemia. On examination, she was found to have a bicornuate uterus with one fetus in each horn. Both siblings were successfully delivered by caesarean section. So far, only one similar case has been reported following in vitro fertilisation. Conclusion: Although poor reproductive performance has been documented in previous reports of bicornuate uterus with twin gestation, our patient managed to reach term with delivery of healthy siblings by caesarean section. © 2007 Springer-Verlag.