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Pregnancy in Herlyn-Werner-Wunderlich Syndrome: A Case Report and Review of Literature

Marizel Ann M. Sucayan-Sta. Ana, MD; Nephtali M. Gorgonio, MD, FPOGS
Department of Obstetrics and Gynecology, Amang Rodriguez Memorial Medical Center

Herlyn-Werner-Wunderlich Syndrome (HWWS) is a triad of uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis.

In the review of the locally published literature, there have been seven HWWS cases reported, none of whom were pregnant.

A 24-year-old was diagnosed with Herlyn-Werner-Wunderlich Syndrome during caesarean section of a term pregnancy, occupying the right hemiuterus with obstructed hemivagina. Ultrasound showed uterus didelphys with communicating endometrial cavities. MRI revealed uterus didelphys, two cervices and an obstructed right hemivagina. The patient refused excision of vaginal septum. Two years later, she delivered spontaneously to a live fetus, occupying the hemiuterus with the unobstructed hemivagina.

In pregnant women with HHWS, who did not undergo prior surgical intervention, the mode of delivery depends on the side of pregnancy. If it is located on the obstructed hemivagina, caesarean section is inevitable. If it is on the unobstructed side, there is hope for vaginal delivery.