Favorable Pregnancy Outcome in a Dicavitary Twin Gestation: A Case Report and Literature Review

Congenital Müllerian anomalies pose unique risks for complications in pregnancy, particularly in the setting of multifetal gestation. Uterine didelphys with dicavitary twin gestation remains a rare entity with fewer than 10 cases reported in the medical literature. Currently, there are no established guidelines for the management or delivery of dicavitary twin gestations. We report a case of naturally conceived dicavitary twins in the setting of uterine didelphys with two functional cervices and a prior vaginal septum excised in childhood. Delivery occurred in the 35th week of gestation via cesarean section with two low vertical hysterotomy incisions. Late‐preterm delivery was recommended for maternal indications, specifically superimposed preeclampsia with severe features. Cesarean delivery was recommended due to malpresentation, with both fetuses in a double‐footling breech position. The patient and twins were discharged home in good condition on Postpartum Day 3 (Day of Life 4). This case contributes to the literature on the management of a rare obstetric condition with favorable outcomes for the mother and infants, including a nuanced surgical technique.