MUMBAI, April 9: In a rare instance, a healthy, full-term baby girl was born to a 35-year-old woman born with the condition uterus didelphys. In non-medical language, this simply means that the woman, Aparna Karnik, had two uteri, two vaginas and two cervixes. "During the foetal development of girls, the two mullerian ducts join to form a single uterus leading to a single vagina and cervix. In some cases like Karnik's, the ducts do not come together at all, giving the appearance of two small uteri," explained Karnik's gynaecologist Dr Sharada Kulkarni.Dr Kaustubh Kulkarni, who delivered Karnik's baby via a Ceasarian section on January 23, has operated on her thrice during the past three years.
"Karnik's fallopian tubes were blocked, so the first operation was to open up the tubes. Both the uteri were cut on the inside and joined together. In the second operation, the vagina was cut open to form a single cavity and one of the cervixes was closed. We then performed a hysteroscopy and laproscopy whichconfirmed that the organs were capable of reproduction," explained Dr Kulkarni.
Though uterus didelphys is a rare condition, the present case is certainly not the first of its kind. "Gynaecologists come across one such case every two or three years. However, if a woman becomes pregnant after the uteri are joined, there is a very high chance of the uterus rupturing during pregnancy. Or else the baby is born prematurely," explains Dr V R Badhwar, Head of Department of Gynaecology and Obstetrics at the Nair Hospital. "The significance of this case lies in the fact that Karnik was able to carry the baby full-term," explained Dr Kulkarni.
Karnik, working as a clerk at Konkan Bhavan, Belapur, would suffer from painful and heavy menstrual bleeding. Soon after she got married a little over three years ago, she became pregnant and miscarried within 15 days. A diagnosis later confirmed her condition. "My family advised me to go in for adoption instead of undergoing these operations. But I had decided to make everyeffort that was possible," recalled Karnik. She even quit her job on her doctor's advice. She was advised bed-rest during her entire pregnancy.From the seventh month onward, Karnik and her husband rented a flat close to the Kulkarnis' Sidhi Hospital in Borivli. "It was a virtual time-bomb. The uterus could have burst or she could have gone into labour at any moment. In case of premature delivery, we would need expert neonate care which is not possible in the suburbs. Luckily, she held on and we planned a Ceasarian delivery after the ninth month," recalled Dr Kulkarni. Doctors opine that Karnik could even have another child few years down the line. For the moment at least, the Rs 1.5 lakh the couple spent on the treatment and the pain Karnik went through seems worth all the effort, as she basks in the joys of motherhood.
Copyright © 1998 Indian Express Newspapers (Bombay) Ltd.
