Archives of General Internal Medicine

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Herlyn-Werner-Wunderlich syndrome and central placenta previa: A case report

15th World Congress on Gynecology, Obstetrics and Womens Health & 17th International Conference on Traditional Medicine and Acupuncture & 9th World Summit on Cancer Science and Oncology
May 26, 2022 | Joint Webinar

Giosue Giordano Incognito

University of Catania, Italy

Scientific Tracks Abstracts : Arch Gen Intern Med

Abstract:

The Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital malformation of the female urogenital tract, characterized by the triad: uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. We report a rare case of a pregnant woman with HWWS and central placenta previa (CPP). We describe a 39-year-old pregnant woman, admitted to our hospital for preterm labor risk at 32 gestational weeks. She referred a previous cesarean section at term and three miscarriages. Non-invasive prenatal testing (NIPT) revealed no alteration of 13, 18 and 21 chromosomes. TORCH screening was negative. Speculum examination allowed visualization of the left cervix, whereas the contralateral one was hidden under the obliterated vaginal septum. Ultrasound examination showed CPP, double uterus and, in addition, right renal agenesis. Subsequent Magnetic Resonance Imaging (MRI) at 32 weeks + 2 days confirmed the condition of uterus didelphys and right renal agenesis, associated with total CPP, covering both uterine cervices. Instead of the classic triad where the uteri are apart, in our case the uterine cavities were in communication, as an iatrogenic consequence of previous CS. The patient is treated with tocolytic, progesterone and betamethasone therapy in attempt to reach almost to the term for a planned CS. In conclusion, HWWS and CPP are a dangerous association owing to the risk of metrorrhagia, miscarriage, preterm birth and either intracesarean or postcesarean hysterectomy. Such a case of association has not been reported so far.

Biography:

Giosue Giordano Incognito is a Resident Medical Doctor in Obstetrics and Gynaecology Resident at “Azienda Ospedaliero Universitaria Policlinico G.Rodolico - San Marco”. He mainly dedicates himself to work in the delivery room and the gynaecology and obstetrics emergency unit, as well as the diagnostic service for outpatients (both obstetric and gynaecological).

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