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Obstetrics » Obstetrics 2nd And 3rd Trimester
Pregnancy in a uterus with synechia
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Presentation These are serial scans of a 32-year-old pregnant woman with a history of prior C-section.
Caption: Longitudinal and transverse views of uterus at 7 weeks of gestational age
Description: Two gestational sacs are apparent in this view, making the possibility of twin gestation likely.
Caption: View of the uterus
Description: An embryo was visualized in only one of the gestational sac. At this stage, a diagnosis of twin gestation was made with one twin being underdeveloped.
Caption: 3D reconstruction of both sacs
Description: This image also demonstrates the presence of only one embryo in one of the gestational sac.
Caption: 3D reconstruction magnification
Description: A small but a very important detail is noted: the wall in between the two sacs does not have continuity.
Caption: Same patient six weeks later
Description: In this image only one sac and a single baby is seen.
Caption: Same patient six weeks later
Description: This image shows the umbilical cord in detail, crossing the membrane.
Caption: Scans of the uterus
Description: This image shows a band crossing the gestational sac, making possible two diagnoses: either uterine synechiae or amniotic band. She never had twin gestation.
Caption: Scan of the uterus
Description: An appropriate for age fetus is noted with a septum like structure seen coursing the gestational sac.
Differential Diagnosis

Twin gestation with an underdeveloped twin in the early stages of gestation, later on two possibilities either an amniotic band or uterine synechium causing asymmetric division of the uterus

Final Diagnosis Pregnancy in a uterus with synechia
Follow Up This patient delivered a healthy baby by a caesarean section and the diagnosis of synechium in the uterus was confirmed.
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