ABOUT THE DISEASE
Bicornuate uterus is a congenital uterine anomaly responsible for a womb that is roughly heart shaped with two elongated horns, instead of the more normal pear shape; resulting from a failure of the embryonic female genital tract (Fallopian tubes, uterus, cervix, vagina) to form properly.
Problems with miscarriage and premature labour occur four times as often as usual when the uterus is malformed because the muscular walls do not stretch as well as normal but the majority of women will carry their babies to term.
CAUSES
No known causes for the same have been identified.
SYMPTOMS
In most cases, a bicornuate uterus is incidentally discovered when the pelvis is imaged. The most common symptomatic presentation is with early pregnancy loss and cervical incompetence. The altered shape of the uterus makes breech presentation (bottom first babies) and transverse lie (babies lying sideways in the womb) more common and repeated breech presentations or transverse lies may be the first clue that a woman`s womb is in fact bicornuate.
Because of the shape of the womb, the regular muscular contractions of the uterine muscles in labour may not be as effective, leading to a fifth of women with a bicornuate uterus requiring a caesarean delivery.
DIAGNOSIS
- Pelvic exam: two horns can occasionally be palpated.
- Sonogram: A bicornuate uterus can sometimes be diagnosed by ultrasound.
- Laparoscopy: provides information on the exterior shape of the uterus.
- Hysteroscopy: provides information on the interior configuration of the uterus.
- MRI: May help confirm anatomy by showing a deep (> 1cm) fundal cleft in the outer uterine contour and an intercornual distance of > 4cm.
TREATMENT METHODS
Surgical intervention is not suggested in absence of reproductive difficulties. However in women with a history of recurrent pregnancy loss and in whom no other infertility issues have been identified:
- Metroplasty surgery is the most preferred method.
- In cases where cervical incompetence is identified, placement of a cervical encerclage may increase fetal survival rates.
In some cases both the above procedures might be advised.
You may also like to learn about:
Septate Uterus
Habitual Abortion
Incompetent Os
Dysmenorrhea
Infertility-female
Cesarean section