Bicornuate Uterus - General Info
A bicorniate uterus is a heart-shaped uterus with two horns. The wall of bicornuate uterus has a partial split outside. This is actually the most common congenital abnormality of the uterus and can be a problem when it comes to conception.
More than a few studies have shown that women whose uterus is bicornuate have approximately 60% success rate in giving birth to a living child. The condition also carries higher risk of cervical incompetence. Bicorrnuate uterus is also connected with higher percentage of spontaneous abortion. Still, the risk of miscarriage is actually bigger in case of septate uterus comparing to bicrnuate uterus. This can be easily explained by the fact that the blood supply to the midline in case of bicornuate uterus is much better. And finally, this medical condition also carries risk for premature labor, a breech presentation, and retained or even trapped placenta.
In the United States bicornuate uterus affects approximately 0.1-0.5 % of all women. If there is a need bicornuate uterus may be surgically repaired. Pathophysiology
A bicornuate uterus develops during embryogenesis. The condition is caused by specific changes in the process of the upper part of the Müllerian ducts fusion. What results from this inappropriate fusion is bifurcation of the cephalo part of the uterus while the caudal part of this organ develops normally.
How is Bicornuate Uterus Diagnosed
This medical condition may be diagnosed with the assistance of several examinations and tests. Firstly the doctor may assume that a woman has bicrnuate uterus after performing pelvic exam. Better insight in this medical condition is achieved after pelvic ultrasonography is performed. Even laparoscopic approach gives suitable insight of the exterior shape of the uterus. And finally, bicornuate uterus can be diagnosed during hysteroscopy. The last medical procedure visualizes the anterior configuration of the uterus.
There is no need for any of the previously mentioned procedures in asymptomatic women suffering from bicornuate uterus. The very presence of bicornuate uterus does not have to be obvious until during pregnancy or delivery. It can be also confirmed during C- section.
Treatment for Bicornuate Uterus
There are two ways to treat bicornuate uterus. The first one is metroplasty surgery. During this surgical procedure the surgeon creates a large uterine cavity with minimal destruction of uterine tissue. The second option is cervical cerclage. This procedure is performed in pregnant women and it significantly improves the fetal survivor rate in some patients. Women with confirmed bicornuate uterus must be carefully monitored during pregnancy so that cervical cerclage can be performed timely. This way premature cervical dilatation can be successfully stopped.