A bicornuate uterus is essentially a heart shaped uterus. Just like malformation can occur on the body, it can also occur inside of the body. In this case, a woman will have an abnormal uterus.
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What is a Bicornuate Uterus?
Uterine abnormalities do occur and aren’t normally known until a woman is pregnant. The literal meaning of a bicornuate uterus is “two horns.” This is a formation problem in the uterus. Just 5 weeks into gestation, the uterus is formed and makes its way to into the pelvis as two “horns” where it will eventually fuse into one.
Normally, the septum will divide into two and be reabsorbed into the body.
A woman that has a bicornuate uterus has not undergone this natural progression. This isn’t a split uterus, but instead a complete uterus that is malformed.
Bicornuate Uterus Symptoms
Every woman is different when it comes to the symptoms they experience when their uterus didn’t form properly. Since this occurs before even birth, a woman may think that what she is experiencing is normal.
- Difficulty conceiving
- Abdomen pain
- Painful ovulation
- Painful menstrual cycle
Cramping and pains felt during a woman’s period are typically exacerbated when they have a malformed uterus. The chance of becoming pregnant is also lessened as a result. Women that are able to conceive will enter into a high-risk pregnancy.
Statistics show that 63% of pregnancies where a woman has a bicornuate uterus will result in a spontaneous abortion. Those that do not have a spontaneous abortion have a 15% – 25% chance of having a preterm pregnancy.
Further disorders can be a result of a malformed uterus, and congenital defects are possible as a result.
What You Need to Know About a Bicornuate Uterus Pregnancy
- Pregnancy is difficult for any woman with a bicornuate uterus. The problem is that the heart shaped uterus is not ideal for birth and actually lowers the chance of a woman getting pregnant. While still possible, women that do get pregnant have a high-risk of miscarriage and will need to be under close supervision throughout their pregnancy.
- Over 50% of women will miscarry.
- Preterm birth is very common and will result in 1 out of 4 women that do not miscarry. This will require further care and may require incubation if the child is born very early into the pregnancy.
- Differing uterus shapes cause an issue with the uterine lining. This is the main reason for preterm babies. Essentially, the odd shape requires further progesterone to thicken the wall of the uterus, or more precisely, the uterine lining.
- Shots can be administered that will add progesterone so that a woman can go full-term.
- Many women will not know that there is an issue when they’re pregnant. In fact, many women have already had one child and don’t know that they have an abnormal uterus.
- It’s very important that progesterone shots are given from early pregnancy until 36 weeks. The body naturally lessens the amount of progesterone produced around the 34 week mark. Since a woman with a bicornuate uterus will have difficulty going full-term already, the added progesterone can greatly lower the risk of a preterm delivery.
- Many doctors and women recommend having a C Section performed instead of having a natural birth to lessen complications. Having this type of uterus will cause babies to breech, which is a major problem when giving birth.
Bicornuate Uterus Surgery and Treatment
Medications, aside from added progesterone, will not help a woman with a heart shaped uterus. If you do not want to get pregnant and don’t plan on having a child, there are virtually no health risks caused by this malformation, and you can continue living life as normal.
Women that do plan on having children will need to undergo reconstructive surgery.
The most common procedure is called “Metroplasty.” This procedure will start with an incision to separate the cavity of the uterus itself. Another incision will be made vertically using a layered closure. This closure is very similar to how a cesarean section is performed.
A complete examination is needed prior to surgery to ensure that the uterus is truly bicornuate.
Once surgery has been deemed a success, a woman will have to wait at least 3 months before trying to get pregnant. The body needs to heal at this time, and pregnancy can cause internal bleeding and other complications.
In the event that pregnancy does occur shortly after surgery, a woman can suffer from a uterine rupture during labor.
Diagnosis can be performed using:
- Pelvis exam
If you’re having trouble conceiving or have miscarried, it is a recommended that an OBGYN conducts an examination to rule out a bicornuate uterus. Many women do not know that they have a malformed uterus, and most doctors will not look for one unless complications continue to arise.