All about the bicornuate uterus

The bicornuate uterus is a common malformation affecting 1 in 3 women. How is a bicornuate uterus characterized? What are the consequences? We explain everything in this article.

What is a bicornuate uterus?

The uterus is the organ belonging to the female genital tract, in which fertilization takes place and where the fetus develops.

The bicornuate uterus is a congenital malformation characterized by the presence of two uterine cavities, which may be distinct or partially separated. Thus, if the basic uterus has the shape of a triangle, the bicornuate uterus also called bifid uterus or hemi-uterus has the shape of a V.

A congenital malformation occurs during the first trimester of pregnancy, usually between the 6th and 9th week, during embryo formation. It is at this time that the two ducts called Müller's ducts fuse, forming the uterus. This final fusion takes place at about the 14th week. But when a uterus is bicornuate, the fusion is not complete.

In fact, the uterus has two separate parts at the top and the pathology can take several forms:

• A bicornuate bicervical uterus: two uterine cavities;
• A unicervical bicornuate uterus: only one uterine cavity.

The bicornuate uterus, regardless of its shape, affects 3% of women. With its V shape, a bicornuate uterus is by definition smaller than a classical uterus. This is not pathological but can nevertheless create complications during pregnancy. For your information, there are different forms of uterus natural or due to a malformation.

What causes a bicornuate uterus?

The cause of a bicornuate uterus is simply a congenital malformation. That is, it is present from birth. It is the consequence of an abnormality in the development of the embryo. The bicornuate uterus appears during pregnancy. At about the 14th week of pregnancy, the Müllerian ducts are supposed to fuse , which forms the uterus. With a bicornuate uterus, the ducts do not meet, resulting in the development of a uterine cavity with two horns that are partially or completely separated from each other.

What are the consequences of the bicornuate uterus?

The bicornuate uterus is most of the time asymptomatic. But this is not always the case.

Painful periods and lower abdominal pain

Some women will have painful periodsSome women will have painful periods, lower abdominal pain during their period, as early as adolescence, and pelvic pain. Dyspareunia (pain during intercourse) is also a symptom that can indicate a bicornuate uterus. Pain in the kidneys and urinary tract can also be a sign of an abnormal uterus.

Women with a bicornuate uterus may also have irregular and unexplained vaginal bleeding .

Complication during pregnancy

A bicornuate uterus can lead to complications during pregnancyThese include recurrent miscarriage, risk of premature delivery and fetal growth retardation.

However, some women with a bicornuate uterus carry their entire pregnancy to term without even realizing they have this type of uterus. It is not necessary to have complications.

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How is a bicornuate uterus diagnosed?

In the vast majority of cases, a bicornuate uterus is diagnosed during a gynecological examination, a pregnancy follow-up examination or even in some cases during childbirth. To confirm the diagnosis, the specialist may perform various imaging tests such as

• An MRI of the organs in the pelvic region;
• A pelvic ultrasound to obtain images of the uterus and make a first screening of a potential uterine malformation;
• Then a hysteroscopy, which will determine exactly which uterine malformation you are concerned with;
• Since renal malformations are very often linked to the presence of a bicornuate uterus, examinations of the urinary tract as well as the kidneys are often performed;
• Potentially a laparoscopic examination. This examination allows us to differentiate a bicornuate uterus from a septate uterus. This examination allows the visualization of the interior of an organ.

Are there any treatments for a bicornuate uterus?

A bicornuate uterus does not require any special treatment or surgery.

In some cases, there is a surgical procedure that consists of bringing the two parts of the uterus together. But this surgical treatment is not very recommended, except in exceptional cases.

Even if a bicornuate uterus does not require any treatment, it does require special care during pregnancy to avoid premature deliveries. This is the same management as for any type of high-risk pregnancy.

To limit uterine contractions, it is possible to be prescribed a medical treatment. As with any high-risk pregnancy, rest is essential to avoid complications.

The FAQ of the bicornuate uterus

How to get pregnant with a bicornuate uterus?

Is it normal to have a bicornuate uterus?