The bicornuate uterus is a common malformation affecting 1 in 3 women. How is a bicornuate uterus characterized? What are its consequences? We explain it all in this article.
What is a bicornuate uterus?
The uterus is the organ of the female genital tract in which fertilization takes place and 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. While the basic uterus is triangular in shape, the bicornuate uterus, also called bifid uterus or hemi-uterus, is V-shaped.
A congenital malformation occurs during the first trimester of pregnancy, generally between weeks 6 and 9, during embryonic formation. This is when the two ducts known as the Müller ducts fuse, forming the uterus. This final fusion takes place at around week 14. However, when a uterus is bicornuate, fusion is not complete.
In fact, the uterus has two separate parts at the top, and the pathology can take several forms:
- A bicervical bicornuate uterus: two uterine cavities;
- A unicervical bicornuate uterus: a single uterine cavity.
The bicornuate uterus, whatever 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 it can nevertheless lead to complications during pregnancy. For your information, there are different types of uterus natural or due to malformation.
What causes a bicornuate uterus?
The cause of a bicornuate uterus is quite simply a congenital malformation. In other words, it's present from birth. It is the consequence of an anomaly in the embryo's development. The bicornuate uterus appears during pregnancy. At around the 14th week of pregnancy, the Müllerian ducts are supposed to fuse , forming the uterus. With a bicornuate uterus, however, the ducts do not merge, resulting in the development of a uterine cavity with two horns that are partially or completely partitioned from one another.
What are the consequences of a bicornuate uterus?
A bicornuate uterus is usually asymptomatic. But this is not always the case.
Painful periods and lower abdominal pain
Some women experience painful periodsSome women will experience painful periods, lower abdominal pain during menstruation, as early as adolescence, and pelvic pain. Dyspareunia (pain during intercourse) is another symptom that may indicate a bicornuate uterus. Pain in the kidneys and urinary tract can also be a sign of a uterine anomaly.
Women with a bicornuate uterus may also experience irregular and unexplained vaginal bleeding .
Complications 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. Complications need not occur.
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 examinations, such as :
- MRI of pelvic organs ;
- A pelvic ultrasound to obtain images of the uterus and make an initial screening for a potential uterine malformation;
- Then a hysteroscopy, to determine exactly which uterine malformation you are affected by;
- Since kidney malformations are very often linked to the presence of a bicornuate uterus, examinations of the urinary tract and kidneys are often carried out;
- potentially a laparoscopic examination. This examination helps to differentiate a bicornuate uterus from a septate uterus. This examination makes it possible to visualize the inside of an organ.
Is there any treatment for a bicornuate uterus?
A bicornuate uterus does not require any special treatment or surgery.
In some cases, surgery can be performed to bring the two parts of the uterus together. However, this surgical treatment is not highly recommended, except in exceptional cases.
Although a bicornuate uterus does not require treatment, it does require special care during pregnancy to avoid premature delivery. This is the same as for any high-risk pregnancy.
To limit uterine contractions, medical treatment may be prescribed. As with any high-risk pregnancy, rest is essential to avoid complications.
Bicornuate uterus FAQs
How do I get pregnant with a bicornuate uterus?
Having a bicornuate uterus has no impact on a woman's fertility. She may, however, experience complications during pregnancy, but fertility is not affected.
Is it normal to have a bicornuate uterus?
The bicornuate uterus affects around one in three women, making it a fairly common congenital malformation.
