All you need to know about the bicornuate uterus

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 Müllerian 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 pathology can take several forms:

• A bicervical 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 conventional 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 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.

periods and lower abdominal pain

Some women will have periods painful lower abdominal pain during pregnancy. periodsand pelvic pain. Dyspareunia (pain during intercourse) is also a symptom that can be indicative of 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 , unexplained vaginal bleeding .

Complications during pregnancy

A bicornuate uterus can lead to complications during pregnancy. pregnancyThese include recurrent miscarriage, 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 are not mandatory.

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How is a bicornuate uterus diagnosed?

In the vast majority of cases, a bicornuate uterus is diagnosed during a gynaecological 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 perform an initial screening for a potential uterine malformation;
• Then a hysteroscopy, which will 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 lurinary tract and kidneys are often performed;
• Potentially a laparoscopic examination. In particular, this examination can differentiate a bicornuate uterus from a septate uterus. This examination makes it possible to visualize lthe interior of an organ.

Is there any treatment for a bicornuate uterus?

The bicornuate uterus requires no 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 other type of high-risk pregnancy.

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

The FAQ of the bicornuate uterus

How can I get pregnant with a bicornuate uterus?

Is it normal to have a bicornuate uterus?