Bicornuate Uterus

Overview


Plain-Language Overview

A bicornuate uterus is a type of congenital uterine anomaly where the uterus has two horns instead of one. This condition affects the female reproductive system and occurs during fetal development when the two halves of the uterus do not fully fuse. Women with a bicornuate uterus may have a uterus shaped like a heart or with a deep indentation at the top. This can impact fertility and increase the risk of miscarriage, preterm labor, and abnormal fetal positions during pregnancy. Many women with this condition may not experience symptoms and only discover it during imaging or evaluation for pregnancy complications. The condition is important to recognize because it can influence pregnancy management and outcomes.

Clinical Definition

Bicornuate uterus is a congenital malformation characterized by incomplete fusion of the paired Müllerian ducts during embryogenesis, resulting in a uterus with two distinct endometrial cavities and a single cervix. This anomaly is classified as a type of Müllerian duct anomaly (Class IV) and is caused by defective lateral fusion of the ducts. The condition leads to a uterus with two horns that may be partially or completely separated by a myometrial septum. Clinically, it is significant due to its association with recurrent pregnancy loss, preterm delivery, and malpresentation of the fetus. Diagnosis is important for counseling and managing reproductive outcomes. It differs from other uterine anomalies such as septate or didelphys uterus by the presence of a single cervix and the degree of myometrial separation.

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