Bicornuate uterus

Specialty of Obstetrics & gynaecology

What is a bicornuate uterus?

A bicornuate uterus is a congenital abnormality in which the uterus is heart-shaped, with a deep indentation at the top. This can affect a woman’s reproductive system, but not their fertility. A bicornate uterus does increase the risk of miscarriage later in pregnancy, and if you are pregnant but have a bicornate uterus, the pregnancy will be treated as high risk.

Symptoms of bicornuate uterus

Women are born with a bicornate uterus, which means they may not know until later in life when an ultrasound or visual imaging test shows the abnormality, as it may not cause any symptoms whatsoever.

Sometimes, however, symptoms can present, such as:

  • Irregular bleeding
  • Painful periods
  • Abdominal pain
  • Pain during sex
  • Repeat miscarriages

It is important to have any irregular symptoms investigated, and attend regular check-ups with your doctor or gynaecologist.

Medical tests to diagnose bicornuate uterus

Imaging tests can be used to diagnose a bicornuate uterus, such as an ultrasound, MRI, or hysterosalpingogram. The condition is often detected during a pregnancy ultrasound or other imaging tests which can be performed to check on unusual symptoms.

What are the causes of a bicornuate uterus?

A bicornuate uterus is a congenital abnormality, which means it cannot be prevented.

What is the treatment for a bicornuate uterus?

Surgery can be used to correct a bicornuate uterus, although the majority of women do not need surgery to correct it. Surgery can be performed in those who have a history of miscarriage. The surgery performed to correct bicornuate uterus is called a Strassman metroplasty, which is generally performed laparoscopically. It removes removing any abnormal tissue separating the cornua (the uterine horns) of the uterus, and using stitches to correct the shape.

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