Uterine malformations

What are uterine malformations?

During foetal development, the uterus is formed from two small tubes, called Paramesonephric ducts or Müllerian ducts, which unite to form a single, larger organ: the uterus. However, sometimes these tubes do not unite in the center of the pelvis or do so irregularly, and that is what a uterine malformation is. The most common of these are:

• Unicornuate uterus: only one side of the Mullerian ducts is formed.
• Double uterus: the ducts develop but do not merge, so the patient has a double uterus.
• Bicornuate uterus: the upper part of the uterus is separate, often appearing as ‘heart-shaped’.
• Uterine septum: the most common uterine malformation, in which the uterus is partially or totally divided by a muscle wall.
• Mullerian hypoplasia: also known as vaginal agenesis, it is the absence of the uterus as the Müllerian ducts have not developed.

Prognosis

Uterine malformations can significantly affect a woman's fertility, and can be the cause of repeated miscarriages. The consequences on fertility will depend on the type of malformation that the patient suffers from.

Symptoms of uterine malformations

In some cases these malformations do not show symptoms, so women get the diagnosis in routine gynaecological examinations or some do not realise until after getting pregnant

In other cases, the most common symptoms of uterine malformations are:

• Pain before or during menstruation
• Irregular blood loss outside of menstruation
• Pain during sexual intercouse
• Repeated miscarriages
• Premature births

Medical tests for uterine malformations

At the moment, there are several imaging techniques to see the uterus to be able to detect abnormalities, such as ultrasounds, hysteroscopy, hysterosonography, MRI scans or even laparoscopy.

What are the causes of uterine malformations?

Uterine malformations develop during pregnancy, and the main factors have a genetic cause or prenatal environmental factors.

Treatments for uterine malformations

A uterine malformation that does not cause symptoms does not usually require treatment. However, if the malformation if causing problems, then surgery will be considered. Surgical intervention aims to fix the malformation and can often be performed laparoscopically with a hysteroscope.

On the other hand, many women with uterine malformations turn to assisted reproduction technology to improve their fertility and to be able to have children. The most common technique used in these cases is In Vitro Fertilisation (IVF).

What specialist treats uterine malformations?

The specialists that diagnose and treat uterine malformations are obstetricians and gynaecologists. If a mlaformation is detected, then regular gyanecological examinations are required to ensure problems do not occur, or if they do, they are treated accordingly.