Bicornuate Uterus: Symptoms, Treatments, and Effect On Pregnancy

The bicornuate uterus, often referred to as a ‘ heart-shaped uterus, is a unique anatomical variation in women’s reproductive system. The normal uterus will have the shape of a pear. But, when the top part of the uterus forms a slight division, it will create a shape that reminds you of a bicorn(two horns).

A bicornuate uterus can make a significant impact on your reproductive system. It can lead to infertility and pregnancy-related complications in women. The bicornuate uterus is a subject of great interest in the field of gynecology. Let’s delve into the intriguing world of bicornuate uterus. Let’s embark on a journey to explore its symptoms, treatments, and its effect on pregnancy. 

Symptoms Of Bicornuate Uterus

A bicornuate uterus, or double uterus, is a rare condition that can affect people who are assigned females at birth. However, having a heart-shaped uterus is not an extremely dangerous condition. The rate of pregnancy among women with bicornuate uterus is 60 to 70 percent.

The chance of pregnancy-related risks and complications is higher in women with bicornuate uterus. This condition may not display any kind of symptoms, or some symptoms may be familiar to a woman with a bicornuate uterus, so there is a higher chance it can go unnoticed until the woman gets pregnant.

Take a look at these common symptoms of the bicornuate uterus.

• Having More Than Three Miscarriages
• Painful Intercourse
• Pain or Discomfort In The Abdomen
• Pelvic Pain
• Painful Period
• Vaginal Bleeding

Causes Of  Bicornuate Uterus

A bicornuate uterus will develop in a woman from the womb itself. It is congenital, which means a woman with a heart-shaped uterus will be born with the condition. It will take 10 to 20 weeks of pregnancy for the development of a fetal uterus. Mullerian ducts merge to form a uterine cavity.

When it comes to the bicorn uterus, the two ducts called the Mullerian ducts will not fuse completely. This abnormality in the merging process will result in the development of two uterine cavities while giving the uterus a deep heart shape. Besides, there is no chance of genetic transfer of the condition. Even if you have a bicornuate uterus, you can not pass the bicornuate uterus to your offspring. It is not a genetic condition.

The Types Of Bicornuate Uterus

There are two common types of bicornuate uterus. The classification is made based on the depth of the uterus dip. Common types of bicornuate uterus are,

• Partial Bicornuate Uterus – The fetal uterus develops when two mullerian ducts combine. But in the bicornate uterus, the Mullerian duct will not merge properly and forms two uterine cavities. When the degree of separation between the two cavities is less it is called partial bicornuate uterus. Your uterus will have the shape of the heart but the uterine dip will be less severe.
• Complete Bicornuate Uterus –  In a complete bicornuate uterus the separation between two uterine cavities will be deeper and severe. It will give the uterus a deep heart shape.

A medical professional will be able to tell you what type of bicornuate uterus you have.

Diagnosis Of Bicornuate Uterus

How is it diagnosed? Well, self-diagnosis of the condition is not possible. Only a medical professional will be able to diagnose your condition. Since it is normal to overlook the symptoms of the bicornuate uterus. A woman may only realize the fact about the shape of her uterus when she becomes pregnant or when she faces many miscarriages. A doctor will suggest imaging and other diagnostic tests after a careful assessment of your symptoms and pelvic exam. If you are pregnant, a regular ultrasound scan finds the presence of a bicornuate uterus. Ultrasound and MRI are the two common tests recommended for the diagnosis of the bicornuate uterus. A doctor may suggest an MRI to get a more detailed image of the uterus.

The Treatment Options 

Surgical procedures can treat bicornuate uterus. However, surgery is not recommended for all bicornuate uterus cases. A doctor may opt for surgery in rare cases. A surgery can fix the shape of the uterus. A minimally invasive surgery called, Strassman metroplasty is carried out laparoscopically to treat the bicornuate uterus.

The surgery will correct the shape of the uterus by removing the tissue that separates the uterine cavities. After metroplasty, your doctor may recommend to wait three to four months to get pregnant. Bleeding, infections, and scarring are the common risk elements involved in the surgery. Your doctor will explain all the process and risk elements of the surgery prior to the procedure.  During pregnancy, your doctor will also prescribe medicines to reduce the pain and discomfort. 

Effects of Bicornuate Uterus on Pregnancy

Women with bicornuate uterus are able to get pregnant, however, there are a few risks involved. Your uterus needs to expand for the baby but for a heart-shaped uterus, the expansion becomes difficult. If you have the condition, your doctor will recommend taking certain precautions during pregnancy. The bicornuate uterus may also contribute to frequent miscarriages and infertility. 

Careful monitoring of your pregnancy will be needed if you have a heart-shaped uterus. It is one of the best ways to prevent other complications. Timely monitoring will lower the risk of complications. Women with bicornuate uterus have normal delivery. Since you have an abnormally shaped uterus, there is a higher chance of C-section. Other complications of bicornuate uterus during pregnancy include,

• Frequent Miscarriages
• Since the uterus faces difficulties in expanding as the baby grows, giving birth to a baby with low weight is possible.
• Early Labour
• Irregular Vaginal Bleeding
• Breech Baby or Breech Birth
• High Chance Of a C-Section
• High Blood Pressure During Pregnancy
• Postpartum Hemorrhage
• Conditions Affecting Placenta
• Cervical Insufficiency

If you can follow the instructions provided by your doctor, it will be easy to manage the complications associated with the bicornuate uterus during the pregnancy.

Conclusion

A bicornuate uterus is a rare congenital condition. A woman with a bicorn uterus will have a heart-shaped uterus, unlike a normal pear-shaped uterus. Frequent miscarriages, vaginal bleeding, painful intercourse, painful period, and abdomen pain are the main symptoms of bicornuate uterus.

Surgery can correct the shape of the uterus, but you have to wait three to four months to get pregnant after the surgery. The condition can cause adverse effects on pregnancy, but careful monitoring and adherence to doctor’s instructions will help to lower the risk of complications.