Bicornuate Uterus

Definition - What does Bicornuate Uterus mean?

Bicornate uterus is a congenital (from birth) disorder of the uterus, resulting in a misshapen uterine cavity. The disorder is characterized by a major indentation at the uterine fundus, or the top, center portion of the organ. The result is a heart-shaped uterus, with a partially or fully divided center cavity.

A bicornate uterus is considered a Mullerian duct anomaly, and may complicate or endanger pregnancy. Because the irregular shape of the uterus, fetal growth may be prohibited or restricted, causing miscarriage, recurrent miscarriage, or pre-term labor.

A bicornate uterus may also be known as a heart-shaped uterus.

FertilitySmarts explains Bicornuate Uterus

The Mullerian ducts begin as two small tubes, apparent in the first weeks of embryonic growth. As the fetus develops, these two tubes fuse together to create one joined cavity, the uterus. When these ducts fail to properly grow or fuse together it known as a Mullerian duct anomaly.

In the case of a bicornate uterus, the tubes failed to fuse entirely. The vagina and cervical cavity remain intact and normal, however the top of the uterus is divided, creating two distinct chambers. The severity of this divided is based on the length of the fuse, and the size of the individual woman’s uterus. There are two primary classifications of bicornate uterus:

  • Complete: full division of the uterus by a piece of tissue that extends throughout the cavity
  • Partial: the division only occurs at the top of the uterus, and the lower portion remains open

The bicornate uterus is a rare condition. It typically causes no symptoms or problems until pregnancy-related issues arise, and often goes undiagnosed until pelvic imaging is used as a diagnostic procedure in infertility testing. Women with bicornate uterus rarely experience problems with conception, as the abnormal shape does not impede implantation. However, as the fetus grows, the misshapen interior can challenge development. This can lead to miscarriage and early labor.

Treatment for the bicornate uterus depends on the severity of the condition and it’s consequences on a woman’s life, primarily her ability to carry a pregnancy to term. The most common treatment option is a metroplasty procedure called the Strassmann procedure, which unifies both segments of the uterus by surgically removing the piece of tissue that extends through the cavity.

Other types of Mullerian duct anomalies include:

  • Arcuate uterus
  • Unicornate uterus
  • Septate uterus
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