The shape of the uterus is a pear. When you’re not pregnant, it measures about 3 inches long, 2 inches wide, and 1 inch deep. During pregnancy, the baby grows in the upper portion of the uterus, called the fundus. The lower part of the uterus dives little ways into the vagina and creates an opening called the cervix. This is the opening that dilates to let the baby pass through during delivery.
Some women are born with congenital uterine anomalies. A bicornuate uterus is a heart-shaped uterine abnormality. The fundus has a sharp indentation at the top, with two “horns” that connect to the Fallopian tubes.
This heart shaped uterus abnormality is not very common. About 1 in 200 women are estimated to have a bicornuate uterus. Most of these women don’t realize they have the condition until they get pregnant.
But this condition can result in a significant impact on your ability to conceive as well as carry a successful pregnancy. Some women have an abnormally developed uterus from birth (congenital) while others may develop a uterine problem from surgery or past infection.
There are many different fertility problems that involve the uterus contributing to infertility and recurrent miscarriage including Uterine fibroids, Congenital abnormalities, Asherman’s syndrome, Adenomyosis, and DES.
Incomplete fusion of the Mullerian or paramesonephric ducts results in the most common types of uterine malformation: such as the septate uterus, unicornuate uterus, and bicornuate uterus. These uterine malformations are rare but known to be associated with infertility, pregnancy loss, intrauterine growth restriction, preterm deliveries, preterm prelabour rupture of membranes, breech presentation and increased rate of cesarean section. However, normal reproductive performance has been seen in association with them.
Symptoms of a Bicornuate Uterus
While many women with a bicornuate uterus don’t have any noticeable symptoms, some report the following symptoms:
- repeated miscarriages
- irregular vaginal bleeding
- abdominal pain or discomfort
- painful intercourse
- painful periods
Pregnancy Complications with a Bicornuate Uterus
If the deformity is slight, there’s a good chance that the shape of your uterus won’t affect your pregnancy at all. Many women who have this condition carry their pregnancies to full term or nearly full term to have a healthy baby.
If you have a bicornuate uterus and become pregnant, your condition could be considered high-risk pregnancy. This means the pregnancy would be monitored more often with increased check-ups on the health and progress of the baby for the best pregnancy outcome.
However, there are some risks for complications, including:
Premature ruptured membrane
If your baby grows too large for your uterine cavity, the uterine walls might overstretch, causing your water to break early. This sometimes results in preterm labor.
When your cervix is too weak to keep the baby inside, it may start to open prematurely. Your Ob/Gyn can strengthen your cervix with cerclage.
Your uterus’s shape may make it more difficult for the baby to get into the ideal position for birth. Experts do not recommend attempting to correct the baby’s position in an abnormally-shaped uterus, and because of this, you may need to deliver by cesarean section.
What Should I Do if I Have a Bicornuate Uterus?
It’s understandable to feel anxious about your pregnancy, especially if you have a history of miscarriages. The best possible thing you can do for your baby is to keep every prenatal appointment so that your Ob/Gyn can keep a close eye on your baby’s development.
Most women with a bicornuate womb have no extra difficulties with conception or in early pregnancy, but there is a slightly higher risk of miscarriage and preterm birth. It can also affect the way the baby lies in later pregnancy so a c-section might be recommended.