Bicornuate uterus is a congenital disease characterized by a bifurcation of the smooth muscle organ in the upper section. The resulting "horns" can be fully developed and absolutely symmetrical. In this case, conception proceeds without problems, and the fertilized egg is introduced into the wall of one of the formed uterine canals.
What is a bicornuate uterus in women?
Two-horned uterus is one of the congenital gynecological pathologies that occur in 0.5% of women of reproductive age. Abnormal formation of a smooth muscle organ occurs during intrauterine development between the 10th and 14th weeks of pregnancy.
Depending on the degree of deformation of the genital organ, three forms of the disease are distinguished:
- The saddle uterus is a mild form of pathology, characterized by the formation of a small depression in the wall of the genital organ;
- Incomplete doubling - bifurcation is observed in the upper third of the smooth muscle organ, so the gap between the two uterine canals is small;
- Full doubling is a severe form of the disease in which the uterus is completely divided into two halves by a muscular septum.
Most women live with an anomaly of the organs of the reproductive system and find out about it only during an instrumental examination by a gynecologist or already during pregnancy.
Bicornuate uterus - is it bad?
The abnormal structure of the uterus and the ability to conceive are not mutually exclusive concepts. Many women with an anatomical defect of the genital organ do not face serious problems during gestation and delivery. However, the features of the course of pregnancy are largely determined by the degree of deformation of the smooth muscle organ.
Unlike many other pathologies, two-horned uterus is not a life-threatening disease. The presence of deformities in the genital organ may be indicated by:
- violation of the menstrual cycle;
- severe dysmenorrhea;
- profuse uterine bleeding.
The severity of symptoms depends on the form of the disease. In the case of complete two-horned uterus, the development of side gynecological pathologies is possible.
Bicornuate uterus and pregnancy
A bicornuate uterus and pregnancy is one of the most pressing problems in obstetrics, because in 30% of cases it leads to miscarriages and complications during gestation. The likelihood of problems depends on the form of the pathology and the place of implantation of the fertilized egg.
The saddle uterus and pregnancy are the most favorable variant of the disease, in which complications occur least often. However, obstetricians warn that in this case, about 20% of women begin labor much earlier than the due date. In this regard, the perinatal morbidity of children increases, as well as the likelihood of death of premature neonates.
Two-horned uterus - is it possible to give birth?
With such a disease, difficulties with conception occur infrequently, but the course of gestation largely depends on the degree of enlargement of the septum. In the case of a complete bifurcation of the uterus, the formed canals may be asymmetrical, and one of them is considered rudimentary. Anchoring the embryo in an underdeveloped "horn" is regarded as an ectopic pregnancy and must be terminated.
Due to the abnormal structure of the genital organ, transverse presentation of the fetus is diagnosed in about 30% of cases. In such a situation, the likelihood of natural delivery is reduced by 3 times, therefore, patients with a saddle uterus have to undergo a Caesarean section.
Possible complications
The most favorable prognosis for patients with a saddle uterus, with such an anomaly, pregnancy is rarely complicated. In the case of incomplete and complete doubling of the genital organ, the risk of developing flow diseases greatly increases. Most often, women face such problems as:
- placenta previa;
- premature birth;
- premature discharge of amniotic fluid;
- spontaneous miscarriage;
- violation of placental circulation;
- fetal hypoxia;
- ectopic pregnancy;
- detachment of the placenta;
- isthmic-cervical insufficiency.
A bicornuate uterus and gestation require constant monitoring by a gynecologist and obstetrician. Due to the high likelihood of premature delivery, patients are admitted to the hospital in advance.
Diagnostics
It is possible to determine the pathological development of the uterus during an ultrasound examination of the pelvic organs. To clarify the diagnosis and determine the degree of organ deformation, they resort to several types of hardware diagnostics:
- hysteroscopy is a minimally invasive procedure to identify intrauterine pathologies;
- laparoscopy - examination of the uterine cavity using an elongated endoscope;
- magnetic resonance therapy - obtaining tomographic images to study the degree of doubling of the uterus and tissue deformation.
If the diagnosis is confirmed by the surgeon, the most appropriate method for removing the septum inside the genital organ is determined. Resection of the rudimentary "horn" and plastic surgery of the uterine cavity subsequently reduce the likelihood of complications during pregnancy by 55-60%.
Conclusion
Dividing the uterus and pregnancy are not mutually exclusive. The likelihood of conception and natural delivery is determined by the degree of proliferation of the septum in the genital organ and the site of implantation of the egg. Starting from the 28th week of pregnancy, patients are hospitalized in a hospital to ensure constant monitoring of the health of the expectant mother and fetus by the medical staff.
