Uterine abnormalities, such as bicornuate uterus, aren't very common, though it's good to be aware of what they mean when it comes to being pregnant.
About one in 100 women has a uterine abnormality, but such statistics aren't clear since there are a lot of unidentified cases (many women don't even know that they have uterine singularities). But before we go deeper into the subject, let's clarify that abnormal uteri are described as those that present alterations in their structure or their form.
The bicornuate uterus may be the most famous uterine abnormality. Bicornuate literally means 'two horns', and the name refers to the shape of the uterus: instead of being pear-shaped, the organ looks like a heart, with an indentation at the fundus, the upper portion of the uterus. The indentation can be partial or complete, in which case it reaches the cervix and doubles it, a phenomenon named bicornuate bicollis uterus.
Besides the bicornuate uterus...
Uterine abnormalities include others besides the bicornuate uterus:
- Uterus didelphys or double uterus: this happens when the uterus becomes a double organ, because it has two cervixes and often two vaginas that are each linked to the fallopian tubes. Only one in 350 women has such a malformation.
- Unicornuate uterus: yes, there's also the possibility that you only have a 'one horn' uterus with just a fallopian tube. Despite this fact, you are likely to have two ovaries as well, though only the one related to the uterus will serve the conception purpose. Keep in mind that a unicornuate uterus, which is usually half the size of a normal one, only affects one in 1.000 women.
- Septate uterus: the septate uterus occurs when the uterus is divided, either partially or totally, into two parts by a muscular and longitudinal wall named septum. This anomaly is pretty common, since it's diagnosed in one out of every 45 women.
- Arcuate uterus: this is the uterine abnormality that causes fewer problems. It happens when the fundus of the uterus is concave towards the inside, instead of convex outwards, and it's found in one in 25 women.
How do they affect pregnancy?
The level of incidence depends on the kind of uterine abnormalities and, also, on whether these are mild or severe. For example, an arcuate uterus is often considered a mild variant of a normal uterus, and it rarely poses any conceiving risks. Focusing on the bicornuate uterus, this doesn't generally affect your fertility, but it's associated with preterm labour instead. Why? Because your growing baby may run out of space to keep developing!
If you happen to have a uterus didelphys or double uterus, you are at a high risk of infertility, premature birth, miscarriage and postpartum bleed, among other conditions. Miscarriage is also linked to the unicornuate uterus, even if the only 'horn' is attached to a healthy ovary, and the septate uterus, which may cause you additional problems when trying to conceive.
Needless to say, pregnant women with uterine abnormalities are extra monitored by doctors, because after all, such future mums are facing high-risk pregnancies.
How can I know if I have an abnormal uterus?
Most uterine abnormalities are detected when women who are having trouble getting pregnant seek medical help. There are different tests that can easily diagnose a malformation in your uterus, such as 3D ultrasound scans, magnetic resonances imaging (MRI), a special X-ray technique that uses dye and a laparoscopy, which allows the doctor to check you internally through a camera.
How can they be treated?
For a start, keep in mind that not all uterine anomalies require treatment. Again, it's a matter of what kind and how much it is affecting you. While an arcuate uterus could host a foetus without any problems, a bicornuate uterus and a septate uterus may need surgery in order to be repaired. The bicornuate uterus is approached through the Strassman procedure, whereas the septate uterus is usually fixed by either surgery or by using a device called hysteroscope that acts as a little telescope. On the one hand, surgery is proven to be more effective to prevent infertility problems but, on the other hand, it is more invasive and risky.
As you can see, having uterine abnormalities like a bicornuate uterus isn't desirable, because they can entail risks for you and your future child. However, you shouldn't come to dramatic conclusions as soon as you are diagnosed with one of these anomalies, because that doesn't necessarily prevent you from having children. You just have to accept that, yes, it may be more difficult than under normal circumstances, but you'll also be taken care of properly by professionals, who will try their best so that you can make it to labour without bad news.