IS Case 225: Bicornuate uterus

Nadia F. Yusaf, MD

Imaging Sciences URMC 2008
Publication Date: 2009-05-22

History

Patient is a 44-year-old female who has had two first- trimester miscarriages. She had not had a previous hysterosalpingogram (HSG).

Diagnosis

Bicornuate uterus

Discussion

Although it is sometimes thought otherwise, infertility is not greater in patients' with this condition versus the general population. However, the rate of abortion appears greater than in the normal female population. There is an increased chance of premature labor (~25%). Also, only 60% of this patient population has a pregnancy resulting in a live birth. Labor is sometimes not successful in these patients because the uterine smooth muscle cells are abnormally arranged and lead to altered uterine contraction.

Some sources recommend surgery of bicornuate uteri, but this is best considered in cases with repeated 1st and 2nd trimester loss as well as premature labor. Some women may need a cervical cerclage, a stitch placed in the cervix to stop premature dilation, which is what can cause premature delivery and possible late pregnancy loss.

References

  1. Becker KL (Ed.). Principles and Practice of Endocrinology and Metabolism. 3rd ed., Lippincott Williams & Wilkins, 2001 Chapter: Disorders of Sexual Differentiation.
  2. # Gibbs RS, Karlan BY, Haney AF, Nygaard IE (Eds.). Danforth's Obstetrics and Gynecology. 10th ed., Lippincott Williams & Wilkins, 2008

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