What is the clinical significance of a bicornuate uterus?

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Last updated: April 11, 2025View editorial policy

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From the Research

A bicornuate uterus is a congenital uterine anomaly that can increase the risk of pregnancy complications, but with proper management, many women with this condition can have successful pregnancies. This condition occurs during embryonic development when the two müllerian ducts fail to completely fuse, resulting in a heart-shaped uterus with two horn-like structures [ 1 ]. The significance of a bicornuate uterus primarily relates to potential reproductive implications, including higher rates of miscarriage, preterm birth, breech presentation, and intrauterine growth restriction [ 2 ].

Diagnosis and Treatment

The condition is typically diagnosed through imaging studies such as ultrasound, hysterosalpingogram, MRI, or during surgery [ 3 ]. Treatment is generally not required unless reproductive problems occur, in which case surgical correction (metroplasty) may be considered in select cases [ 4 ]. Women with a bicornuate uterus who become pregnant should receive specialized prenatal care with more frequent monitoring to detect and manage potential complications early.

Pregnancy Outcomes

Studies have shown that women with a bicornuate uterus can have successful pregnancies, even with assisted reproductive technologies such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) [ 5 ]. In fact, one study found that bicornuate uterus had no significant negative effects on cumulative IVF/ICSI outcomes of infertile patients [ 5 ]. However, it is essential to note that each pregnancy should be managed individually, and women with a bicornuate uterus should be closely monitored for potential complications.

Key Points

  • A bicornuate uterus is a congenital uterine anomaly that can increase the risk of pregnancy complications
  • Proper management and specialized prenatal care can help women with this condition have successful pregnancies
  • Surgical correction (metroplasty) may be considered in select cases
  • Women with a bicornuate uterus can have successful pregnancies with assisted reproductive technologies such as IVF and ICSI
  • Close monitoring is essential to detect and manage potential complications early [ 1 ].

References

Research

Successful pregnancy in one horn of a bicornuate uterus.

Annals of African medicine, 2013

Research

Bicornuate uterus is an independent risk factor for cervical os insufficiency: A retrospective population based cohort study.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2017

Research

Uterine anomaly and recurrent pregnancy loss.

Seminars in reproductive medicine, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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