Bicornuate Uterus Pregnancy & Complications

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Bicornuate Uterus Pregnancy & Complications

A woman’s uterus can suffer from an array of abnormalities which can alter its shape and structure. Furthermore, more often than not, these anomalies remain undetected and asymptomatic until the individual becomes pregnant. As a matter of fact, uterine malformations are estimated to affect nearly 3 percent to 5 percent of the general population.

One such uterine malformation is bicornuate uterus – let’s investigate further.

What Is a Bicornuate Uterus?

A bicornuate uterus is a condition when a woman has a uterus that is heart-shaped.  Regarded as one of the most common uterine abnormalities, this condition is often referred to as “heart-shaped womb.” It is a condition wherein the uterus has two cavities and is caused by an abnormal fusion of the Mullerian ducts.

In most cases, women found out that they have this condition after undergoing an ultrasound or an imaging test. Here are some of the other common symptoms:


  • Painful menstruation and uterine bleeding
  • Pain or discomfort in the abdomen
  • Excruciating pain during intercourse
  • Repeated miscarriages

Bicornuate Uterus – Pregnancy and Complications

Generally, the shape and size of a woman’s uterus play a significant role when she is trying to conceive, as well as during her pregnancy. However, there have been cases where women diagnosed with a bicornuate uterus faced no extra difficulties with conception or early-on while being pregnant. In that vein, women with a bicornuate uterus have experienced successful pregnancies and even uneventful vaginal deliveries.

Risks and Complications


  • This condition is usually associated with adverse pregnancy outcomes as studies have revealed that women face a slightly higher risk of miscarriage and of her baby being delivered early. It also needs to be mentioned that women with a bicornuate uterus have higher odds of giving birth to a baby with birth defects as compared to a woman with a regular-shaped uterus.
  • Because of the presence of two horns, the fetus might develop in either of the two horns. The lack of space could cause further problems resulting in a miscarriage as well.
  • In cases where the fetus grows in the larger section of the bicornuate uterus, a full-term pregnancy is possible. That being said, the position of the unborn child could be in a breech or transverse position – affecting the way the baby lies in later pregnancy thus necessitating the need for a cesarean delivery.
  • Chances of uterine rupture are high during pregnancy owing to the presence of a thin wall along with the inability of the malformed uterus to expand like a normal one. In these cases, higher doses of progesterone are administered to increase the thickness of uterine walls and strengthen the lining of the uterus.
  • A bicornuate uterine pregnancy can also hamper the fetal growth of the child thus causing the fetus to be developed with an abnormally low weight as compared to a healthy fetus.



A diagnosis is usually performed with the help of an ultrasound, hysterosalpingography, MRI, hysteroscopy, and laparoscopy. In case the woman has a history of repeated miscarriages and the bicornuate uterus is said to be the cause, surgery is usually recommended. This surgery aims to restore the uterus by eliminating the narrow/smaller cavity and expanding the bigger cavity. This can be done through a Strassman or Thomson procedure.

Studies have stated that with the help of surgical intervention, the risk of miscarriage in women with a bicornuate uterus goes from 90 percent all the way down to 30 percent. However, a pregnancy in a bicornuate uterus requires an early diagnosis of the anomaly following which meticulous care should be taken during pregnancy and delivery to avert the associated adverse outcomes.

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