Q: Bicornuate Uterus?
Posted
Monday, November 05, 2007 8:05 PM
Q: I was recently diagnosed with a bicornuate uterus. Can you
tell me more about this condition? And, what methods should we use in
hopes of success? -sarahbeear
Dr. Joseph Hill:
There are many uterine (womb) abnormalities. Bicornuate uterus
literally means "two horns," and refers to a congenital uterine
formation problem.
Embryologically,
the uterus is formed beginning at five weeks of gestation. It starts
out near the kidney as two separate structures called horns, then
migrates down into the pelvis as the two horns fuse into one. The area
of fusion is a septum dividing the two, and is reabsorbed to make a
normal intrauterine cavity. Sometimes, however, this normal
progressions does not occur.
A true bicornuate uterus is one in
which the two horns migrate down but do not completely fuse to make a
normal uterus. A more common abnormality is a septate uterus. This is
an abnormality in which the uterine horns fuse completely, but the
intervening septum is not completely absorbed. The uterus then appears
as two horns internally, but externally looks to be unified.
A
septate uterus may be associated with miscarriages, while a true
bicornuate uterus is generally associated not with miscarriages, but a
higher risk of preterm labor and birth. A noninvasive procedure called
a pelvic MRI can differentiate these two conditions and other uterine
congenital abnormalities.
Both abnormalities can be approached
surgically. A septate uterus can be repaired with a day surgical
procedure walled an operative hysteroscopy with septum resection. A
true bicornuate uterus can only be approached through a more major
surgery called a Strassman procedure, which requires an abdominal
incision.
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