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What is a bicornuate uterus?
If you have a bicornuate uterus it means your uterus appears heart-shaped instead of round. A typical uterus is shaped like an upside-down pear. The wide, round part of the pear most resembles the top portion of the uterus (called the fundus). If your uterus is bicornuate, the top of your uterus dips inward at the middle, making it look like a heart. It’s commonly referred to as a heart-shaped uterus.
The uterus is one hollow cavity and is made to expand to accommodate a growing baby during pregnancy. If you have a bicornuate uterus, the top of your uterus is separated by a piece of tissue. Depending on the degree of separation, this can cause problems during pregnancy because your uterus may not be able to fully expand.
A bicornuate uterus is a congenital condition, which means it formed this way before you were born. A bicornuate uterus is usually not a cause for concern. For people who become pregnant with a bicornuate uterus, there is an increased risk of miscarriage and preterm labor. Most people won’t be aware they have a bicornuate uterus because they usually don’t have symptoms. Some people do experience painful periods or repeat miscarriages.
How common is a bicornuate uterus?
A bicornuate uterus is one of the more common abnormalities of the uterus, but it’s still considered rare. Less than .5% of people assigned female at birth (AFAM) have a bicornuate uterus. Most people won’t be aware they have an irregularly shaped uterus until they’re pregnant and experience several miscarriages.
Is having a bicornuate uterus bad?
No. Having a bicornuate uterus isn’t bad or dangerous. In most cases, you won’t know you have a heart-shaped uterus because you won't have noticeable symptoms. Having an irregular-shaped uterus can contribute to complications during pregnancy. If you have a bicornuate uterus, speak with your healthcare provider to understand the condition and how it affects your life.
Symptoms and Causes
What are the symptoms of a bicornuate uterus?
If you have symptoms of a bicornuate uterus, you might experience:
Frequent miscarriages (usually more than three).
Vaginal bleeding.
Painful menstruation.
Painful intercourse (dyspareunia).
Pelvic pain.
In some cases, you may not realize you have a heart-shaped uterus because you don’t have symptoms. Since you’re born with a bicornuate uterus, the symptoms may feel normal to you. Oftentimes, a person isn’t aware they have a heart-shaped uterus until they’re pregnant or have had several miscarriages.
What causes a bicornuate uterus?
A bicornuate uterus is congenital, meaning you were born with it. The fetal uterus develops while in it's still in the uterus — sometime between 10 and 20 weeks of pregnancy.
During development, two ducts (called the Mullerian ducts) normally fuse together to form one uterine cavity. In the case of a bicornuate uterus, two uterine cavities exist because the ducts did not merge together completely. A bicornuate uterus can have a deep heart shape or it can be minor and never cause a problem.
A heart-shaped uterus is not hereditary — meaning you won’t pass it on to your children.
Diagnosis and Tests
How is a bicornuate uterus diagnosed?
Most people aren’t aware they have a bicornuate uterus until they experience repeated pregnancy loss. Checking the shape of the uterus after repeat miscarriage will reveal the irregularity. In other cases, a heart-shaped uterus is found during a routine ultrasound during pregnancy or because of painful periods.
After an initial pelvic exam, your healthcare provider will use several imaging techniques to confirm a bicornuate uterus. This is done to measure the depth of separation and distinguish a bicornuate uterus from other uterine abnormalities.
Ultrasound: An ultrasound is usually the first diagnostic test used to detect a heart-shaped uterus. After it’s detected, your healthcare provider may use more advanced diagnostics to get a better view of the shape of your uterus. 3D ultrasound can also be very helpful.
MRI (magnetic resonance imaging): This produces the most detailed images of the uterus because it can show multiple dimensions and angles.
What are the different types of bicornuate uterus?
Your healthcare provider may describe your bicornuate uterus as either partial (or incomplete) or complete. These terms refer to how far your uterus dips down at the top of the uterus towards the cervix.
Partial bicorn
