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Abnormal Uterus

About one woman in a 100 has a uterine abnormality. There’s nothing you can do to prevent an abnormal uterus, and it could go undetected. While it might not affect your ability to get pregnant, it could make it difficult for you to carry your baby for the full nine months, and the risk of miscarriage is greater. It could also make a caesarean necessary at the time of the baby’s birth.

There are a number of different abnormalities of the uterus – some more severe than others. The most common abnormalities are

  • A bicornuateuterus is heart-shaped rather than the upside-down pear-shape.
  • A unicornuate uterus is banana-shaped with a single fallopian tube. If you have a unicornuate uterus, there’s a good chance you’ll still have two ovaries but only one will be connected to your uterus.
  • A unicornuate uterus is banana-shaped with a single fallopian tube. If you have a unicornuate uterus, there’s a good chance you’ll still have two ovaries but only one will be connected to your uterus.
  • An arcuateuterus is the mildest form of the abnormality, and looks quite similar to a normal uterus, but it has a slight dip or arc at the top.

When the two horns migrate down but do not completely fuse together, it is called a true bicornuate uterus and a more common uterine abnormality is a septate uterus where the horns are fused completely but the septum is not completely absorbed. A septate uterus appears as two horns internally but looks unified externally.

‘’Miscarriages may be associated with a Septate Uterus while a true bitcornuate uterus can be generally associated with a higher risk of preterm labour and birth but not with miscarriages. These abnormalities can be approached surgically’’- says Dr.S.Samundi Sankari.

Diagnosis

Usually we recommend our patients for a HSG (Hysterosalpingogram) which confirms the size of the septum and also the calibre of the uterine horns. Sometimes a more advanced MRI would be required to confirm the uterine anomalies.

Treatment

At Srushti, we repair a septate uterus by operative hysteroscopy with septum resection – Dr DivyaSivaraman. And for a bicornuate uterus our approach will be through a more major surgery which is also called Strassman procedure – Dr Samundi Sankari.

Surgical correction otherwise known as Metroplasty is the most recommended line of treatment for a septate or bicornuate uterus. Soon after the surgery, pregnancy can be attempted and your chance for a successful pregnancy is excellent.

For women who had surgery for a bicornuate uterus, we recommend that they wait for at leastthree months before conceiving, and that cesarean section should be the best option for their delivery. This is recommended to avoid the risk of uterine rupture during labor.

In our experience, we do not recommend surgical approach (metroplasty) for both unicornuate uterus or uterus didelphys as it doesn’t help the women to conceive.