Bicornuate uterus and pregnancy: features of gestation and what will be the birth. Bicornuate uterus and pregnancy

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During pregnancy, it is quite common to have various pathologies at the fetus. This also applies to the formation of the genital organs. In this article we will talk about such an anomaly as bicornuate uterus. Interestingly, this phenomenon does not occur as often as compared to other pathologies. For example, some pathologies of female organs are found in 62% of women. Whereas the bicornuity of the organ is found in only 0.5-1% of all women. So, let's take a closer look at what kind of pathology it is, and what consequences it has on a woman's life.

What is a bicornuate uterus and what does it look like?

A bicornuate uterus is a congenital malformation of the body of an organ that begins to develop even in the prenatal period of a girl's life. This defect affects the structure of the body of the uterus. Interestingly, when the bicornuate body of an organ is present in women, they do not even suspect it. This pathology It has several types, and therefore its manifestations are different.

How does she look? Normally, the uterus resembles a pear in shape. With bicornuity, this organ visually resembles a jester's cap. That is, the body of the organ diverges into different sides, as if branching off. Hence these branches are called horns. These two branches are connected cervical canal. Sometimes these two horns are not symmetrically developed. One of them may even cease to function over time. Interestingly, with this form of uterus, the fetus can develop in the right, left, or in the middle. Therefore, in a woman with this pathology, during pregnancy, you can see such an entry in the card: "a bicornuate uterus with pregnancy on the right side." Visually, a variety of bicornuate queens can be seen in the picture below.

Causes of the anomaly

Name exactly what influenced the formation of a bicornuate uterus, on this moment nobody can. It remains only to assume what could cause the development of this anomaly. One of the assumptions remains that during pregnancy and the maturation of the fetus, the woman did not consume enough vitamins and macronutrients. And this contributed to the formation of pathology. Below are a few conditions that, according to the observation of specialists, can cause the formation of this pathology.

• stress and psychological trauma during pregnancy;
• avitaminosis;
• taking certain medications (tetracycline group);
• the presence of bad habits during gestation;
• drug intoxication;
• previous diseases during gestation, such as influenza, measles, jaundice, rubella, and even the usual SARS;
• the presence of a heart defect in the mother;
• endocrine abnormalities: diabetes, abnormalities in the thyroid gland;
• negative ecological atmosphere;
• hereditary manifestations of pathology.

Also adverse effects for normal development fetus can serve as toxicosis and fetal hypoxia.

Symptoms

Most patients with this defect do not feel any clinical manifestations until the first ultrasound. Some learn about their pathology only during pregnancy. In some cases, pregnancy and childbirth are so successful that it cannot be assumed that a woman suffers from a pathology. But still, the symptoms make themselves felt in most cases. The following are the most common manifestations of a bicornuate uterus.

• hormonal disorders;
• painful menstruation;
• the duration of menstruation is maximum;
• pain during PMS;
• miscarriages;
• difficulty in pregnancy;
• an enlarged organ begins to put pressure on nearby organs, causing discomfort.

Those who have been diagnosed with the presence of this pathology should not consider themselves different from everyone else. After all, the bicornuate uterus does not affect the quality of sexual life at all. The woman still experiences excitement and has the opportunity to get an orgasm. And the anomaly does not always affect the possibility of conception. A girl may well conceive and give birth to a child without any problems. Also, with a bicornuate uterus, girls and women should not experience pain during intercourse, unless there are concomitant diseases with a similar symptom.

Kinds

Uterine pathology caused by bicornuity is different types. The following are the three main types of bicornuity.

Consequences and complications

All the consequences and complications from pathology can manifest themselves only during childbearing and childbirth. What are these manifestations?

• vaginal discharge during gestation with bicornuity can be observed throughout pregnancy;
• partial placenta previa at 8 weeks of gestation;
• spontaneous abortions in the early stages;
• premature birth due to the fact that the egg is not fully attached correctly;
• low position gestational sac;
• leakage of amniotic fluid;
• due to the fact that such a uterus is much smaller in size than usual, the child is not able to move freely, so the fetus may lie incorrectly;
• poor fetal nutrition;
• the risk of developing postpartum endometritis;
• early opening of the cervix (cervical insufficiency);
• if the embryo is attached to a non-functional uterine horn, then actions similar to an ectopic pregnancy are carried out - an operation to eliminate the fetus;
• exfoliation of the placenta ahead of time.

Diagnostics

How is it possible to detect this pathology, even if all the symptoms are absent? There are basic effective methods diagnosis of a bicornuate uterus. First of all, this is a visual examination by a gynecologist. Already at this stage, the doctor will see the presence of partitions and send for additional methods research. The main purpose of these examinations should be to determine the functionality of the uterus and the possibility of conception and childbirth.

• ultrasound. Ultrasound should be performed using vaginal or abdominal probes. If changes in the uterus are insignificant, then bicornuity may not be detected immediately. Therefore, it is very important to use 3D ultrasound instead of 2D.
• MRI. This is a fairly highly informative method for establishing pathologies. internal organs. Tomography allows you to accurately determine the presence of pathologies and the degree of their development. It shows the shape, structure and location of the pathology in the uterus.
• Laparoscopy. Surgical examination. With small incisions in abdominal cavity place the sensor with the camera. The image of all internal organs is displayed on the screen. So the doctor will determine the exact location of the pathology.
• Hysteroscopy. The cavity is examined using an endoscope. The structure of the endometrium and the shape of the uterus are assessed. The doctor also determines whether the mouths in the fallopian tubes are passable.
• Hysterosonography. This is a study of the inner female organ by introducing into it contrast medium. Next is done X-ray and it determines the type of pathology of the uterus. It allows you to determine the non-functioning sides of the bicornuate organ.

After determining the presence of a pathology, the doctor decides whether it is worth treating. Positive decision accepted if the pathology

The diagnosis of "bicornuate uterus" in medicine is not uncommon. It is often associated with female infertility or problems with childbearing. Malformations of the reproductive system are formed even before the birth of a girl.

Malformations

Congenital anomalies of the reproductive system average about four percent of all malformations. AT reproductive age 3–3.5% of women have this pathology.

Among girls with various gynecological diseases, malformations of the uterus and vagina can be found in 6.5%. They seriously complicate the life of the child and in the future pose a threat to the realization reproductive function. AT last years there is an increase in the frequency of anomalies of the genital organs in women, more than 10 times.

Most often, doctors observe atresia of the hymen, underdevelopment of the vagina or uterus, as well as their doubling. The latter also includes a bicornuate uterus.

Anomalies in the development of the reproductive system are often associated with malformations of the urinary and musculoskeletal systems. Such combined pathologies are often combined into syndromes.

bicornuate uterus

The internal genital organs of a girl are formed in the early stages of pregnancy from symmetrical genital canals - the Müllerian passages, or ducts.

The Latin name for a bicornuate uterus is uterus bicornis. Most often, it is formed in a situation where the body of the organ is divided by a septum, but there is a tight connection in the neck area.

Depending on the level at which the fusion of the Muller passages occurred, there may be various options bicornuate uterus. So, it happens with one neck or two (and in this case it is called the uterus bicornis biccollis).

In addition, sometimes developmental disorders also affect the vagina - a partial septum may be found in it. This pathology is called vagina subsepta.

A variant of the bicornuate uterus is saddle-shaped, when a woman has only a recess in the bottom area, and the "horns" are expressed to a small extent. The saddle shape of the organ in gynecology is designated uterus arcuatus.

Sometimes the uterine septum may be incomplete - only in the neck or bottom, and the patient has a uterus subseptus. If the cavity is completely divided, then medical diagnosis sounds like uterus arcuatus septus.

The presence of an incomplete septum and the saddle shape, as a rule, do not disturb the normal functioning of the organ too much, and its surface looks normal.

If one of the paramesonephric ducts lags behind in development, then a uterus bicornis is formed with an additional rudimentary horn.

Causes

Modern medicine still cannot explain all the causes of birth defects reproductive system. Most often, their formation is associated with the following factors:

• Heredity.
• Influence of physical agents.
• Infectious lesions.
• Taking medication, especially in the early stages.
• Biological inferiority of the cells from which the reproductive organs are formed.

The main mechanism for the appearance of anomalies in the development of the reproductive system is a violation of the fusion of the embryonic genital canals. These structures are paired and are better known as "Müllerian channels". They can remain completely separate, in such a situation the girl will have a doubling of the genitals.

With partial fusion, a bicornuate uterus is formed. The reason for its appearance may be various processes and states.

The genetic theory connects the appearance of a defect with the translocation (movement) of a gene that activates the formation of a mullerinhibiting substance on the X chromosome. In addition, a significant influence gene mutations sporadic nature, as well as the action of teratogenic factors.

Also, doctors put forward another theory linking the incorrect formation of the internal genital organs with the perforation of the wall of the so-called urogenital sinus.

Such perforation leads to a pronounced decrease in pressure in the lumen of the vagina and genital ducts. Because of this, the cells of the septum do not die, but retain their vital activity, blood vessels begin to grow into the zone. Bottom line pathological process becomes the formation of a bicornuate or double uterus.

Diagnostics

Most often, such a defect does not manifest itself in any symptoms. At a certain age (11–15 years), the girl begins menstruation, which is then observed every month.

Sometimes there are violations of the female sexual cycle, which force the patient to consult a gynecologist. This is usually dysmenorrhea, but there may be recurring uterine bleeding. In this situation, the diagnosis is established in a timely manner.

But more often a woman learns about a bicornuate uterus during an examination for infertility or habitual miscarriages. With such a defect, miscarriage is more common, since it is characterized by a violation of the formation of the placenta. Problems with conception are more characteristic of combined anomalies of the reproductive system.

Diagnosis of this defect is based on data:

1. Gynecological examination. However, it is not always highly informative.
2. Ultrasound.
3. Hysteroscopy and laparoscopy. This method is one of the most accurate and reliable, as it allows you to consider all the features of the structure of the organ.
4. Magnetic resonance imaging.

Malformation and pregnancy

A bicornuate uterus is not always manifested by problems with conception. However, infertility occurs with this malformation, which should be remembered by any doctor.

The probability of violation of conception depends on the degree of "bicorns". The more pronounced splitting, the more likely problems are when trying to get pregnant. The saddle uterus is considered the most favorable option in this regard.

But even if pregnancy has occurred, with a bicornuate uterus, the risk of miscarriage in the early stages increases. In addition, this defect is often accompanied by the following complications:

1. Placenta previa.
2. Violation of the position and presentation of the fetus.
3. Isthmic-cervical insufficiency.
4. Pathological uteroplacental blood flow.
5. Spontaneous abortion.

How to get pregnant with a bicornuate uterus? To date, gynecologists agree that every effort should be made for natural conception. And only with the ineffectiveness of long-term attempts to seek help from surgeons. However, most often a bicornuate uterus and pregnancy are not mutually exclusive concepts.

Malformations of the genital organs can also affect labor activity.

childbirth

Childbirth with a bicornuate uterus can be accompanied by certain problems. With a pronounced splitting of the organ, the fetus is located in one of its halves. This means that the uterine muscles are overstretched and the risk of weakness of labor activity, as well as its discoordination, increases.

Also, with this defect, premature rupture of amniotic fluid is often observed.

The probability of traumatizing the child and mother during childbirth in the case of a bicornuate uterus increases. That is why many obstetricians offer a woman a planned caesarean section. However, in some situations it is possible natural childbirth without serious complications.

Treatment

The treatment of such a defect as uterus bicornatis is currently only surgical. Indications for surgical intervention are usually various disorders of the reproductive function. The most common among them are:

• infertility;
• miscarriage.

The technique of operation for this anomaly depends on its variant.

Most often, the surgeon cuts uterine walls along the inner (medial) rib on both sides longitudinally. In some cases, even part of the wall has to be excised. Then the edges of the horns obtained by dissection are sutured. As a rule, several rows of sutures (2-3) are used. As a result of surgical intervention, one, full-fledged uterus is formed.

To date, a bicornuate uterus is not a sentence. Sometimes a woman can become pregnant on her own and bear the baby without the intervention of surgeons. However, close medical supervision during this period is necessary.

Some women have congenital anomalies uterus development. If deviations in anatomical structure pronounced, symptoms of disruption of the reproductive system may appear. But sometimes a woman does not even suspect that her uterus has an irregular shape, since the defect does not bother her. The onset of pregnancy in the presence of such a pathology is possible, but there is a possibility of complications. If the diagnosis is established, then before planning a pregnancy, it is recommended to do metroplasty. You can use the IVF method.

Content:

Features of the pathology

A bicornuate uterus is the result of a violation prenatal development girls, which occurs at the very beginning of the formation of organs in the embryo (approximately at 6-8 weeks of pregnancy). The uterus and vagina are formed from the so-called Mullerian ducts. Pathology leads to improper fusion of these structures.

Normally, the uterus is a cavity that has branches (pipes) at the base and narrows at the exit to form the cervical canal. Pathological development leads to the fact that 2 sections (two horns) are formed in the cavity at once. They may be equivalent, but sometimes one of them is only a rudimentary process associated with the main cavity. If the fetal egg is fixed in this process, then the pregnancy in the bicornuate uterus will develop in the same way as an ectopic one. The danger is that when the embryo reaches a certain size, the vestigial horn ruptures, which leads to severe internal bleeding.

The neck of the organ may have the usual form, but sometimes it is also bifurcated (with complete division of the bicornuate cavity). It is even possible to have a second vagina, and this is not an obstacle to a normal sexual life.

The formation of a bicornuate uterus is observed very rarely, in about 0.5% of women. Most often, the presence of such a pathology affects the functioning of the reproductive system. How much depends on the degree of violation of the shape and structure of the genital organs.

Options for deviations from the norm

A bicornuate uterus may different shape. Several variants of its pathological development are observed.

Complete split. 2 horns appear, forming an angle. The bicornuate cavity may have a common neck, while there may be a septum dividing the vagina into 2 parts. The so-called absolute doubling can occur when 2 independent uteruses are formed, each with a separate neck extending into its own half of the vagina. If the branches are full, the onset of pregnancy, its normal course and birth healthy baby quite possible. Usually the fertilized egg is fixed in one of the horns from the side of the ovary where ovulation occurs. There are also extremely rare cases when, during the maturation of eggs in two ovaries, embryos develop in both parts of the bicornuate cavity.

Incomplete splitting. From the side of the bottom of the bicornuate uterus, a partition is formed, partially separating its cavity, but then both horns are connected, passing into a single neck. With this form of uterus, pregnancy is possible, but there is a high probability of miscarriage, especially if the fetal egg begins to develop in the region of the septum. Even if the fetus is located in an unbranched area of ​​the bicornuate cavity, it may not have enough room for growth or it may not be positioned correctly, which will complicate childbirth.

Saddle bicornuate uterus. Its bottom bends into the cavity, dividing it in half in the upper part. With this form of the organ, pregnancy occurs and proceeds as usual. But if the saddle shape is combined in a woman with a narrow pelvis, she will not be able to give birth on her own. In this case, the fetus is removed by doing a caesarean section.

Reasons for this anomaly

The main reason for the improper fusion of the Mullerian ducts in the embryo and the congenital formation of a bicornuate uterus is the complicated course of pregnancy in the expectant mother. Increased blood pressure, Availability cardiovascular disease in a pregnant woman, other malformations leading to fetal hypoxia provoke developmental abnormalities.

This is also facilitated by the contact of a pregnant woman with harmful chemicals in production, the use of potent medicines, alcoholic beverages as well as smoking. A bicornuate uterus can form in an embryo if a woman has had an infectious disease during pregnancy.

Extremely harmful to the health of the unborn baby is reflected in the lack of vitamins and minerals in the mother's body. Hormonal abnormalities, metabolic disease, endocrine pathologies(e.g. diseases thyroid gland) can also cause the formation of a bicornuate uterus.

Such a pathology is hereditary and occurs in female relatives from generation to generation.

Signs of a split uterus

With this pathology, symptoms do not always appear. If both horns are developed normally, the woman's menstruation proceeds as usual. However, menstruation can be painful, especially if atresia occurs - narrowing of the horn cavity as a result of its partial overgrowth. There may be uterine bleeding.

It is possible to assume that a woman has a bicornuate uterus by the following signs:

• menstruation is abundant and prolonged, since the volume of the endometrium is larger, and its excretion is difficult due to irregular shape necks;
• for a long time a woman fails to get pregnant;
• pregnancy occurs, but it is not possible to bear the child, every time a miscarriage occurs;
• pregnancy in a woman develops normally, but body weight is added slightly, since the fetus grows more slowly than it should. The reason is that the space in which it is located is too small.

Addition: There may be other problems during pregnancy. The placenta is too close to the cervix breech presentation fetus, miscarriage occurs due to placental abruption. It is possible to reduce contractility, with a severe and prolonged course of childbirth.

If the fetus develops in one horn of a completely split cavity, the usual cyclic processes can occur in the other half, at one time even menstruation appears.

Possible Complications

In the bicornuate uterus, blood circulation is disturbed, especially in the area of ​​\u200b\u200bthe walls, which leads to improper formation of the endometrium. It may be too thin for the embryo to be fixed in it.

Violation of the structure of the body sometimes leads to endometriosis, tubal pregnancy. Long and frequent periods cause anemia. At the same time, iron deficiency affects the functioning of all organs and the central nervous system. Women with a bicornuate uterus have an increased risk of postpartum hemorrhage, stagnation of blood in the cavity (hematometers), inflammation of the mucous membrane (endometritis), formation of adhesions, accumulation of pus in them.

How is a bifurcated uterus diagnosed?

Diagnosis starts with gynecological examination to determine the shape of the vagina. By palpating the lower abdomen, the doctor checks for abnormalities in the shape of the uterine fundus.

ultrasound urinary organs carried out both with the help of an external sensor (abdominal examination), and with the help of a vaginal one. In this case, it is established what shape the uterus has, what is the structure of the cavity. With minor deviations from the norm, it is not always easy to detect a bicornuate uterus in this way.

An examination of the organ cavity is carried out using optical instrument hysteroscope. Sometimes applied diagnostic laparoscopy, with which you can detect defects in neighboring organs, and if necessary, eliminate them without cutting the stomach.

Hysterosalpingography (X-ray with the introduction of a contrast solution into the bicornuate cavity) allows you to study the nature of the splitting. However, this method cannot detect a small branch from the main uterine cavity, as well as an atrezated horn (in which the lumen has been overgrown).

The most effective diagnostic methods in this case are CT and MRI, which allow you to get an image of a bicornuate uterus from different angles, accurately determine its shape, wall thickness, and location relative to other organs.

Video: Bicornuate uterus. Diagnosis and treatment

Treatment

If a bifurcation of an organ is the cause of infertility, constant miscarriages or the birth of a dead child, then a woman seeking to normal pregnancy, held surgery. There is no other way to eliminate such a defect as a bicornuate uterus.

The so-called metroplasty is carried out. During the operation, a rudimentary branch is removed, a septum is excised inside the bicornuate cavity, or the shape of the saddle bottom is corrected. In this case, low-traumatic methods of penetration into the organ cavity are used, such as laparoscopy under ultrasound control or hysteroscopy.

Operations are also carried out using as a knife laser beam. These techniques avoid significant damage to the uterus.

Sometimes a woman is advised to resort to artificial insemination, if, in addition to the fact that the uterus is bicornuate, tubes are found to be blocked in it. IVF is also performed if a woman's follicle supply is depleted, the only chance for her to give birth to a child is the transplantation of donor eggs.

In most cases, the operation is successful, and the goal that the woman aspires to is achieved. 90% of patients after such treatment are able to endure and give birth to a healthy baby.

After the onset of pregnancy in a patient who has undergone surgical treatment, the development of the fetus and the condition of the expectant mother require especially careful monitoring in order to prevent spontaneous abortion or bleeding. If the threat of miscarriage occurs after the 26th week of pregnancy, the child is saved by giving birth with the help of caesarean section.

Features of contraception

If a woman does not want to get pregnant, she uses contraceptives, then in the presence of a bicornuate uterus, she needs to be especially careful in choosing contraceptives. For example, contraception with an intrauterine device will not work for her if the bifurcation of the organ is complete or the septum separates most of the cavity. With a saddle-shaped uterus, such contraception is possible.

The most convenient method of protection against unplanned pregnancy in the presence of such a pathology is the use of condoms or combined oral contraceptives.

There comes a time when a girl realizes that she is ready to become a mother. At the same time, each even thought does not admit that she may have any problems in this area. It seems that everything is simple - she got pregnant when she wanted to, carried a child and gave birth without problems. What's wrong with that, a normal natural process that many women have gone through. And when something does not go according to plan, fear arises inside and the question is: "Why with me?".

First pregnancy

Rarely, when planning a pregnancy, passes full examination and knows exactly about all the features of his body. And the first pregnancy or unsuccessful attempts to get pregnant is the period when unpleasant moments can open up. During an ultrasound, a woman can find out that she is pregnant with a bicornuate uterus. And this can be cause for concern.

Such a discovery is not yet a reason for hopeless despair and fears, but the bicornuate uterus belongs to the category of pathologies, therefore, there are still some peculiarities and nuances of the course of pregnancy. This has a significant impact on its course. First, nevertheless, we will clarify the question of what a bicornuate uterus is and why it has an irregular structure.

Abnormal structure of the uterus

There are many pathologies in the development of internal organs, and the uterus is no exception in this case. A bicornuate uterus is a pathology when an organ has an abnormal structure. You need to understand what it is serious problem, the course of pregnancy is complicated, and such a pathology is the reason for increased control by the gynecologist.

Such an anomaly of the structure is congenital, the deviation occurs already in the prenatal period, when the embryo grows, and in the first trimester the laying and development of internal organs takes place. During this period, a failure may occur caused by severe intoxication or some diseases of the mother. When a girl is born, she already has this problem. Of all possible pathologies abnormal development of the uterus, bicornuity is considered the most common. She meets in different forms and degrees of severity, therefore, you should not attribute the diagnosis and terrible forecasts to yourself.

How does the irregular structure of the uterus affect pregnancy?

Such a diagnosis does not mean at all that now a woman will not be able to have children. In this position, you can get pregnant, but you should follow the advice of doctors, as well as a little patience. The uterus has congenital modifications, in its upper region there is a division into two parts, they resemble horns. The horns may be symmetrical and fully developed, or one may be larger than the other. Pregnancy can occur in each of these horns. There is also a saddle uterus, it has a different shape. All these developmental anomalies can lead to uterine infertility. Pregnancy with a bicornuate uterus may not occur at all. This is what becomes the main factor for concern.

Pregnancy has come

The abnormal structure of the uterus does not yet mean that there will definitely be problems with conception. Expectant mothers can find out about the anomaly only by registering for pregnancy, and such a diagnosis puzzles them greatly.

The bicornuate uterus can also manifest itself before pregnancy with amenorrhea and impaired menstrual cycle, painful periods. But these same symptoms can occur with other gynecological diseases. So during pregnancy, a woman may hear for the first time that something is wrong with her. A doctor of few words can say that the patient has a bicornuate uterus and pregnancy in the left horn without going into details. No doctor wants to scare the expectant mother with possible complications, but they are quite real.

Possible Complications

Even with the normal structure of the uterus, problems can occur during pregnancy. And what does a bicornuate uterus mean during pregnancy, what risks can arise during this period? What can happen:

• In the early stages of pregnancy, a breakdown occurs. The risks that a woman does not bear a fetus increase many times over. This is due to the fact that the uterus with an elongated shape does not allow the fetal egg to attach correctly. The bicornuate uterus has a thinner the inner layer, and for the attachment of the embryo, this is bad.
• premature birth. An irregularly shaped uterus stretches worse. It is usually smaller in size.
• The bicornuate uterus and pregnancy in the right horn restrict the child's movement. This causes the baby to take wrong position, and there is a breech presentation, oblique or transverse.
• When the embryo is attached very low, then there is a high probability that placenta previa will develop.
• Pregnancy with a bicornuate uterus may be accompanied by leakage of amniotic fluid.
• The pregnancy is terminated different terms due to the fact that the cervix cannot hold the fetus and opens ahead of schedule. When this happens, doctors talk about cervical insufficiency.
• Pregnancy in a rudimentary horn (poorly developed) is equated with an ectopic pregnancy, these two points are considered an indication for termination of pregnancy.
• With this structure, insufficient blood circulation causes placental abruption.

Despite all possible complications, with a bicornuate uterus, a second pregnancy is also possible. This is very rare, but such cases have been recorded in medical practice.

Uterine discharge during bicornuate pregnancy

In addition to the symptoms that are inherent in all pregnant women, in the form of toxicosis or increased fatigue, the owners of a bicornuate uterus also face such a problem as discharge. In the first trimesters may appear bloody issues, they can be both dark and bright. If something suspicious begins to occur in the body, then you should immediately consult a doctor. Most often, a woman is recommended complete rest and hospitalization. If the fetal egg is attached to the side wall or bottom of the uterus, then this will provoke bleeding. The internal uterine os may be blocked by a low-attached embryo. In this case, the woman feels pain, which is the first stage of abortion.

The likelihood of problems

With such a structure of the uterus, problems in pregnant women arise. But not all at once and not everyone has the same difficulty during pregnancy. For up to two months, 35% of women with bicornuate pregnancy have bleeding. 45% have a partial placenta previa.

Bleeding can open much later, after thirty weeks of pregnancy, in the last trimester. This means that in the place of previa, the placenta can no longer stretch, and the uterus continues to grow and detachment begins. This leads to premature birth, often they end in a caesarean section. If a woman has a bicornuate uterus and the pregnancy is in the right horn, then you need to understand that there is absolutely no difference if the pregnancy was in the left horn. The manifestations and condition of a woman in these cases will not differ in any way.

fertilized egg in the horn

If the fetal egg is attached in one of the horns, it does not really matter in which one. Bicornuate uterus and pregnancy in the left horn do not give any special manifestations. The most important thing is that there is a good supply in this place, the capillaries and vessels are in enough. The more underdeveloped the uterus, the farther apart are the horns. Most the best way with a bicornuate uterus, so that the fetal egg is well fixed in it. If the fixation occurs in any of the horns, then there is an increased load on the genital organ. If the embryo is attached to a place with insufficient nutrition, then the pregnancy will terminate itself, a miscarriage will occur.

Treatment of a bicornuate uterus

As mentioned above, you can get pregnant and bear a child even with such a pathology. But there are cases when pregnancy does not occur with a bicornuate uterus, or different stages a woman has miscarriages. There are already many questions about possible ways treatment and solution to this problem.

One of effective methods is an operation during which the intrauterine septum is removed and artificially creates a single uterine cavity. Often this is the only right decision and allows the expectant mother to bear the child without difficulty. There are time limits here, you can get pregnant no earlier than a year later. It is necessary to give time for the tissues to grow together, if you do not meet these deadlines, then when stretched, the uterus can rupture in this place and open internal bleeding. This is dangerous not only for the death of the child, but also for the mother.

Features of the course of pregnancy

All women in a position with such a structure of the uterus are under increased control of gynecologists. Pathology can make itself felt at any stage of pregnancy. The doctor must monitor the symptoms and do everything possible so that the pregnancy is maintained and the fetus develops correctly.

When the uterus is incomplete, the blood circulation in it may be impaired, in connection with this, the fetus may have oxygen starvation. In this case, so that the child does not suffer, a caesarean section is performed from the 28th week. There are also good news- such a pregnancy can take place without pathologies, there may be minor violations. Pregnancy with a bicornuate uterus and discharge almost always occur together. Nose blood secretions you need to be careful, they can appear at any stage of pregnancy, the doctor should know about it. Since this can be a clear symptom of a threat, and this process cannot be stopped.

Pregnancy and childbirth

If the embryo is stuck in the wrong place, then spontaneous abortion usually occurs in the first trimester, the fetus simply does not have enough nutrition, and it becomes unviable. The risks are also associated with a small space in the horn, the fetus does not have enough space for development. Bleeding during pregnancy with a bicornuate uterus does not always indicate the danger of a breakdown. However, you should be careful. We have already talked about the difficulties, but not everything is so simple when we talk about a bicornuate uterus and pregnancy. Reviews of women who have gone through this path, in fact, give hope and confidence that everything can be fine.

Women note that the onset of pregnancy can be difficult, there is uterine hypertonicity, detachment of the fetal egg, but by the third trimester everything can return to normal. The baby may be born with minor defects such as torticollis and increased tone but it's easy to fix. With such a pathology, the baby may appear for several weeks. ahead of time.

As a rule, not all births in the owners of a bicornuate uterus end surgical intervention, but there are cases when it is simply necessary for the safety of mother and child. A photo of a bicornuate uterus during pregnancy allows you to see why it is so problematic for the fetus to be in it. There simply isn't enough room for him.

Pregnancy planning

Ideally, pregnancy should be planned, before conception it is necessary to undergo an examination, ultrasound of the female genital organs. Having heard about such a diagnosis, it can be assumed that the pregnancy may end in a miscarriage. To prevent this from happening, some women want to plan their pregnancies in a year and bear the child without fear for his life, but doctors do not go for it. Question about surgical intervention rises after a woman has had 2-3 miscarriages in a row or she cannot get pregnant at all. After the operation, the woman is given intrauterine device for 6-8 months to exclude pregnancy at this time.

What to prepare for?

Naturally, everything that is connected with our body causes a lot of emotions in us. Nobody wants to have problems in any area of ​​their health. Any diagnosis already suggests that not all is well. Increased risks spontaneous abortion, strong feelings, the need to limit oneself in something - all this is very unpleasant, but women are ready to go for it for the sake of the desired motherhood.

Even with such a diagnosis, pregnancy can proceed without complications if the body of the uterus is of sufficient size. After surgery to correct the uterus, the risks of pregnancy are reduced by 60%. There are also assisted reproductive programs and technologies that can solve this issue.

So don't let the bicornuate uterus and pregnancy scare you. Reviews of doctors about modern technologies reproductive medicine based on real practices. These cases are not isolated, and there are already many solutions for them.

Frozen pregnancy

With a fairly high percentage of successful pregnancies, there are cases with an unfavorable outcome. At the first stages, the fetus can freeze and stop its development, the result is its death. This happens almost always if the egg clings to the septum, and not to the uterus. There are no barriers blood vessels. The embryo does not receive nutrition and dies.

In some cases, artificial insemination is carried out and the embryo is engrafted to the place where it has the most chances for full development, where it will have sufficient nutrition and a place to grow.

The most favorable option

This pathology has a variety called the saddle uterus. Such a deviation is considered one of the favorable options for the development of the fetus. This type can also cause miscarriage, but this happens much less frequently. Up to 25% of women with a saddle uterus experience preterm labor. The position of the fetus in such a uterus is often oblique or transverse. Sometimes you have to do a caesarean. If the birth goes naturally, then such a uterus contracts for a long time and bleeds.

There are also cases when twin pregnancy occurs, but then two-hornedness has nothing to do with it. This pregnancy belongs to the group with a high degree risk. They may even happen. There have been cases in medical practice when one of the fetuses was aborted, and the second child developed fully and was born at the right time.

Pregnancy can simultaneously develop in two horns. Most often, pregnancy with uterine pathology ends with an operation, but this does not detract from the joy of parents. After all, another person came into the world.

There's a lot physiological pathologies, which are a contraindication for a woman to become pregnant and give birth. These problems are not only related to reproductive system, it can be heart disease, and kidney problems. For a sick organism, pregnancy is a real test, and the risks are sometimes incredibly high.

But any woman wants to be a mother and is even ready to sacrifice her life and health for the sake of a child. Doctors always warn about everyone possible risks, they are obliged to do their part of the work, but the final decision is still made in the family. A bicornuate uterus during pregnancy is not a sentence.

Pregnancy and a bicornuate uterus are often identified together with the first ultrasound, at the end of the first trimester. Such congenital pathology is caused by the fact that the cavity is divided into two parts and threatens ectopic pregnancy. But the most common manifestation of an anomaly is the inability to conceive a child or infertility.

What is a bicornuate uterus?

Depending on the degree of separation, several types are distinguished:

• the bicornuate saddle uterus looks like a heart and is caused by the presence of a small depression, which does not prevent conception;
• complete bicornuity - accompanied by an almost absolute division of the cavity into two parts, in each of which fertilization of the egg is possible;
• incomplete separation is characterized by the development of a slight septum in the upper part.

Features of the pathology

In the case of a complete bicornuate organ, the division may form unevenly. If, for example, conception occurs in the right horn, which is smaller in size, then the development of the embryo becomes impossible. Pathology is characterized by an ectopic pregnancy, a rupture will occur and bleeding will begin. And vice versa, if - in the left horn, which is sufficiently formed, then gestation will occur without significant deviations.

A structural defect can be accompanied by various difficulties at different times:

• placenta previa is caused by the overlap of the cervical pharynx, thus, this location prevents the natural birth of the child;
• premature aging of the placenta poses a danger to the formation of the baby, hypoxia develops and there is a lack nutrients;
• oblique or transverse presentation of the child, caused by a reduced size of the cavity.

What is dangerous bicornuate uterus during pregnancy

An anomaly in the formation of several embryos is dangerous for the incorrect presentation of children, which indicates more likely use of caesarean section alternative means for new life to emerge.

The main feature in this pathology is labor activity ahead of schedule, up to 37 weeks. Childbirth is preceded by the outflow of amniotic fluid, and the immaturity of the cervix provokes additional stimulation. Toddlers at this stage are already fully formed and ready for independent life, but regardless of this, the supervision of specialists should remain unchanged during the first weeks.

Childbirth with a bicornuate uterus

The anomaly should be detected early, during the passage ultrasound examination. At the same time, doctors understand that it is necessary to take into account all possible factors that determine the entire nine-month period.

The main features of the bicornuate uterus are the presentation of the fetus and premature birth, so you need to carefully prepare for this outcome. Specialists, in a few weeks, put the woman in storage in order to respond in time to the symptoms of early labor and provide the baby with proper care.

The postpartum stage is also dangerous for the woman in labor, there is a threat bad contraction and low tone uterus. When there is too little blood, the outflow from the cavity is disturbed, there is a risk of infectious and inflammatory processes.

Deformed cavity reproductive organ can become an obstacle to conception. Therefore, the best solution would be a planned pregnancy, in which all defects and diseases will be cured. But the onset of conception with an abnormal structure of the reproductive organ should not cause fear and anxiety. Already after the 30th week, doctors will strongly recommend to go to the hospital for preservation in order to avoid complications during the onset of labor or to apply a caesarean section in a timely manner.