Two-horned uterus - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Women's Diseases

bicornuate womb (uterus bicornis) - it malformations of the uterus, in which there is a full or partial separation of the uterine horns into two, in the presence of the merger in the area of ​​the cervix.This pathology is related to abnormalities of the uterus and vagina, it is quite common and may or may not cause a problem, and the cause of infertility, miscarriage, cycle disorders, etc.

total incidence of uterine malformation is not high, about 0.5-1% of the population.Among the most common is two-horned uterus 62%.

Causes of uterine bicornuate

The appearance of malformations, apparently, depends on the conditions of malnutrition, gas exchange, and other environmental conditions in which the fetus develops.The environmental conditions of the fetus determined by the state of the mother.Therefore diseases, especially infectious, toxic, endocrine disorders and other abnormalities in the mother's body, causing sudden changes in terms of embryo protection, can serve as a cause of congenital malformati

ons.It should also add that it is not a small role in the formation of defects can play and genetic factors.

To understand the question should refer to the Embryology.bicornuate uterus Education takes place on 10 -14 week of intrauterine development of the embryo to the uterus forming time (due to the merger paramezonefralnyh ducts).After the merger of the two ducts are formed utero-vaginal cavity, which initially separated by a median septum, and then, after the disappearance of the partition and merge the uterus becomes sheeted.If there is an incomplete fusion of mezonefralnyh ducts, the options bicornuate uterus formed during embryogenesis.It must be remembered that the beginnings of the genital organs of the embryo anatomically closely associated with the beginnings of the kidneys and urinary tract.Therefore, abnormal development of these two systems is often found together.For example, often a combination of a two-horned uterus and the doubling of the kidneys or kidney CHLK.

There are the following options bicornuate uterus:

1. Incomplete form - in this case, the division into two horns is expressed only in the upper third of the uterine body.Previously, the term two-horned uterus with one cervix (uterus bicornis unicollis) had been distributed.
2. Complete the form - thus there is a complete separation of the uterus into two horns extending from each other by one or another angle.the name of the two-horned uterus with different necks (uterus bicornis bicollis) was also common.In this situation, as the vagina can be of the usual form, with a partition and a full and even doubling.
3. Saddle uterus - in this case in the uterus is formed saddle recess.The rest of the antlered not expressed.Today saddle uterus is the most common among all types bicornuate uterus.

Often, especially with incomplete doubling and saddle uterus, severe symptoms may not be.But even so, you can identify the following main pathologies:

1. Violation of the menstrual cycle - in connection with the structure and the formation of endometrial pathology.Rarely.
2. Nevynashivaeni pregnancy - often due to the violation of the formation of the placenta and, consequently, a violation of the fruit supply.
3. Infertility - a rare condition, as itself a doubling of the uterus can cause infertility.Pregnancy occurs even in the complete doubling, and in this case most often develops in one of the uterine horns (less in both horns).Usually the cause of infertility is a combination with other malformations.

All of these symptoms are characteristic mainly for the full doubling of the uterus.In this case, you need to plan a pregnancy after consulting your doctor, as you may need pre-surgery.Pregnant woman with a full doubling of the uterus must at all times be under the supervision of a doctor obstetrician-gynecologist.Saddle uterus and incomplete form of doubling, as a rule, do not lead to such a pathological condition that would require medical intervention.

Diagnostics bicornuate uterus

1. Regular gynecological examination - usually palpable abnormality can be installed in the structure of the uterus.However, to ascertain the nature of change is difficult.
2. US - the most informative method in which often relatively accurately determine the nature of the changes.
3. hysteroscopy and hysterosalpingography - not only can visually inspect the uterine cavity and assess her condition, but also to introduce radiopaque substance, and with the help of X-ray and install doubling its shape.

Metrosalpingogramma at bicornuate uterus

4. MRI - a rather expensive method.Its use is permissible in extreme cases, where in addition to the establishment of developmental abnormalities have other goals.

Therapies at bicornuate uterus

As mentioned above, the treatment requires only the extreme forms that have clinical implications.The only effective method of treatment is surgery, at which the recovery of the uterus and the integrity of creation of normal cavity.Perhaps a laparoscopic surgery, which is less traumatic and more easily tolerated by the patient, with sufficient skill of the surgeon.

It is also important to note that in the case when beremnnosti bicornuate uterus must be observed at all beremnnosti physician, preferably at the same who will rodorazreshat.operation may become the method of choice during delivery Caesarean section, what the patient needs to know and what it should be ready.

Obstetrician-gynecologist Kupatadze DD