Bicornuate Uterus Overview

I am 12 weeks pregnant and everything seems to be going well. However, I've been diagnosed with bicornate uterus, which I understand has a high incidence of miscarriage and premature birth. I previously had a miscarriage at nine weeks. Should I be concerned?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

The answer to this really depends upon what the deformity is, how extensive it is and where the embryo implanted. Ultrasound or hysterosalpingogram (x-ray with dye before pregnancy) can demonstrate what type of duplication exists. There may be complete duplication of everything but, more commonly, there may be a duplication of one part of the uterus -- a rudimentary "horn." Those with this type may have a horn with or without an endometrium. When there is an endometrial cavity, there may or may not exist a communication between the horns.

The fact that you have progressed to 12 weeks is a very good sign. Reports of miscarriage with a bicornuate uterus show a high rate of about 30 percent. Preterm birth rates in one study were about 20 percent, and fetal growth restriction occurred in about 10 percent. Abnormal presentation or position of the baby can occur; breech presentation occurred in about 43 percent. Cesarean-birth rates also are increased; in one study, cesarean births were performed in about 82 percent.

Ultrasound can demonstrate where the embryo implanted and if it appears to be in an area which has a potential to support growth. Fetal growth should be monitored with serial ultrasounds, and the pregnancy should be monitored for any signs/symptoms of premature labor.

I have followed several women with this problem who have delivered fine, healthy babies. You should be seen by providers who are experienced with this type of problem and with the facilities to manage antepartum surveillance and premature birth, should it occur.

I hope all continues to go well.

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