A safe bearing of pregnancy does not always guarantee even an absolutely healthy woman. What can we say about those who, by the will of fate, had to face any gynecological problem. Let's talk about an unpleasant pathology - a one-horned uterus. We will analyze the causes of development, diagnosis and treatment of such a rather rare phenomenon. To begin with, we learn what a one-horned uterus, endosonography means, whether pregnancy with such a pathology is possible, and how to make a healthy baby.
The main reproductive organ
The uterus is a pear-shaped smooth muscle unpaired hollow organ in which the embryo develops and carries the fetus. It consists of a bottom, a body and a neck. In the normal anatomical structure, the organ has the shape of a triangle. Its natural position is harmoniously created for the unhindered development of the fetus. For 9 months of pregnancy, the uterus undergoes tremendous changes in size. Any defect may interfere with the proper development of the child. Moreover, this can jeopardize the life of the mother and baby.
Main pathologies
Along with the normal structure, a number of pathologies are found:
- two-horned uterus;
- uterus with a septum;
- saddle uterus;
- complete doubling of the uterus;
- one-horned uterus (photo of which can be seen in the article).
Any of these non-standard manifestations may promise the patient the inability to give birth to a child. However, there are chances even in the rarest cases with a one-horned uterus.
What is this pathology and how does it affect a woman's life?
In simple terms, a one-horned uterus is half the normal uterus. It has a round, elongated shape upward, it does not have a bottom when moving from the inside into the fallopian tube. It is worth saying that the body of the uterus of a unicorn form is quite common. It is also important to mention that this species has several subspecies:
- With interconnected cavities of the rudimentary and main horn.
- With non-communicating cavities of the rudimentary and main horn.
- With a barren rudimentary horn.
- With the missing rudimentary horn.
These four options can be identified only with the help of complex diagnostics: laparoscopy and hysteroscopy. The most dangerous with this diagnosis may be the occurrence of ectopic pregnancy. The fetus, which began to develop in the rudimentary horn, simply does not have the conditions for a full existence. The outcome of pregnancy in this situation can be life threatening. So what are the reasons for the appearance and development of such a vice?
Causes
The real causes of such a pathology are still unknown. It accounts for only 1 - 2% of the total number of incorrect, mutational formation of the female reproductive system. The only thing scientists can say is that a malfunction in the system occurs at the stage of embryonic development, that is, in the first trimester of pregnancy. It is in these first 12 weeks that all the vital organs of the girl are laid. The likelihood of developing anomalies increases if the mother suffered an infection during this period of time. The hereditary factor is also considered as one of the reasons for the appearance of this anomaly.
So, when forming a one-horned uterus, instead of two paramesonephric ducts, one is formed. Less often - two, but any of them is rudimentary, underdeveloped, unable to function normally. Most often, the unicorn uterus is not the only anomaly in the genitourinary system. In combination with other disorders in the structure of female organs, it is an aggravating factor in the development of infertility and miscarriage.
What are the symptoms of this disease and how to diagnose it? Is it possible to do this on your own or is a doctor's consultation necessary?
Symptomatology
The appearance of the first clinical signs of the disease depends on the type of defect. With a functioning closed rudimentary horn, they appear shortly after the menarche. Characterized by algodismenorea.
Violation of the outflow of menstrual blood from a pathological organ leads to the formation of hematometers and hematosalpinges in it with unilateral pain on the 3-4th day of the female cycle. Retrograde discharge reflux may be accompanied by acute abdominal syndrome, the development of endometriosis and adhesions in the pelvis. In most cases, problems with reproductive organs in women are similar in their symptoms. Summarizing them, we get the following clinical picture:
- painful and heavy menstruation or their absence;
- one-sided abdominal pains, extending around the entire circumference;
- tumor formations;
- involuntary miscarriages;
- miscarriage.
The consequence of all this is infertility.
Diagnostics
It is almost impossible to identify and diagnose a unicorn uterus during a routine gynecological examination. This can only be done with hardware methods. The primary diagnosis for suspected diagnosis of a one-horned uterus is an ultrasound study. During its implementation, you can clearly see the reduced wall thickness of the female organ, asymmetry, the absence of one of the ovaries.
For a more accurate vision of the picture, laparoscopy, hysteroscopy, MRI, and ultrasound of the kidneys are prescribed. These methods determine the shape of the uterus, the presence or absence of a rudimentary horn, its size, the presence of additional abnormal formations in the uterine appendages, a single mouth of the fallopian tube.
When making an accurate diagnosis, a woman can be offered various types of therapy.
Treatment
The management of such patients does not have a single tactic. Doctors agree that each case should be considered individually. According to the appointment of a specialist, depending on the condition of the patient, the following types of treatment are used:
- Indisputable indications for surgery are: pain, endometrial cavity in the rudimentary horn, ectopic pregnancy.
- In the absence of pain and copious discharge, normal monitoring of a woman with the appointment of periodic examinations is indicated. Although many experts believe that surgical intervention is shown to everyone. In any case, before conception, the patient must decide on how to get rid of the existing problem.
The surgical method for removing the rudimentary horn can be carried out in two ways: laparoscopic and during gluttonectomy.
Of course, a less traumatic method is currently being chosen. This is laparoscopy. It allows you to make not only the removal of the rudimentary horn, but also to correct other gynecological pathologies revealed during surgery. Also, this method can significantly minimize possible postoperative complications and reduce the patient’s hospital stay.
Operation is important
During corrective operations (regardless of the method), other related gynecological problems are also solved. These include:
- conservative myomectomy (removal of fibroids);
- removal of the ovary or fallopian tube;
- salpingolysis (restoration of patency of the fallopian tubes);
- resection or biopsy;
- salpingostomy (opening a hole in the fallopian tube to connect with the abdominal cavity);
- electrocoagulation of foci of endometriosis (germination of uterine cells in other organs);
- separation of adhesions.
After such a laparoscopic operation in gentle mode, patients can begin to walk after 2 to 3 hours and be discharged to an ambulatory mode after 2 to 3 days.
Most of the operated patients noted an improvement in their general condition. Those who experienced unbearable pain during menstruation, accompanied by dizziness, nausea and vomiting, subsequently note the disappearance of these manifestations.
After 2-3 months, patients with a rudimentary horn removed are allowed to become pregnant. At the same time, nothing prevents a woman from giving birth to a child in a natural way, without resorting to the cesarean section method. This is due to the fact that when amputation of an underdeveloped vestigial rumen remains.
In every third case, in women without correction of a congenital malformation of the uterus, a defect was detected during cesarean section or manual separation of the placenta in childbirth. According to clinical data and ultrasound echography, no pathology was detected. This indicates the complexity of its diagnosis, especially in the absence of a violation of the outflow of menstrual blood.
One of the reasons for the difficult to diagnose congenital malformations of the genitals was a later visit to the doctor due to infertility and repeated miscarriage.
Total
Doctors advise all women who have had this problem not to panic. Conception and pregnancy with a one-horned uterus with a rudimentary horn is quite real. And if you follow all the recommendations, then the chance to make and give birth to a healthy baby will be one hundred percent.
The right decision is to contact your doctor. He must appoint all the necessary studies. Then, together with the patient, find the optimal way out of a specific situation.
Modern medicine can do a lot. Do not be afraid of this diagnosis. Remember that there is a way out - a laparoscopic operation, after which it will be possible to conceive, endure and give birth to a healthy baby.