Two-horned uterus is a congenital defect in the anatomical structure of the uterus. An anomaly lies in the splitting of the organ cavity into two parts, which merge in the lower sections. The presence of a defect is manifested by dysmenorrhea, infertility, miscarriage, abnormal uterine bleeding.
A two-horned uterus is diagnosed during ultrasound, hysteroscopy, hysterosonography, laparoscopy. If there is a need for correction, an endoscopic intervention is performed to restore the organ cavity, the Strassman operation.
For women who are diagnosed with a two-horned uterus, childbirth is possible. However, they, like pregnancy itself, are associated with an increased risk.
Among all abnormalities, the two-horned uterus is most common. Although in general it is detected only in 0.1-0.5% of cases. As a rule, the formation of a defect is associated with an intrauterine growth disorder . Pathology is formed as a result of insufficient connection of the Muller ducts during the tenth to fourteenth week of embryogenesis. This leads to the division of the organ into two cavities.
As a rule, with an anomaly, there is one vagina and one cervix, however, a bicornuate uterus can be accompanied by a doubling of the cervix and an incomplete vaginal septum.
One organ cavity may be rudimentary (rudimentary). The attachment of a fetal egg in such a horn provokes an ectopic type of pregnancy, with rupture and intra-abdominal bleeding. In other cases, both cavities are developed correctly. In each of them, cycles can occur, pregnancy can develop, which ends with childbirth.
Two-horned uterus. Causes
Various abnormal factors contribute to the development of anomalies during gestation. They primarily include intoxication (drugs, nicotine, alcohol, chemicals), vitamin deficiency, endocrine diseases (thyrotoxicosis, diabetes mellitus), mental injuries during pregnancy, and mother’s heart defects.
In addition, infectious agents have a damaging effect on the embryo. They include the causative agents of measles, flu, rubella, syphilis, toxoplasmosis and other pathologies. Hypoxia of the fetus of a chronic nature, as well as the course of pregnancy, accompanied by toxicosis, is very unfavorable for the development of organs inside the womb.
Depending on the size of the splitting of the uterine cavity, a saddle, full and incomplete two-horned uterus is isolated.
In the first case, a small depression is present in the region of the bottom of the organ. It resembles a saddle in its shape. With a saddle uterus, conception is not excluded. However, in the case of the presence of concomitant defects, the probability of spontaneous interruption of bearing is high. This type of organ, combined with a narrow pelvis, can provoke a fetal malposition. This, in turn, excludes independent birth.
The full version of the two-horned cavity is characterized by the discharge of horns in the uterine-sacral ligament. In this case, the angle formed between the two cavities may be different. The pronounced separation forms separate niches resembling two ordinary uterus, located very close to each other. In this case, conception and development of pregnancy is possible only in one of the cavities.
In an incomplete version, there is a separation of the uterus in the upper third and a small opening between the horns. In this case, as a rule, the shape and size of the formed niches are the same.
Surgical treatment of organ developmental abnormalities is indicated only in case of two or three miscarriages in a row (habitual miscarriage) or infertility. The purpose of the intervention is to restore a single cavity.