A bicornuate uterus is a uterus that has two horns and a heart shape. The uterus has a wall inside and a partial split outside. A bicornuate uterus is the most common congenital uterine anomaly and can impact a woman's reproductive capabilities.

A bicornuate uterus is a uterus that has two horns and a heart shape. The uterus has a wall inside and a partial split outside. A bicornuate uterus is the most common congenital uterine anomaly and can impact a woman's reproductive capabilities.

Several studies show that women with a bicornuate uterus have about a 60% success rate in delivering a living child but have a higher risk of cervical incompetence. The condition is associated with an increased rate of spontaneous abortion, though the miscarriage rate is lower with a bicornuate uterus than with a septate uterus . That's probably because the blood supply to the midline indentation is better. Premature labor, a breech presentation and/or a retained or trapped placenta are also common complaints with a bicornuate uterus.
If necessary, a bicornuate uterus can be corrected surgically. Few studies of the surgery have been published. In three studies reporting on a total of 11 women, approximately 90% successfully carried a pregnancy to term.

Diagnostic procedures

A bicornuate uterus can be confirmed through use of the following techniques:

• Pelvic exam – two horns can occasionally be palpated. 
• Sonogram - A bicornuate uterus can sometimes be diagnosed by ultrasound
• Laparoscopy – provides information on the exterior shape of the uterus. 
• Hysteroscopy – provides information on the interior configuration of the uterus.

Treatment

Metroplasty surgery - to create a large uterine cavity with minimal destruction of uterine tissue is the treatment of choice.
Cervical cerclage - improved the fetal survival rate in selected patients. Both metroplasty and a cervical cerclage may be prescribed.