A bicornuate uterus is the most common congenital uterine anomaly. It is a uterus that has two horns, often is heart shaped and that has a wall and a partial split outside. Sometimes, a bicornuate uterus also has a septum dividing the inside of the uterus.A bicornuate uterus can have a major impact on a woman's reproductive capabilities. Women with a bicornuate uterus have an increased rate of spontaneous abortion (though the miscarriage rate is lower with a bicornuate uterus than with a septate uterus) and they have about a 60% success rate in delivering a living child but have a higher risk of cervical incompetence.
Premature labor, a breech presentation, and/or a retained or trapped placenta are also common pregnancy complications. The diagnosis is made through a pelvic examination, laparoscopy, ultrasound, hysteroscopy, and hysterosalpingography.
A bicornuate uterus can be corrected surgically (metroplasty), but there are few studies of the surgery that have been published.