Bicornuate Uterus: What It Is & the Causes | Peanut

Bicornuate Uterus: What It Is & the Causes

By Tassia O'Callaghan

Nov 3, 2023

4 min read

KL

Reviewed by Kellie Leonard,

Biomedical Scientist / Medical Writer

If you have a bicornuate uterus, it means your uterus (the organ where a fertilized egg develops into a baby) is shaped like a heart. Yep, it’s also referred to as a heart-shaped womb. But what does this mean for fertility, pregnancy, and childbirth? Let’s take a closer look.
In this article: 📝

Get to know the uterus — typical vs. heart-shaped

Your uterus is the organ in your abdomen where the fertilized egg is implanted. It’s where a baby grows, develops, and receives nourishment. A typical uterus resembles an upside-down pear in shape, with your fallopian tubes meeting pretty much right across the top of the uterus (or maybe in a slight U-shape) at the widest part. But with a bicornuate uterus, instead of the fallopian tubes meeting in a line across the top of the uterus, they come together in a dip, giving the uterus a distinct heart shape.

What causes bicornuate uterus?

If you have a bicornuate uterus, rest assured that there wasn’t anything you could’ve done to prevent it. You were born with it! It happens when a baby girl’s uterus develops abnormally in the womb—sometime between 10 and 20 weeks of pregnancy. When you’re developing in your mother’s womb, two ducts (called Mullerian ducts) usually fuse to form one uterine cavity. However, if you have a bicornuate uterus, your ducts have not merged together completely, forming two uterine cavities. Many women go through life not knowing that they have it unless they receive an ultrasound. This is because a bicornuate uterus is largely symptom-free, although some women do report the following:

How common is a bicornuate uterus?

Uterine irregularities like this one aren’t very common. In fact, only around 3% of women are born with a difference (or, in medical speak, “defect” or “abnormality”) in the shape, size, or structure of their uterus. That being said, a bicornuate uterus is one of the more common types of uterine irregularities, affecting around 1 in 200 women. But this form of uterus shape is not hereditary, so you won’t pass this onto your little ones

Can you have a baby if you have a bicornuate uterus?

Yes! Bicornuate uterus pregnancy is possible, with studies showing that having a heart-shaped uterus won’t lower your chances of getting pregnant. We’re about to discuss the potential risks of a bicornuate uterus pregnancy, but let’s start out with the good news: many women with a heart-shaped uterus go through pregnancy with little-to-no issues. But yes, there are some risks attached to being pregnant while having a heart-shaped uterus. Because of the dip at the top of the organ, a developing fetus may run out of room to grow in the uterus. The unusual shape can also result in erratic uterine contractions. These problems could result in a miscarriage later in the pregnancy or preterm labor. That’s why, if you have a bicornuate uterus, your pregnancy will be treated as high-risk. This means you’ll be monitored closely throughout, with frequent scans and extra checkups to track the position of your baby. In some cases, the baby could end up in the breech position before birth, and this may require a cesarean section.

Can you fix a bicornuate uterus?

You might never need treatment for your bicornuate uterus. It probably won’t impact your fertility, and, as mentioned, with careful monitoring, you can have a successful pregnancy. But if you suffer from repeated pregnancy loss and the shape of your uterus is thought to be responsible, you can undergo surgery to correct it. This is called Strassman metroplasty.

Can you have twins with a Bicornuate uterus?

Having twins with a bicornuate uterus is very (VERY) rare—but not impossible. According to one report, at the time of publishing (2013), there had only been 12 recorded cases of twin pregnancy in a bicornuate uterus. And in 2018, one example of it happening was described as a 1-in-500 million event. In other words, if it happens to you, well, you’re probably going to make headlines. Do you have questions or concerns about your bicornuate uterus? Give your healthcare provider a call! And remember, the mamas on Peanut are always ready to listen and share their experiences.

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