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Unicornuate Uterus: Symptoms, Types & Treatment
- Published on August 08, 2022
A Unicornuate Uterus is a rare congenital abnormality —in which only half uterus is formed. In this condition, the uterus is smaller in size and differently shaped than a normal uterus.
It is also referred to as a type of uterine malformation that occurs in the womb as an embryo develops from only one of the paired Müllerian ducts. The other duct, if it forms at all, does so incompletely. A unicornuate uterus has one fallopian tube, a single cervix and a vagina
According to the research, the occurrence of a unicornuate uterus is relatively rare, with a prevalence of 0.3% in the general population, 0.6% in infertile individuals, and 0.2% in fertile individuals. However, among all Müllerian defects, a unicornuate uterus is observed in 3 to 13% of women.
In the unicornuate uterus, there is only one functional fallopian tube; the other is either entirely absorbed by your body or remains underdeveloped and assumes the shape akin to a rudimentary horn (hemi-uterus). A rudimentary horn is present in around 75 per cent of women.
Table of Contents
Types of Unicornuate Uterus
There are four different types of unicornuate uterus:
- No Rudimentary Horn: This is common and typically does not cause any symptoms.
- Rudimentary Horn Without Cavity: A rudimentary horn exists alongside a unicornuate uterus but lacks a lining (endometrial cavity), so there is no blood buildup or distressing symptoms.
- Communicating Rudimentary Horn: The rudimentary horn is connected to the uterus, allowing menstrual blood to flow freely from the horn into the uterus and out of the body.
- Non-Communicating Rudimentary Horn: It is not connected to the unicornuate uterus. It blocks the flow of blood to the uterus, causing severe pelvic pain.
Signs & Symptoms of Unicornuate Uterus
Typically, it’s asymptomatic and women find out about the condition until they start trying for pregnancy and face complications in conceiving a baby. When the rudimentary horn is connected, it is called a communicating horn. And, when it is not, it can obstruct the flow of menstrual blood, leading to several symptoms such as:
- Severe pelvic pain
- Menstrual irregularities due to the altered uterine structure
- Abnormal fetal position due to the shape of the uterus
- Painful menstruation
- Premature birth due to limited uterine capacity.
- Hematometra (accumulation of blood in the uterus)
- Miscarriages due to the limited space within the unicornuate uterus.
- Difficulty conceiving
How to Diagnose Unicornuate Uterus?
This genetic condition may go unnoticed until you experience challenges getting pregnant and require imaging tests.The doctor recommends a 3D ultrasound scan, to assess the uterine structure. However, sometimes, if it fails to detect the unicornuate uterus, an MRI scan is advised to examine the condition thoroughly.
Besides these imaging tests, in a few cases, hysterosalpingogram (HSG), laparoscopy, and hysteroscopy are suggested to diagnose unicornuate uterus.
Treatment for Unicornuate Uterus
At times, this condition may result in painful symptoms affecting your life’s quality. But, be rest assured, unicornuate uterus treatment options are available and personalized to your specific type and severity of the condition. To achieve pregnancy, here are a few methods to address this condition effectively:
-
Laparoscopic Surgery:
This method involves surgically removing a solitary hemi-uterus to relieve severe abdominal pain caused by menstrual blood buildup.
-
Cervical Stitch (Cerclage):
Recommended for those at high risk of premature delivery, miscarriage, or with an incompetent cervix, this procedure involves stitching and closing the cervix during pregnancy.
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Assisted Reproductive Technology (ART):
Techniques like In vitro fertilisation (IVF) or intrauterine insemination can assist in conception for those experiencing difficulty conceiving or infertility. In a study, 53.1% of women with a unicornuate uterus achieved pregnancy after one IVF cycle, compared to 65.7% in the control group.
What is the Pregnancy Complication of a Unicornuate uterus?
A unicornuate uterus pregnancy is often accompanied by several complications. So, special care and caution need to be taken at all times to minimise the risks and complications. Some of the common pregnancy complications include:
-
- Pre-term delivery,
- Breech (feet first) delivery
- Ectopic pregnancy
- Recurrent miscarriages
- Placental abruptions
- Stillbirth
Conclusion
A Unicornuate Uterus can cause painful symptoms, recurrent miscarriages, and pregnancy complications. If you’ve been diagnosed with this condition and need personalized guidance or treatment for pregnancy, schedule an appointment with our fertility specialist.
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Written by:
Dr. Sonal Chouksey
Consultant
Dr. Sonal Chouksey is an OBS-GYN, Fertility and IVF specialist with 16+ years of experience. She specializes in IVF, IUI, ICSI, IMSI, focusing on diminished ovarian reserve and recurrent failed IVF/IUI cycles. She has successfully treated complex cases of endometriosis, azoospermia, and recurrent pregnancy loss. A member of the Federation of Obstetrics and Gynaecological Societies of India, and the Indian Society of Assisted Reproduction, she actively contributes articles to various medical publications. Her patient friendly approach makes her truly caring and compassionate healthcare expert.
Bhopal, Madhya Pradesh
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