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Book

Bicornuate Uterus

Parneet Kaur  1 , Karen Carlson  2 , Deepan Panneerselvam  3
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
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Book

Bicornuate Uterus

Parneet Kaur et al.
Free Books & Documents

Excerpt

In 2021, the American Society of Reproductive Medicine (ASRM) Müllerian Anomalies Classification created 9 classifications:

  1. Cervical agenesis

  2. Müllerian agenesis

  3. Unicornuate uterus

  4. Bicornuate uterus

  5. Septate uterus

  6. Uterus didelphys

  7. Longitucinal vaginal septum

  8. Transverse vaginal septum

  9. Complex anomalies

The most common subtype of Müllerian anomalies is the unification defect known as a bicornuate uterus (55.1%-73.5%). A bicornuate uterus arises from incomplete fusion of the paired Müllerian ducts during embryogenesis, typically between the sixth and tenth weeks of gestation. This anomaly results in a uterus with 2 distinct endometrial cavities and a single cervix, although variations exist (see Image. Uterus Embryology).

Clinically, a bicornuate uterus is associated with an increased risk of infertility, recurrent pregnancy loss, preterm labor, malpresentation, and adverse obstetric outcomes. Accurate diagnosis, often requiring advanced imaging modalities such as 3D transvaginal ultrasound or magnetic resonance imaging (MRI), is essential to differentiate it from other uterine anomalies like a septate uterus, which has markedly different management implications. The risk of severe maternal morbidity for a bicornuate uterus is 3.0%.

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Conflict of interest statement

Disclosure: Parneet Kaur declares no relevant financial relationships with ineligible companies.

Disclosure: Karen Carlson declares no relevant financial relationships with ineligible companies.

Disclosure: Deepan Panneerselvam declares no relevant financial relationships with ineligible companies.

References

    1. Pfeifer SM, Attaran M, Goldstein J, Lindheim SR, Petrozza JC, Rackow BW, Siegelman E, Troiano R, Winter T, Zuckerman A, Ramaiah SD. ASRM müllerian anomalies classification 2021. Fertil Steril. 2021 Nov;116(5):1238-1252. - PubMed
    1. Naeh A, Sigal E, Barda S, Hallak M, Gabbay-Benziv R. The association between congenital uterine anomalies and perinatal outcomes - does type of defect matters? J Matern Fetal Neonatal Med. 2022 Dec;35(25):7406-7411. - PubMed
    1. Mandelbaum RS, Anderson ZS, Masjedi AD, Violette CJ, McGough AM, Doody KA, Guner JZ, Quinn MM, Paulson RJ, Ouzounian JG, Matsuo K. Obstetric outcomes of women with congenital uterine anomalies in the United States. Am J Obstet Gynecol MFM. 2024 Aug;6(8):101396. - PubMed
    1. Alhubaishi L, Alsalihi A, Sharaf A, Khalifa J, Sharaf A. Bicornuate Uterus With a Rudimentary Horn: Management and Considerations. Cureus. 2024 Nov;16(11):e74642. - PMC - PubMed
    1. Al Najar MS, Al Ryalat NT, Sadaqah JS, Husami RY, Alzoubi KH. MRI Evaluation of Mullerian Duct Anomalies: Practical Classification by the New ASRM System. J Multidiscip Healthc. 2022;15:2579-2589. - PMC - PubMed

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