Pregnancy with a bicornuate uterus: features of the course of pregnancy, possible complications

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

The time comes when a girl realizes that she is ready to become a mother. At the same time, each even thought does not admit that she may have any problems in this area. It seems that everything is simple - she got pregnant when she wanted to, carried a child and gave birth without problems. What's wrong with that, a normal natural process that many women have gone through. And when something doesn't go according to plan, fear arises inside and the question is: "Why with me?".

First pregnancy

Rarely, when planning a pregnancy, does a full examination and knows exactly about all the features of his body. And the first pregnancy or unsuccessful attempts to get pregnant is the period when unpleasant moments can open up. During an ultrasound, a woman can find out that she is pregnant with a bicornuate uterus. And that could be cause for concern.

Such a discovery is not yet a reason for hopeless despair and fears, but the bicornuate uterus belongs to the category of pathologies, because there are still some peculiarities and nuances of the course of pregnancy. This has a significant impact on its course. First, let's clarify the question of what a bicornuate uterus is and why it has an irregular structure.

Abnormal structure of the uterus

There are many pathologies in the development of internal organs, and the uterus is no exception in this case. A bicornuate uterus is a pathology when an organ has an abnormal structure. You need to understand that this is a serious problem, the course of pregnancy is complicated, and such a pathology is a reason for increased control by the gynecologist.

Such an anomaly of the structure is congenital, the deviation occurs already in the prenatal period, when the embryo grows, and in the first trimester there is a laying and development of internal organs. During this period, a failure may occur caused by severe intoxication or some diseases of the mother. When a girl is born, she already has this problem. Of all the possible pathologies of the abnormal development of the uterus, bicornuity is considered the most common. It occurs in various forms and degrees of severity, so you should not attribute the diagnosis and terrible forecasts to yourself.

How does an abnormal uterine structure affect pregnancy?

Such a diagnosis does not mean at all that now a woman will not be able to have children. In this position, you can get pregnant, but you should follow the advice of doctors, and also have a little patience. The uterus has congenital modifications, in its upper region there is a division into two parts, they resemble horns. The horns may be symmetrical and fully developed, or one may be larger than the other. In each of these hornspregnancy may occur. There is also a saddle uterus, it has a different shape. All these developmental anomalies can lead to uterine infertility. Pregnancy with a bicornuate uterus may not occur at all. This is what becomes the main factor for concern.

Pregnancy has come

The abnormal structure of the uterus does not mean that there will definitely be problems with conception. Expectant mothers can find out about the anomaly only by registering for pregnancy, and such a diagnosis puzzles them greatly.

The bicornuate uterus can also manifest itself before pregnancy with amenorrhea and menstrual irregularities, painful menstruation. But these same symptoms can be with other gynecological diseases. So during pregnancy, a woman may hear for the first time that something is wrong with her. A doctor of few words can say that the patient has a bicornuate uterus and pregnancy in the left horn without going into details. No doctor wants to scare an expectant mother with possible complications, but they are quite real.

Possible Complications

Even with a normal uterus, problems can occur during pregnancy. And what does a bicornuate uterus mean during pregnancy, what risks can arise during this period? What can happen:

• Relapse occurs early in pregnancy. The risks that a woman does not bear a fetus increase many times over. This is due to the fact that the uterus with an elongated shape does not allow the fetal egg to attach correctly. The bicornuate uterus has a thinnerthe inner layer, and for the attachment of the embryo is bad.
• Premature birth. An irregularly shaped uterus stretches worse. It is usually smaller in size.
• The bicornuate uterus and pregnancy in the right horn limit the baby's movement. This causes the baby to take the wrong position, and a breech presentation occurs, oblique or transverse.
• When the embryo is attached very low, then there is a high probability that placenta previa will develop.
• Pregnancy with a bicornuate uterus may be accompanied by leakage of amniotic fluid.
• Pregnancy is interrupted at different times due to the fact that the cervix cannot hold the fetus and opens ahead of time. When this happens, doctors talk about cervical insufficiency.
• Pregnancy in a rudimentary horn (poorly developed) is equated with an ectopic pregnancy, these two points are considered an indication for abortion.
• With this structure, insufficient blood circulation causes placental abruption.

Despite all the possible complications, with a bicornuate uterus, a second pregnancy is also possible. This is very rare, but such cases have been recorded in medical practice.

Uterine discharge during bicornuate pregnancy

In addition to the symptoms that are inherent in all pregnant women, in the form of toxicosis or increased fatigue, the owners of a bicornuate uterus also face such a problem as discharge. Bloody spots may appear in the first trimestersselection, they can be both dark and bright. If something suspicious begins to occur in the body, then you should immediately consult a doctor. Most often, a woman is recommended complete rest and hospitalization. If the fetal egg is attached to the side wall or bottom of the uterus, then this will provoke bleeding. The internal uterine os may be blocked by a low-attached embryo. In this case, the woman feels pain, which is the first stage of abortion.

Probability of problems

With such a structure of the uterus, problems arise in pregnant women. But not all at once and not everyone has the same difficulty during pregnancy. For up to two months, 35% of women with bicornuate pregnancy have bleeding. 45% have a partial placenta previa.

Bleeding can open much later, after thirty weeks of pregnancy, in the last trimester. This means that in the placenta previa, the placenta can no longer stretch, and the uterus still continues to grow and detachment begins. This leads to premature birth, often ending in a caesarean section. If a woman has a bicornuate uterus and the pregnancy is in the right horn, then you need to understand that there is absolutely no difference if the pregnancy was in the left horn. The manifestations and condition of a woman in these cases will not be any different.

Fertilized egg in the horn

If the fertilized egg is attached in one of the horns, it does not really matter in which one. Bicornuate uterus and pregnancy in the lefthorn do not give any special manifestations. The most important thing is that there should be a good supply in this place, there should be enough capillaries and vessels. The more underdeveloped the uterus, the farther apart are the horns. The best option for a bicornuate uterus, so that the fetal egg is well fixed in it. If the fixation occurs in any of the horns, then there is an increased load on the reproductive organ. If the embryo is attached to a place with insufficient nutrition, then the pregnancy will terminate itself, a miscarriage will occur.

Treatment of bicornuate uterus

As mentioned above, you can get pregnant and bear a child even with such a pathology. But there are cases when pregnancy does not occur with a bicornuate uterus, or miscarriages occur at different stages in a woman. There are already many questions about possible treatments and solutions to this problem.

One of the effective methods is an operation during which the intrauterine septum is removed and a single uterine cavity is artificially created. Often this is the only right decision and allows the expectant mother to bear the child without difficulty. There are time limits here, you can get pregnant no earlier than a year later. It is necessary to give time for the tissues to grow together, if you do not meet these deadlines, then when stretched, the uterus can burst in this place and internal bleeding will open. This is dangerous not only for the death of the child, but also for the mother.

Features of pregnancy

All women in a position with such a structure of the uterus areunder the increased supervision of gynecologists. Pathology can make itself felt at any stage of pregnancy. The doctor must monitor the symptoms and do everything possible to ensure that the pregnancy continues and the fetus develops properly.

When the uterus is incomplete, the blood circulation in it may be disturbed, in connection with this, the fetus may have oxygen starvation. In this case, so that the child does not suffer, a caesarean section is performed from the 28th week. There is good news - such a pregnancy can take place without pathologies, minor violations can be observed. Pregnancy with a bicornuate uterus and discharge almost always occur together. But you need to be careful with bleeding, they can appear at any stage of pregnancy, the doctor should be aware of this. Since this may be a clear symptom of a threat, and this process cannot be stopped.

Pregnancy and childbirth

If the embryo is stuck in the wrong place, then spontaneous abortion usually occurs in the first trimester, the fetus simply does not have enough nutrition, and it becomes unviable. The risks are also associated with a small space in the horn, the fetus does not have enough space for development. Bleeding during pregnancy with a bicornuate uterus does not always indicate the danger of a breakdown. However, you should be careful. We have already talked about the difficulties, but not everything is so simple when we talk about a bicornuate uterus and pregnancy. Feedback from women who have gone through this path really gives hope and confidence that everything can be fine.

Women note that the onset of pregnancycan be difficult, there is hypertonicity of the uterus, detachment of the fetal egg, but by the third trimester everything can return to normal. The baby may be born with minor defects, such as torticollis and increased tone, but this is easily corrected. With such a pathology, the baby may appear a few weeks ahead of schedule.

As a rule, not all births in the owners of a bicornuate uterus end in surgery, but there are cases when this is simply necessary for the safety of mother and child. A photo of a bicornuate uterus during pregnancy allows you to see why it is so problematic for the fetus to be in it. There simply isn't enough room for him.

Pregnancy planning

Ideally, pregnancy should be planned, before conception it is necessary to undergo an examination, ultrasound of the female genital organs. Having heard about such a diagnosis, it can be assumed that the pregnancy may end in a miscarriage. To prevent this from happening, some women want to have an operation on the uterus in order to plan pregnancy in a year and bear the child without fear for his life, but doctors do not go for it. The question of surgical intervention is raised after a woman has had 2-3 miscarriages in a row or she cannot get pregnant at all. After the operation, the woman is placed with an intrauterine device for 6-8 months to exclude pregnancy during this time.

Prepare for what?

Of course, everything that is connected with our body causes a lot of emotions in us. Nobody wants to have problems in any area of their he alth. Any diagnosis already suggests that not all is well. Increased risksspontaneous abortion, strong feelings, the need to limit oneself in something - all this is very unpleasant, but women are ready to go for it for the sake of the desired motherhood.

Even with this diagnosis, pregnancy can proceed without complications if the body of the uterus is of sufficient size. After surgery to correct the uterus, the risks of pregnancy are reduced by 60%. There are also assisted reproductive programs and technologies that can solve this issue.

So don't let the bicornuate uterus and pregnancy scare you. Reviews of doctors about modern technologies of reproductive medicine are based on real practices. These cases are not isolated, and there are already many solutions for them.

Missed Pregnancy

With a fairly high percentage of successful pregnancies, there are cases with an unfavorable outcome. At the first stages, the fetus can freeze and stop its development, the result is its death. This happens almost always if the egg clings to the septum, and not to the uterus. There are no blood vessels in the septa. The embryo does not receive nutrition and dies.

In some cases, artificial insemination is carried out and the embryo is engrafted to the place where it has the most chances for full development, where it will have sufficient nutrition and a place to grow.

The most favorable option

This pathology has a variety called the saddle uterus. Such a deviation is considered one of the favorable options for the development of the fetus. This type can also cause miscarriage, but this happens muchless often. Up to 25% of women with a saddle uterus experienced preterm labor. The position of the fetus in such a uterus is often oblique or transverse. Sometimes you have to do a caesarean. If childbirth takes place naturally, then such a uterus contracts for a long time and bleeds.

There are also cases when twin pregnancy happens, but then bicornuity has nothing to do with it. This pregnancy belongs to the high-risk group. Uterine ruptures may even occur. There were cases in medical practice when one of the fetuses was aborted, and the second child developed fully and was born at the right time.

Pregnancy can develop simultaneously in two horns. Most often, pregnancy with uterine pathology ends with an operation, but this does not detract from the joy of parents. After all, another person has come into the world.

There are many physiological pathologies that are a contraindication for a woman to become pregnant and give birth. These problems are not only related to the reproductive system, they can also be heart disease and kidney problems. For a sick body, pregnancy is a real test, and the risks are sometimes incredibly high.

But any woman wants to be a mother and is even ready to sacrifice her life and he alth for the sake of a child. Doctors always warn of all possible risks, they are obliged to do their part of the work, but the final decision is still made in the family. A bicornuate uterus during pregnancy is not a death sentence.