HealthMedicine

Double-horned uterus

Double-horned uterus is a congenital defect in the anatomical structure of the uterus. There is an anomaly in the splitting of the body cavity into two parts, which merge in the lower parts. The presence of a defect manifests itself dysmenorrhea, infertility, miscarriage, abnormal uterine bleeding.

Diagnosis of a bicornic uterus during ultrasound, hysteroscopy, hysterosonography, laparoscopy. If there is a need for correction, endoscopic intervention is performed to restore the body cavity, the Strassmann operation.

For women diagnosed with a bicornic uterus, childbirth is possible. However, they, like pregnancy itself, are associated with an increased risk.

The bicornic uterus among all anomalies is most common. Although in general it is only found in 0.1-0.5% of cases. As a rule, the formation of a defect is associated with an intrauterine development disorder . Pathology is formed as a result of inadequate union of the Müllerian ducts during the tenth-fourteenth week of embryogenesis. This leads to division of the body into two cavities.

Typically, with an anomaly, there is one vagina and one neck, but the bicornate uterus may be accompanied by a doubling of the cervix and an incomplete vaginal septum.

One cavity of the organ can be rudimentary (rudimentary). Attachment of the fetal egg in such a horn provokes the course of pregnancy by an ectopic type, with a rupture and intra-abdominal hemorrhage. In other cases, both cavities are well developed. In each of them cycles can occur, pregnancy can develop, which ends with childbirth.

Double-horned uterus. Causes

The development of anomalies during gestation is facilitated by various damaging factors. To them, first of all, include intoxications (drugs, nicotine, alcohol, chemicals), beriberi, endocrine diseases (thyrotoxicosis, diabetes), mental traumas during pregnancy, heart defects of the mother.

In addition, infectious agents have an injurious effect on the embryo. They include measles, influenza, rubella, syphilis, toxoplasmosis and other pathogens. Very unfavorable for the development of organs inside the womb is the hypoxia of the fetus of a chronic nature, as well as the course of pregnancy accompanied by toxicosis.

Depending on the size of the splitting of the uterine cavity, a saddle, full and incomplete bicornic uterus is isolated.

In the first case, there is a small depression in the region of the organ bottom. It reminiscent of its shape saddle. With a saddle uterus, conception is not ruled out. However, in the presence of accompanying vices, the probability of spontaneous interruption of gestation is high. This type of organ, combined with a narrow pelvis, can provoke the wrong location of the fetus. This, in turn, excludes independent births.

The full version of the two-horned cavity is characterized by the removal of horns in the area of uterosacral ligaments. The resulting angle between the two cavities can be different. The pronounced division forms separate niches, reminiscent of two common uterus, located close to each other. In this case, conception and development of pregnancy is possible only in one of the cavities.

In the incomplete variant, the uterus is divided into the upper third and a small opening between the horns. In this case, as a rule, the shape and size of the niches formed are the same.

Treatment of abnormality of organ development by surgery is indicated only in the case of two or three miscarriages in a row (habitual miscarriage) or infertility. The aim of the intervention is to restore a single cavity.

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