Double-horned uterus - congenital defect inanatomical 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.
Diagnosed by a bicornic uterusUltrasound, 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.
Double-horned uterus among all anomalies occursmost often. Although in general it is revealed only in 0.1-0.5% of cases. As a rule, the formation of a defect is associated with a disorder of intrauterine development. Pathology is formed as a result of inadequate union of Mullerian 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 bicorne can 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 pregnancy during the 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
Development of abnormalities during pregnancycontribute to 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, the damaging effect on the embryohave infectious agents. 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, the saddle, full and incomplete bicornic uterus is isolated.
In the first case, there is asmall depression. It reminds us of its saddle shape. With a saddle uterus, conception is not ruled out. However, in the presence of concomitant defects, 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 bythe departure 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 very 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 formed niches are the same.
Treatment of abnormality of organ development by surgicalthe way is shown 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.
