Discussion of Bicornuate uterus
- The bicornuate uterus results from incomplete fusion of the uterovaginal horns at the level of the fundus
- Accounts for approximately 10% of müllerian duct anomalies.
- A bicornuate uterus consists of two symmetric cornua that are fused caudad, with communication of the endometrial cavities.
- The intervening cleft of the complete bicornuate uterus extends to the internal cervical os (bicornuate unicollis)
- The cleft of a partial bicornuate configuration is of variable length.
- A bicornuate bicollis uterus is associated with a duplicated cervix, although a degree of communication is maintained between the two horns.
- Surgical intervention is usually not indicated.
- Strassman metroplasty has been advocated in women with a history of recurrent pregnancy loss and in whom no other infertility issues have been identified
- The bicornuate uterus has been reported to have the highest associated prevalence (38%) of cervical incompetence among müllerian duct anomalies and prophylactic placement of a cervical cerclage in selected patients has been reported to increase fetal survival rates.
 Imaging Findings for Bicornuate uterus
- The horns of the endometrial cavity are usually widely separated with an intercornual angle greater than 105°.
- Each horn has a fusiform appearance, with apices that taper and end in a single fallopian tube.
- Radiographic appearance has such a large degree of overlap with that of the septate uterus and differentiation from the septate uterus often not possible.
- A large fundal cleft with divergence of the uterine horns and associated echogenic endometrial complexes.
- MRI demonstrates a cleft of at least 1.0 cm of the external fundal uterine contour.
- The horns demonstrate normal uterine zonal anatomy.
 See Also
- Mullerian duct anomalies classification system
- Arcuate uterus
- Septate uterus
- Unicornuate uterus
- Uterus didelphys
 External Links
 References for Bicornuate uterus
- Robert N. Troiano, and Shirley M. McCarthy. Müllerian Duct Anomalies: Imaging and Clinical Issues. Radiology 2004 233: 19-34.