Anomalies of the structure of the genitals are found in one woman in a hundred. Often they do not manifest clinically in any way until the moment of pregnancy and childbirth, when the features of the anatomical structure are established during the examination regarding the pathology of gestation. One of the common anomalies is the two-horned uterus. At the same time, the body of the uterus has features of development and structure, which can be reflected in the process of conception and carrying. Is a successful pregnancy possible with the two-horned uterus? It is important to establish the correct diagnosis and time to undergo treatment.
Any defects associated with the violation of the formation of organs during fetal development. Of fundamental importance are the first 12 weeks, when the laying and differentiation of the main structures takes place. Exposure to even minor at first glance factors (alcohol, drugs, chemical reagents) can lead to serious changes in the anatomy of the organs. Identification of such features before pregnancy planning will help avoid unpleasant complications of pregnancy.
Why an anomaly occurs
After fertilization, the egg begins to divide intensively and gradually "allocate" cells to certain organs. By the eighth or tenth week of pregnancy, two Müller ducts form at the embryo in the place of the future internal genital organs - special strands from which the body and cervix, the upper part of the vagina and the fallopian tubes are subsequently formed.
Closer to week 12, the Müller ducts, located on the right and left, merge in certain areas into a single “hollow tube”. After these tissues normally form one vagina, one cervix and the body of the uterus, and the fallopian tubes are formed from non-connected parts.
Depending on how many cells and at what level they do not undergo fusion, there are various options for duplicity.
- Saddle (uterus arcuatus). This is the most frequent and favorable malformation for pregnancy. The merger does not occur only in the bottom of the uterus, so the "saddle" is formed. Saddle uterus does not interfere with conception. If the placenta is not fixed in the area of the "saddle", the carrying is usually proceeding. But this defect can provoke anomalies of labor directly in childbirth.
- With a septum inside the cavity (uterus septus, subseptus). At the same time, there is no fusion of the body of the uterus at different lengths, which causes the size of the septum - it can spread to the whole body or occupy one or two thirds of it. Conception and pregnancy can proceed without pathology if the partition is made of soft tissues. The formation of a dense partition increases the risk of miscarriage, detachment and other complications of pregnancy and childbirth.
- Two-horned (uterus bicornis). When this occurs, the non-merging throughout the entire body of the uterus - two separate cavities are formed, which open into one cervix and vagina. Less commonly, two cervical canals form. Conception can occur without hindrance. Pregnancy begins to develop in the right or left horn. There is a high probability of various complications of gestation and labor.
- Single-horned (uterus unicornus). At the same time, only one Muller duct undergoes a further development, from which a single horn is formed. The second Müller duct atrophies and remains in its embryonic state. He may or may not have messages with another horn and cervix. Conception can take place normally, a successful pregnancy is possible only with the localization of the ovum in a full horn. If it falls into a rudimentary horn, a state of "ectopic pregnancy" arises - an abnormal in structure horn cannot grow with the fetus, leading to rupture of the uterus and massive intra-abdominal bleeding.
Possible extreme deviations in the development of internal genital organs.
- Complete atresia (underdevelopment) of the Mullerian ducts. In this case, instead of the uterus, connective tissue strands are determined. The woman has no menstrual function, she is not able to conceive and carry out the baby even using assisted reproductive technologies.
- Complete doubling of the uterus. Formed in the case when a full-fledged reproductive organ is formed from each Müller duct. In this case, the woman is determined by two separate functional parts of the body, each of which is capable of bearing and giving birth. They can be completely separated or reported at some level.
How to identify
Often a woman will learn about the abnormal development of the genital organs after a failed pregnancy. This is especially true of non-coarse vices - the saddle-shaped uterus, an incomplete septum in the cavity. It is advisable to diagnose using the following methods.
- Ultrasound procedure. With the help of ultrasound can be assumed defects, however, this is an inaccurate method. Some abnormalities can be detected by ultrasound in the first trimester.
- Hysterosalpingography. The essence of the study lies in the introduction of contrast into the cervix and uterus, after which it spreads further through the fallopian tubes and into the abdominal cavity. As you progress, you need to take several X-rays, which helps to track the path of the contrast agent.
- Hysteroscopy. This is one of the reliable methods for determining the pathology inside the uterus. Using hysteroscopy, you can not only identify the septum or saddle shape of the uterus, but also try to correct the defect, for example, remove the structure. But hysteroscopy is not so informative with single speed, especially if the additional horn is non-functional.
- Laparoscopy. With the help of special manipulators and a camera placed in the abdominal cavity, one can study in detail the structure of the uterus.
Pregnancy with two-horned uterus: prognosis
Most often, the conception of various violations of the structure of the uterus occurs unhindered, except for the complete absence of the cavity and fallopian tubes. But a woman may not know about successful fertilization, as there is a high probability of miscarriages for a period of four to five weeks, when there is no menstruation delay or it is small and within the normal range of the cycle.
Of particular danger is pregnancy in the rudimentary (underdeveloped) horn, when it has little communication with the uterine cavity. A fetal egg continues to develop, and the woman believes that the pregnancy is going well. But having reached the size of the cavity, the ovum provokes rupture of the rudimentary horn and massive bleeding. This is due to the fact that the abnormal area is not able to grow with the ovum. Clinically, pregnancy in the rudimentary horn is very similar to an ectopic pregnancy, but over a longer period (six to eight weeks).
In addition, features of pregnancy in the two-horned uterus include an increased risk of the following complications.
- Spontaneous miscarriages. An anomaly of the structure of the uterus is expressed not only in the change in the anatomy of the organ, but also in increased excitability of the myometrium. This provokes spontaneous miscarriages at different times, premature labor.
- Abnormal attachment of the placenta. Violation of the anatomy of the uterus leads to an increased risk of abnormal location of the "children's place". Often, the placenta can be attached to the bottom of the saddle uterus. High probability of central and regional presentation, when the placenta is localized above the internal cervix of the cervix. Such an abnormal location leads to frequent bleeding, not associated with the threat of miscarriage. Sometimes the bleeding is so heavy that in order to save the life of a woman, pregnancy is interrupted. In case of developmental pathology of the uterus, there is a high risk of placental abruption, which in the early stages can lead to missed abortion.
- Bleeding from additional horns. When bipodal, the ovum can develop normally in one horn, and the second will at this time undergo the usual cyclical changes, as with menstruation - with an increase in the endometrium and a periodic release of blood or just a daub. Erroneously, such a small discharge in a two-horned uterus during pregnancy can be mistaken for the threat of termination. However, they do not pose a serious danger to carrying.
- Cervical function failure. With abnormal development of the genital organs in women, the risk of insufficiency of the cervical closure function is increased. As a result, it opens ahead of time and leads to premature labor or rupture of amniotic fluid. It is important to monitor the dynamics (by ultrasound and with the help of examinations) the consistency and length of the cervix in order to take measures in time - to install a pessary or to put a circular suture.
- The wrong arrangement of the child. The deformed uterine cavity prevents the fetus from being within normally. This leads to a greater frequency of gluteal and transverse positions of the fetus, irregular head (face, forehead) positions. Some presentations make impossible successful delivery, so a cesarean section is often performed.
Not only complications of pregnancy with the uterine biopsy are characteristic, but also the pathological course of the birth itself. In later periods it is impossible to suspect abnormalities in the structure of the genital organs, if they have not been identified before. The following complications of labor are possible.
- Anomaly of labor. Normally, rhythmic uterine contractions begin from the right, less often the left corner of the uterus and a descending gradient cause contractions. When the anatomy is violated, the uterus muscle fibers are often reduced in isolation, which causes discoordination of labor, weak contractions and attempts. This increases the incidence of obstructed labor.
- Protracted labor. A mechanical obstruction in the form of a septum often contributes to pathological prolonged labor.
- Bleeding. Disturbed anatomy of the uterus leads to violations of its reduction after childbirth. And this is the first factor for the development of serious uterine bleeding, sometimes threatening the life of a woman.
- Pathology of placenta attachment. In case of malformations of the uterus, partial or dense attachment of the placenta is more common. In some cases, one has to perform a complete removal of the organ, since the “children's place” literally grows into the myometrium.
- High probability of serious breaks. Pathological childbirth, early rupture of water, reduced tissue elasticity - all this increases the risk of serious ruptures of the cervix, vagina, and even the body of the uterus.
If anomalies are detected before pregnancy, a comprehensive examination should be performed to clarify the type of defect. To do this, do the following:
- detailed ultrasound of the pelvic organs,
- if necessary, laparoscopy.
If there are anomalies that can be removed using relatively simple methods, for example, to excise the septum, this should be done before planning pregnancy. Extra horn should also be removed. The question of the need to connect the cavities in case of incomplete duplexism should be addressed individually.
If IVF is planned, the need for surgical correction of the reproductive system is also assessed individually.
If a pregnancy has occurred, for example, in a two-horned uterus with a full or partial septum, and the carrying flows without significant disturbances, there is no indication for interruption. Usually, women wear safely, and at the end of the 3rd trimester delivery is given. If a cesarean section is performed, during surgery, excision of the septum or repair of other defects as necessary is indicated.
The rest of the treatment in case of a two-horn uterus during pregnancy is to maintain gestation, hospitalization at a critical time to prevent the threat of termination, as well as to treat any complications that arise.
Therefore, the two-horned uterus and pregnancy are two compatible concepts. Only some developmental anomalies are accompanied by the complete exclusion of the possibility of conception and carrying. But it should be remembered that the risk of pregnancy complications with such defects is several times higher. Therefore, women need more careful monitoring and frequent hospitalization.
The difference between the two-horned uterus and the usual
Normally, the main female organ has the shape of a triangle and one cavity, which is connected to the vagina. Disorders of fetal development can lead to its abnormalities. The two-horned uterus is a cavity divided into 2 parts by a septum or two cavities that have a common lower part at the bottom of the organ. In the latter case, the defect is considered complete, that is, more complex.
When menstruation exfoliates the inner lining of the uterus, replacing fresh. Normally, it does not meet any obstacles. The top layer of the mucosa under the influence of hormones is separated and excreted through the vagina.
Two-horned uterus and monthly with her retain their features. The body has a different shape, the endometrium - a large area. These reasons are due to differences between menstruation and normal.
Cycle with two-horned uterus
One of the important characteristics of menstruation is the length of the cycle. Two-horned uterus causes a lot of difficulties with critical days, but as a rule, they do not relate to their duration. The cycle is largely determined by the work of the ovaries and other organs that produce hormones. Two-horned uterus monthly able to delay, if supplemented by other problems in the reproductive system, which often happens. But if only this anomaly is present, the critical days will be regular.
Nature of menstruation
How do the menstrual periods go with the two-horned uterus depends not only on this defect of its development. Sometimes they are the same as women who do not have this anomaly. But for the most part, biporness is accompanied by hormonal disorders. So any deviations from average manifestations of a menses are possible: both scanty allocation, and breakthrough bleedings, including, besides critical days.
Feelings during menstruation and two-horned uterus
In most cases, the two-horned uterus is found when an infertility problem or miscarriage arises. Otherwise, it may not cause significant trouble even on critical days. Many women are accustomed to feeling unwell during this period and do not complain about it to the gynecologist.
Meanwhile, the two-horned uterus and painful periods - an everyday combination. And if you compare the sensations of a healthy woman and having this anomaly, then in the latter they will be much harder. There are several explanations for this:
- The organ with malformation is larger than the normal one. The two-horned uterus puts more pressure on the surrounding tissues than causes a sharp reaction of the nerves present in this area. Sensations can spread to the bladder. Because of this, a woman often has a desire to urinate, but its implementation brings little relief,
- Painful periods with the two-horned uterus are also due to the fact that the area of smooth muscles is increased. The rejection of the upper layer of the endometrium occurs with their contractions, which are accompanied by spastic sensations. The more cuts a body has to do, the greater the pain from it,
- Difficulty in the withdrawal of discharge occurs at full duplicity. Both improperly developed parts of an organ have the form of branches deviating from its vertical axis. Endometrial tissues may linger in their bends, causing stronger discomfort on critical days,
- Two-horned uterus pain during menstruation provokes because of the nuances of its structure. In its upper parts the infection easily settles. Because of the inflammatory phenomena that tend to escalate during the menstrual period, and the sensations can become very painful. One of the horns of the uterus may differ in its development from the other. The processes occurring in them because of this will not be synchronous, and the accumulation of menstrual fluid is likely in the lagging area. This is another culprit in sharp pulling pain in the lower abdomen.
The amount of discharge in the two-horned uterus
Abundant menstruation due to the two-horned uterus is another sign of its abnormal development. As already mentioned, the size of the body increases. If in normal its configuration can be compared with a triangle, the double-bakedness gives the uterus a heart shape. But even this is not important, but the fact that not one, but two cavities become cavities. And both are covered from the inside with a layer of the endometrium, that is, on critical days, the mucous membrane is renewed in both. Monthly with two-horned uterus go with high intensity, in many cases they are compared with bleeding. This anomaly often allows not only an increase in the area of its internal coating, but also thickness. Naturally, there will be more secretions in this case, and a significant part of them will be blood. Hence, the manifestations of anemia in a woman are possible, since the periods are intense all the time. The body does not have time to replenish its reserves before the beginning of the next menstrual cycle.
Abundant menstruation with clots double-headed uterus also often presents its owner. Due to the complex configuration of the body, the endometrium may, peeling, linger in one of the cavities. Выделения собираются в сгустки и выводятся через некоторое время. По этой же причине коричневая слизь может выходить и в середине цикла.
Месячные при имеющейся двурогой матке могут указать на существование данной аномалии, если женщина будет к ним внимательной. After all, even when they have ovulation, pregnancy is not always possible. And in most cases with such an anomaly it is impossible to endure it. Therefore, it is better to detect the defect before conception, in order to know what to fear. Treatment of the two-horned uterus is surgical, and after it the likelihood of a happy pregnancy increases. Menses too come to normal.
The exact factors of the appearance of the two-horned uterus are unknown, but experts believe that this defect is due to violation of the process of formation of the fetusoccurred at 2-3 months of pregnancy. The likelihood of this increase is influenced by the following factors:
- Intoxication substanceswhich have a teratogenic effect:
- waste resulting from industrial production.
- Significant lack of vitamins and other substances necessary for the development of the child.
- Infectious diseasesthat the expectant mother suffered in the first trimester of pregnancy.
- Oxygen starvation tissues of an unborn baby.
- Metabolic imbalance a woman carrying a child (if it is associated with a serious endocrine disease).
In some cases, the bipodalness is due to genetic predisposition women to the abnormal development of the reproductive organs.
Anatomical variants of the two-horned uterus
Depending on the exact form of an organ with a defect, several types of anomaly can be distinguished.
In this case the uterus is completely blocked, with the result that its halves are isolated from each other. At the same time, the cervical canal (cervix) can be common to both parts or double. In such a situation, experts are no longer talking about duplicity, but about doubling the entire organ. This applies particularly to cases of detection in the number of accompanying pathologies of the vaginal septum, which likewise separates the vagina of a woman.
If this form is present, the uterus is also divided, but its halves have a message next to the cervical canal. The length of the barrier between parts of the body may vary.
Saddle-shaped is the least pronounced disorder in the structure of the uterus. Deformations of the organ cavity are minor, there is only a depression in the middle of the bottom.
The symptomatology observed when the uterus has two faces does not differ in specificity. Usually it is completely absent. Therefore, without special studies to identify the anomaly is almost impossible.
Most often, women with two-horned uterus have the following symptoms:
- inability to conceive a child (optional),
- the occurrence of complications in the process of gestation,
- pathological course of menstruation.
The presence of serious problems in the endocrine system, anomalies of the ovaries and other complications for this disease is unusual. In the absence of violations in the structure of the vagina, pathology does not affect the quality of sex life.
A woman who has been diagnosed with a double uterus of the uterus may become pregnant and give birth to a healthy baby in a natural way. However, the defect significantly increases the likelihood of complications in the process of carrying.
What threatens the anomaly
Such a violation is dangerous to the health of women for several reasons:
- If one of the cavities with a full-fledged (in terms of functionality) endometrium, is closed, then due to changes occurring in the female body during menstruation, blood will accumulate in this part of the uterus. This condition is complicated by the appearance of suppuration, which often leads to inflammation of the surrounding tissue and their subsequent melting. Similar complications are observed if the horn is severely deformed or its position does not correspond to a physiologically acceptable variant.
- If an infection gets into the blood, which is in a closed cavity, then sepsis or purulent peritonitis.
- With bipodalism uterine bleeding more likely. It may become cause of anemia, which will lead to the dysfunction of important organs for life.
Of the methods of preventing pregnancy, patients with dvurogosti should prefer the barrier and preformed forms. The use of coils and other intrauterine contraceptives is allowed only on prescription.
Monthly with two-horned uterus
Menstruation in girls with similar pathology is different. soreness (due to the increased size of the organ) and profusion. In addition, they may be longerSince the endometrium is rejected in significant quantities, and the process of its removal from the uterus is difficult.
Particularly painful syndrome is expressed in the case, when the fallopian horns are arranged horizontally, as this prevents the outflow of blood to the outside, which leads to its stagnation and increased pressure on the adjacent organs.
Features of pregnancy and childbirth in the two-horned uterus
In this disease, nothing interferes with the process of the natural conception of a child, but in 70% of cases there is spontaneous abortion or there are certain complications.
Two-horned uterus is worse for carrying a child for the following reasons:
- the cavity in which the fertilized egg must develop has an insufficient volume,
- myometrium of the body is reduced too actively
- the uterine wall may be functionally underdeveloped (especially in the area where the partition is located and a split organ occurs),
- high probability of problems with blood supply and innervation of uterine tissues,
- improper angle of the body of the body relative to the cervical canal can cause isthmic-cervical insufficiency.
Uterine malformations are often interferes with the process of implantation of an already formed ovum. In this case, the embryo will be removed from the organ cavity during the menstruation period, which may occur with a slight delay (but this is not necessary).
Spontaneous abortions, premature birth, frozen and ectopic pregnancies are also likely with this ailment. Finally, the risk of developmental abnormalities in the child being born increases.
When identifying increasing and not amenable to the correction of fetal hypoxia, a caesarean section may be prescribed. In this case, the expectant mother is included in the risk group according to the probability of development of uterine bleeding.
However, there are many cases when a woman with a uterine defect was able to safely carry the baby without any developmental disabilities. At the same time, a woman should be under the supervision of specialists before birth and until complete recovery after it.
Identification of the uterus bilogy includes:
- Inspection (performed by a gynecologist and allows you to detect the presence of septum in the vagina, a split of the cervical canal, deformation of the uterine bottom).
- Conducting instrumental studies:
- Ultrasound (determines the presence of developmental abnormalities in the entire urogenital system),
- laparoscopy (surgical technique to assess the state of the appendages, uterus, kidneys and urinary tract),
- hysterosalpingography and review radiography (both methods allow to evaluate the features of the external outlines of the body),
- hysteroscopy (in addition to information about the shape of the uterus, provides data on the patency of the mouths of the cervical canals, the tissue structure of the septum),
- CT and MRI (both methods give information about the form of the body, the features of its structure and the correctness of its development).
All conducted research should not only reveal the anomaly, but also determine how functional the uterine tissues are, whether conception is possible, and how effective the surgical method of returning to childbearing function will be.
Treatment of uterine disease is possible only by surgical intervention. The reason for his appointment are:
- cases of spontaneous abortion and stillbirth,
- accumulation of blood in the isolated uterine cavity.
The main method used is metroplasty. It allows you to combine both parts of the uterus by excision of tissues separating them or by removing the functionally underdeveloped horn. Instead of a scalpel they often use a laser. This makes postoperative complications less likely, and subsequent pregnancy more favorable.
If, in addition to the uterine dvurys, the patient was found to have obstruction of the fallopian tubes or other pathologies that prevent conception, she IVF may be prescribed.
The presence of the two-horned uterus is a serious developmental anomaly that can interfere with the successful conception and subsequent birth of the child, and also represents a danger to the health of the woman herself. Identify it by external signs is impossible. Therefore, in case of suspicion of this type of anomaly, it is necessary to contact a gynecologist for a diagnostic examination.
Features of conception with two-horned uterus
And yet, conception may be complicated if there is a full organ duplicity. When the egg cell is located in one horn (department) of the uterus, and the sperm cells move in the other, they will not meet. In this case, you can become pregnant if you change the path of the spermatozoa, and here it is sufficient to use a certain posture during intimacy.
In any form of this anomaly, normal follicle maturation, ovulation, and endometrial growth occur. The impossibility of conception can also occur due to the presence of a septum, because it has an effect comparable to the action of the intrauterine device. Thus, the two-horned uterus and pregnancy may be incompatible states at the conception stage. However, this happens extremely rarely, and, as a rule, fertilization occurs.
If the partition is so long that it interferes with the process, it is better to remove it in an operational way. After such treatment, you can become pregnant only after a year, since uterine rupture may occur earlier.
Pose for conception
Spouses can help conceive by using poses suitable for moving sperm as deep as possible into the uterine cavity. For example, such:
1. The greatest rapprochement of the male penis with the uterus is achieved in the pose “man behind”, regardless of the pose of the woman: on the knees or on the side.
2. In the pose “woman on the back, man - on top,” it is better to place an elastic pad under the woman’s buttocks.
Conditions of successful conception
For successful conception, it is important not to jump out of bed after intercourse and not rush into a shower, but lie down on your back for about half an hour. Such recommendations are suitable when a saddle-shaped uterus is diagnosed and pregnancy does not occur for a long time. With a full biprogy, the same postures are applied, it is recommended to lie on the stomach or back. The main thing is to keep the sperm in yourself as long as possible (do not get up, do not wash, do not use the “woman on top” pose). It is also desirable to calculate the most favorable days.
Features of carrying
You can become pregnant with this anomaly even without special techniques, and you will have to use a lot of effort to carry the baby. With a two-horned uterus with a long septum, when 2 horns are formed, the pregnancy develops as follows:
- the ovum is fixed in one of the 2 divisions (horns) of the uterus
- the horn grows, develops and, according to nature, stretches
- the second department, on the contrary, begins to contract, deform, bleed
- formed the tone of the uterus, which leads to miscarriage.
When the chances of a normal pregnancy are great?
If the pathology differs in the bottom deflection without a septum, the chance to carry the baby well and give birth on its own is very high. It is the saddle uterus and pregnancy with normal delivery that occurs most frequently. The uterus as it straightens as the fetus grows and takes on a normal form.
What threatens the partition?
With a bipod with a septum, regardless of its length, the embryo can be lost if it attaches to it or is too low to the wall of the organ.
In the first case, events develop like this:
- the septum does not provide sufficient blood circulation, the fetus does not survive.
- the uterus does not stretch, tries to push the embryo, which leads to miscarriage.
At the same time, the uterus is bleeding, and it seems that menstruation is on. A woman can take the bleeding for the usual periods and not suspect that she was able to get pregnant. However, even this state is not a reason to despair. Pregnancy can be saved, and false monthly to stop or prevent, if constantly under the supervision of a physician.
It should be remembered that a woman should:
- exclude any loads (physical and psychological)
- to lie a lot, to support the hormonal background of the body by taking drugs (prescribed by the doctor!)
- go to save whenever recommended by the doctor.
With the observance of these rules, it is possible to carry a baby even if bleeding is observed, similar to menstruation. However, this fact should be reported to the doctor immediately or call an ambulance if the woman is outside the hospital.
How is the birth?
Births in this pathology often begin prematurely, much earlier than 40 weeks. For a successful delivery, it is better to go to the hospital for a few days (weeks) earlier (the doctor recommends this). The doctor always foresees the possibility of natural childbirth, but the pronounced form of bipod often excludes such a method. This is due to the following dangerous situations:
- traumatization of the baby and mother
- improper passage of the child through the birth canal
- weakness of generic forces due to the insufficiency of nerve impulses.
Often with incomplete two-leggedness and always with a full cesarean section. After giving birth, a woman can plan the next pregnancy in a year. It should be noted that this pathology and such genera do not affect the correct development of the baby. The percentage of birth of healthy children is the same as for mothers with a normal uterus. A pregnant woman with bilithology should remember that childbirth can begin at any time after 28 weeks, and be ready to go to hospital.
Treatment of two-horned uterus. The operation of the two-horned uterus
The only way to treat the two-horned uterus is surgery. During surgery, the uterine cavity stops.
Treatment of two-horned uterus. The operation of the two-horned uterus
But the doctor may prescribe the operation only after several miscarriages, or when there is a diagnosis of infertility caused by the two-horned uterus. The most common operation is to remove a septum or horn extirpation.
But again, we will make a reservation that you can prescribe a treatment, and in this case treatment is an operation, only a highly qualified specialist can do after all the necessary tests have been taken.
Why can go monthly during pregnancy?
Any qualified specialist will say that monthly during pregnancy is not possible. During the menstrual cycle, the inner layer of the uterus grows - the endometrium. And, if fertilization has not occurred, then the egg comes out with the contents of the endometrium - blood and mucus. Therefore, it is impossible to be both pregnant and have menstruation at the same time.
During pregnancy, it will be more about bleeding. The nature and duration of discharge is usually different from the usual monthly. Therefore, do not postpone the visit to the gynecologist. The doctor will calm you or provide timely assistance.
Options and signs of the norm
Menstruation occurs in the normal course of pregnancy when a woman has a two-horned uterus. In one part the fetus is formed, and in the other a natural monthly cycle continues. For two to four months, the woman continues “critical days”. This phenomenon is rare and it is desirable that the pregnancy was under the supervision of a gynecologist. Hence the stories that women learned about their position at 2, 3 and even 5 months.
In most cases, conception during menstruation is impossible. But sometimes late ovulation occurs right before the menstrual period. And then the woman goes monthly at the very beginning of pregnancy. That is, the fertilization of the egg occurred in the previous cycle, and the ovum had not yet managed to reach the site of implantation. A woman may not feel any corresponding signs and symptoms. For this reason, doctors never consider the duration of pregnancy from the date of conception. All over the world, it is customary to start counting from the first day of the last menstruation (with the exception of IVF). If you suspect that you are pregnant, it is necessary to pass the analysis of hCG, which will accurately show whether fertilization has occurred or not.
From the moment of fertilization to the complete implantation of the egg to the wall of the uterus, 7 to 15 days pass. During implantation, some blood is often excreted, on average, 10 days after conception. But to confuse this phenomenon with menstruation is practically impossible, since there is very little discharge.
The likelihood of pregnancy without delay exists. In the different ovaries mature one egg. One is fertilized, and the other comes out, causing menstruation. Often monthly more scarce than usual.
In any case, such periods go once and if the next month the bleeding recurs, then you should take this carefully and consult a doctor.
First trimester bleeding
Monthly in the first month of pregnancy is a common phenomenon. But rarely safe and natural.
Вызывать опасения должны любые кровотечения на ранних сроках беременности. Это очень опасно для будущего малыша. Up to 12 weeks there is a high probability of abortion without the delay of menstruation. This happens due to hormonal imbalance, both physiological and provoked by the use of contraceptive pills. Doctors recommend to stop taking contraceptive drugs at least six months before the intended pregnancy.
It is necessary to guard when the blood goes clots.
Early menstruation sometimes indicate that there has been a rejection of the placenta. The placenta delivers oxygen and nutrients to the baby, so detachment can cause spontaneous abortion. If the discharge is scanty, the body will probably cope on its own, highlighting more progesterone. And if the monthly went abundantly and accompanied by severe pain, then you need to urgently seek help. You are shown bed rest and complete peace!
Abundant bleeding can be a sign of missed abortion. In that case immediate hospitalization with the subsequent cleaning is required.
Sometimes the fertilized egg at the beginning of the term begins to grow without an embryo and doctors can not determine the cause. The woman appears daub with a bloody shade. Pregnancy cannot develop, therefore, for a period of maximum 8 weeks, a spontaneous miscarriage begins.
Observed bleeding and ectopic pregnancy. Such pregnancy develops outside the uterus: in the fallopian tube, ovary, less often in the cervix and abdomen.
It occurs quite often: there are 1 ectopic per 100 normal pregnancies. In the early stages of this pathology is almost impossible to distinguish from a normal pregnancy. At the beginning of the development, the symptoms are irregular or lack of menstruation, the appearance of daub instead, sometimes pain in the abdomen. Such a pregnancy develops to a certain time. Then, due to the increase in the size of the embryo, a pipe rupture occurs.
The main symptoms are acute pain in the abdomen, pallor, rapid heartbeat, drop in blood pressure. But such manifestations are not always pronounced in the early stages, therefore, this pathology is diagnosed only by ultrasound.
Treatment is only operative. Moreover, the earlier the diagnosis is established, the more benign the operation will be.
Second trimester bleeding
Bleeding in the 2nd trimester is no less dangerous. Monthly on such dates are no longer possible, but there is still a chance of placental abruption. The future mother feels pain in the abdomen and daub appears.
By this time, the hormones return to normal on their own or when the appropriate therapy is completed.
If bleeding with clots or scarlet color has begun, you should immediately call an ambulance, and lie down before arrival and ensure absolute peace.
Daubs or scanty menstruation in the 2nd trimester may be a sign of vaginal infections. The doctor will prescribe urine, blood, and smear tests from the church canal to clarify the diagnosis and subsequent treatment.
Third trimester bleeding
After the 28th week of pregnancy, the 3rd trimester begins. It is believed that a child born after week 23 has a high probability of survival, provided proper medical care is provided. But at this time of pregnancy, there are also "scanty periods".
At a later date, daub appears as a result of the placenta previa or abruption. Immediate hospitalization is required, as there is a threat of miscarriage and dangerous bleeding.
Some women notice that after having sex they instead of the usual discharge appear daub with the inclusion of blood. This is possible as a result of rubbing the sensitive cervix. There is nothing wrong, but you still need to inform the doctor about your condition. Most likely, he will advise to refrain from sexual intimacy.
At the entrance to the cervix is mucous plug, protecting the baby from infections. She can go out immediately before or during childbirth. But there are cases when the cork departs 1-2 weeks before the onset of labor. Due to a rupture of blood vessels, the mucus turns pink or red. There is no cause for concern. It is enough to visit a doctor and talk about the situation.
But, if along with the discharge of the mucous membrane, there are watery discharges, then an urgent need to go to the maternity hospital, as such manifestations are often a symptom of the onset of labor.
Bleeding and prophylaxis
We figured out that menstruation at the beginning of pregnancy can appear for the following reasons:
- Progesterone deficiency,
- Two formed eggs, one of which was fertilized, and the second came out with menstruation,
- The egg cell, which has not yet sent a signal to the body, because it did not have time to attach to the wall of the uterus,
- Fading pregnancy,
- Pregnancy without embryo
- Placental abruption,
- Ectopic pregnancy (often menstrual with ectopic pregnancy differ darker shade).
Spotting in late and late pregnancy indicates:
- vaginal infections,
- rejection or placenta previa,
- rupture of the vessels when rubbing the cervix,
- the output of the mucous membrane and the onset of labor.
Whatever the reasons for the appearance of spotting instead of the usual ones, it is recommended to visit a qualified obstetrician-gynecologist. After all, menstruation and daub during pregnancy are not normal. Of course, there are cases when women have menstruation and they have given birth to absolutely healthy children. But these cases are exceptions to the rule.
The probability of carrying out and giving birth to a healthy child is sharply reduced, if it is not timely to begin drug therapy, which can be provided only in medical institutions.
The expectant mother needs to rest more, lie down, not overwork, monitor her nervous system and visit the doctor in a timely manner. Only such an order guarantees a safe course of pregnancy and childbirth.
- Paracetamol during early pregnancy
- Cork discharge during pregnancy
- How to defeat ureaplasma?
- What to do if uterus hypertonus was diagnosed?
What is the two-horned uterus in a woman - the causes, the possibility of becoming pregnant and giving birth
During the period of pregnancy, when the organs of the child are formed, some developmental abnormalities may occur. Two-horned uterus in gynecology is extremely rare, a woman with this diagnosis will have problems with conception and difficult childbirth. The formation of this anomaly is associated with intrauterine development and is due to the incomplete confluence of the Mullerian ducts. On ultrasound, this uterus is visible in the shape of a heart, the risk of occurrence is 0.1-0.5%.
What does the two-horned uterus look like?
The uterus with two-horned anomaly has pronounced physical signs, the organ cavity is divided into two parts. This rudimentary process can merge at different levels of the lower part. In gynecology, the magnitude of the splitting is used the following classification of the dual axis anomaly:
Two-horned anomaly of this type is characterized by the separation of the separation of cavities in different directions, starting with the uterosacral ligaments. The angle between the horn "pockets" may differ from case to case. The separation is pronounced, two separate niches are formed, which are located in close proximity to each other. Pregnancy can proceed normally in one of the parts of the uterus.
Separation may be partial. Incomplete doubling of the uterus outwardly differs by splitting the inner space only by a third with a shallow opening between the two horns. Horn anomaly on both sides has the same size. Pregnancy can proceed normally in one of the "pockets", there are cases of conception of twins. Both fetuses are in a separate horn of the uterus.
Pregnancy with two-horned uterus
This diagnosis is not a sentence for women who want children. There is no clear instructions on how to become pregnant with a two-horned uterus, but with successful conception, physicians prefer not to interfere with the natural course of gestation. A pregnant woman is taken under scrutiny to take action in time for one of 2 possible serious complications:
- Bleeding. Often the cause of this complication in two-horned pathology becomes placental presentation. The embryo does not attach on the side or back of the womb, but closer to the bottom. In the early stages of bleeding or bleeding, indicate that the placenta has blocked the uterus mouth. In 30-35% of cases, this symptom, along with pain in the lower abdomen, indicates the likelihood of abortion in two-pronged pathology. In later periods, this indicates detachment of the placenta.
- Fading pregnancy. If the embryo is attached to a septum that does not have blood vessels, development will not occur due to a lack of nutrition. The fetus does not grow and perishes. Two-pathology can provoke a missed abortion if the embryo has consolidated very close to the cleavage site. The fruit will not be able to grow normally, which will lead to his death.
Childbirth with two-horned uterus
This diagnosis requires the future mother to be constantly supervised in the gynecology by an obstetrician. Often the parturient women need prenatal hospitalization, in some cases it may be necessary at the 27th week of gestation. When diagnosing uncorrected or increasing fetal hypoxia, a decision will be made about the operation (cesarean section). A woman will be in a high-risk group because often hematometers, postpartum uterine bleeding, and endometritis develop.
Natural childbirth is not excluded in case of two-horny separation, even when this disease is combined with abnormal development of the vagina or neck. In the literature on gynecology, there are descriptions of independent safe delivery with full type of organ splitting. Often, childbirth is accompanied by injury to the tissues of the female genital organs, which require an episiotomy.
Treatment and diagnosis
An experienced doctor can determine the two-pathology according to the patient's complaints. Symptoms include miscarriages, inability to conceive, bleeding and an irregular menstrual cycle. Further, to confirm the diagnosis, a full gynecological examination is carried out, are they prescribed from tests?
Surgical intervention for horn separation is recommended only for several consecutive miscarriages or infertility. The main task of the operation is the restoration of the uterine cavity into a single whole. In operative surgery, as a rule, they carry out the extirpation of a rudimentary horn or the complete removal of the septum that separates the cavity. There are two procedures for this:
- the Strassmann operation,
- Thompson operation.
The first option is considered standard, a laparotomy is performed, a dissection of the uterus bottom is done through a cross-section, and then the median septum is excised. The sheath of the uterus at the end of the procedure sew. For correction, a hysteroscopic technique is also sometimes used. After prompt adjustment and restoration of a single uterine space, a woman is placed in the IUD (intrauterine device) for 6-8 months.
What is the two-horned uterus?
Abnormalities of the structure of the uterus are very rare. The most common type of pathology of the structure of the uterus is its duplicity, which is observed in less than half the percent of females.
Full is considered two-horned uterus having an internal septum. In the area of the uterosacral ligaments, her horns are removed from each other for some distance. They may look like two different wombs.
This abnormal structure of the uterus allows you to safely conceive and carry out the child. The fetus develops in one of the branches of the uterus. In some cases, doubling of the cervix is possible.
Considered incomplete such a uterus in which the cavity is divided only in the upper part, and the horns are apart from each other at a short distance.
Third variety two-horned uterus - saddle. In this case, the bottom of the uterus has a peculiar depression, which by its shape resembles a saddle.
Sometimes the pathology of the structure of the uterus is accompanied by defects in the structure of the urinary system.
Causes of bipod
The reasons for the development of the abnormal structure of the uterus are many. To provoke its development can poisoning during pregnancy with drugs, alcohol, poor-quality food and so on.
Increases the risk of developing a two-horned uterus, the presence of such a pathology in someone from the next of kin.
Its appearance is also influenced by poor ecology, strong nervous disorders and stress, infectious diseases and diseases affecting the endocrine system.
Only the gynecologist can reveal more exact causes of the appearance of the two-horned uterus.
Do you know if pregnant women can drink non-alcoholic beer or not? Ask the doctor!
The use of valerian in pregnancy is described in detail in this article.
Symptoms of uterus dvuhurogosti quite vague. The characteristic symptoms include uterine bleeding and a periodic state of weakness and nausea, accompanied by aching pain in the lower abdomen, similar to the state during menstruation.
It is also possible violations of the menstrual cycle, or even amenorrhea.
In some cases, the presence of the two-horned uterus is accompanied by early miscarriages.
What risks does a woman face?
The risk of difficulties during pregnancy increases with the degree of cleavage of the uterine cavity.
When both fallopian horns are developed equally normal., pregnancy can normally proceed when the fetus is fixed in any of them. It is very rare that fertilization occurs simultaneously in both branches.
Much worse, when one of the horns of the uterus remains underdeveloped. When you attach the fetus in it, the pregnancy proceeds similarly to the ectopic, which is fraught with damage to the uterine horn.
In some cases, complications may occur. at the end of the first trimester. So, by this time the fetus may experience a shortage of free space and circulatory disorders.
The development of various pathologies of development is also possible. in later pregnancy. This may be premature aging of the placenta, previa or the threat of miscarriage. In this case, after the onset of the twenty-eighth week of pregnancy, it is advisable to use a cesarean section in order to preserve the life of the baby.
Predicting how pregnancy and childbirth will proceed in a woman with a double-horned uterus is quite difficult. Much depends on the anatomical features of the future mom and the location of the fetus. In most cases, the possibility of the occurrence of natural childbirth, just to consider the possibility of using emergency cesarean section.
What are the risks to health of a baby smokers pregnant women? How to get rid of the bad habit? This is our article.
On the signs of missed abortion, this article will tell in detail.
The causes of the formation of two-horned uterus
The formation of the two-horned uterus in the female fetus can be promoted by the action of various damaging factors in the first months of gestation when the organs of the child are laid and develop. Such teratogenic factors include various types of intoxication (alcohol, nicotine, drugs, drugs, chemical agents), avitaminosis, psychological trauma during pregnancy, endocrine diseases (diabetes, thyrotoxicosis) or heart defects in the mother.
Infectious agents that cause measles, rubella, influenza, toxoplasmosis, syphilis and other diseases have a damaging effect on the embryo. Chronic fetal hypoxia, pregnancy with toxicosis adversely affects the process of organogenesis. Two-horned uterus can be combined with some other anomalies, most often with the defects of the urinary system.
Symptoms with two-horned uterus
The presence of two-horned uterus may not be accompanied by pronounced clinical manifestations. Sometimes with two-horned uterus, algomenorrhea, uterine bleeding is noted. Often, women with two-horned uterus have spontaneous abortions or infertility. However, it is possible that pregnancy and childbirth will occur without complications.
With a two-horned uterus, pregnancy usually develops in one of the existing horns, in rare cases, simultaneously in both horns. Pregnancy with a two-horned uterus is often fraught with risks of interruption, which requires careful medical observation. Spontaneous abortions in the two-horned uterus usually occur in the first trimester, since the growth of the embryo is hampered by insufficient blood supply and a small volume of the internal cavity of the uterine horn.
In addition, when the two-horned uterus is often found anomalies of the location of the placenta (presentation or low placement), fraught with its premature detachment and bleeding. The presence of two-horned uterus increases the likelihood of cervical insufficiency, pelvic presentation of the fetus, premature birth and violation of the contractile activity of the muscles of the uterus, postpartum hemorrhage. With oblique or transverse position of the fetus, cesarean section is shown.
The prognosis of the two-horned uterus
При достаточной емкости полости матки вынашивание беременности может происходить без осложнений. При выраженной степени раздвоения полости матки повышается риск спонтанного аборта или преждевременных родов. Conducting pregnancy in patients with two-horned uterus requires the prevention of miscarriage, the development of isthmic-cervical insufficiency, bleeding.
In the event of a threatened abortion at a later date (after 26-28 weeks of gestation), a cesarean section is performed to preserve the fetus. At full-term pregnancy, the issue of delivery is solved taking into account various factors (the position and presentation of the fetus, comorbidity in a pregnant woman, etc.). After surgical correction of the two-horned uterus, the risk of miscarriage is reduced from 90% to 30%. In women with an insufficient volume of the uterus or with a miscarriage remaining after surgical treatment, maternity is possible due to assisted reproductive technologies, namely, IVF under the surrogate motherhood program. Artificial insemination of the egg of the patient is carried out using ICSI technology or IMSI (using donor sperm if necessary), after the cultivation stage, embryos are transplanted into the uterus of the surrogate mother.
What does the two-horned uterus mean?
Congenital serious abnormalities in the structure of the main genital organ in a woman, the uterus, are extremely rare. A common type of uterus pathology is bipodal. Almost half of the female population walks with this diagnosis, and many people do not even know about it. Women become pregnant and have children, and most often the pregnancy is uneventful. Miscarriage is not an exception, as the two-horned uterus can be of different types.
The classic concept of diagnosis is when there is one cervix, and the uterine cavity itself is divided into two parts. Externally, the two-horned uterus takes the form of a heart. The upper cavity of the uterus (approximately the third part) is divided into 2 parts or 2 branches. In the people it is accepted to call each cavity "horn", from here and the name of the diagnosis "two-horned". Based on this, we can draw the following conclusion: since the uterus is divided into 2 parts, a new life can develop in each of them. Fetal egg is able to attach both in the middle and in the right or left part of the uterus. As a result, the gynecologist makes the following diagnosis: “Two-horned uterus and pregnancy in the left horn,” or vice versa.
The normal structure of the uterus is as follows: if you look closely at the picture, and then turn it upside down, you can see the shape of a pear in the picture. The lower part of the body is the neck, and the top resembles a drop or pear.
Consider the two-horned uterus:
- Complete In such an organ there is a partition, and the so-called "horns" or branches are located far from each other. Outwardly, it may seem that a woman has 2 wombs. Such a diagnosis will allow you to quietly conceive, bear and give birth to a child. The fetus will develop in one of the branches of the uterus. There is one neck or forked.
- Incomplete uterus. The body is divided only at the top, "horns" are located at a short distance from each other.
- The uterus of a saddle form from above has small deepening. Conception with such a deviation of the body is possible, the pregnancy can proceed without complications, the gynecologist will recommend the delivery options. A woman can have a baby by herself or with a caesarean section.
Types of two-horned uterus you can look at the photo:
Two-horned saddle uterus
As mentioned earlier, the uterus of the "saddle" type is formed incorrectly, this is when the lower part of the uterus (bottom) splits into 2 parts. Such an anomaly may not manifest itself or disturb a woman. Often she does not even suspect that she has an abnormal structure of the uterus, and she finds out the whole truth on the first ultrasound in her life (most often this happens during pregnancy).
Genital organs are formed in the female fetus at 11-13 weeks of pregnancy. The reasons for the abnormal development of the uterus can be different: poor maternal health, smoking, stress, medication, chemical poisoning.
According to statistics, 23% of women are owners of the saddle uterus. This deviation does not affect the course of pregnancy, only in special cases surgical intervention may be required. For example, if a woman cannot become pregnant for this reason, and also if an abnormal shape of the two-horned saddle-shaped uterus can adversely affect the development of the fetus.
There are cases when anomalies of the development of the genital organ are directly related to other vital organs. For example, women often suffer from disruption of the bladder and kidneys, fighting in the endocrine system. They are at risk because the uterus of an irregular shape can affect the normal course of pregnancy. As a result, after conception, pathology, birth trauma are possible, and fetal death of the fetus is not excluded.
Future moms are concerned about how much their uterus shape can affect the normal course of pregnancy. In this case, you should not worry, because the baby in this womb will develop normally.
If the pregnancy is prolonged, then at the age of 7-8 months a woman needs to decide on the delivery tactics. A gynecologist may recommend natural childbirth if the pregnancy was stable, without complications. In addition, if a woman has no other indications for surgery, then you should try to give birth to yourself. In the course of labor, the doctor can radically change his decision - when there is a threat to the life of the child and mother.
Causes and symptoms
Until now, doctors can not say for sure what can affect the development of the two-horned uterus. There are suggestions that when laying the female genital organs of the fetus, the maternal organism does not receive enough nutrients.
The reasons may be:
- medication. In the 70s of the last century, doctors often prescribed to women, including pregnant women, the medication of the tetracycline group. According to scientists, this could cause abnormal development of the genital organs of the fetus. But this is only one of the assumptions, there is no exact evidence yet,
- drinking alcohol, smoking during pregnancy,
- the presence of infection in the body, as well as influenza, toxoplasmosis and rubella.
Two-horned uterus, as we found out, can not manifest itself in any way. If there is no cause for concern, then a woman will find out about this only on ultrasound. Most often, on the first examination, when the pregnancy has already begun.
It happens and vice versa, when the uterus of an irregular shape “declares” itself much earlier - as soon as the first menses begin. Two-horned uterus often causes painful and heavy periods, cycle disorders, the appearance of amenorrhea, as well as miscarriages and infertility.
If anomalies in the development of the uterus prevent a woman from conceiving a child, then this problem can be solved promptly. Positive feedback from women with two-horned uterus, who have gone through a laparoscopy procedure, testifies to the earliest possible occurrence of pregnancy, proceeding without complications.
If the pregnancy has already come, then you should not panic in advance, perhaps in your case everything will be fine. It is only important to undergo an examination and be observed throughout a pregnancy with a specialist. The doctor will recommend you how to behave in order to maintain a pregnancy and have a baby. Even if the labor begins before the appointed time, there are chances for a happy outcome.
Pregnancy and two-horned uterus
When the uterine form of the uterus is extremely rare, anomalies of fetal development occur, but the course of pregnancy can differ dramatically and depend on the degree of bifurcation of this organ.
As many gynecologists say, the two-horned uterus and pregnancy may be incompatible. This manifests itself in different ways: first, the abnormal shape of the uterus can cause the full development of the fetus, plus, as soon as the fetus begins to grow, the organ can no longer stretch. As a result, early termination of pregnancy is possible. To this did not happen, you need to plan conception in advance. Modern gynecology allows you to solve the problem of the two-horned uterus by surgery: the septum is removed, as a result, the integrity of the organ is restored.
What complications may arise during pregnancy in a woman with a double-horned uterus? Such questions are often asked by women at the gynecologist, but not always get clear answers. We will understand this issue in more detail.
- abortion on different terms. This may be a miscarriage at an early term or premature birth. The risk of miscarriage of the fetus increases many times, since the uterus of irregular shape (extended) does not allow the fetal egg to attach properly. The thickness of the endometrium (inner uterine layer) in the two-horned uterus is always thinner, which can also affect the attachment of the embryo. And yet, which is very important - such a uterus stretches worse, and this already leads to the risk of developing premature birth,
- if the embryo is attached too low, then the risk of developing placenta prevailing is high,
- full or partial leakage of amniotic fluid,
- the fetus is misplaced, since the two-horned uterus is always smaller than the usual one. As a result, the child is limited in his ability to change position, he cannot move actively and because of this he chooses a position that is convenient for himself. As a result, most often in women with the two-horned uterus, the fetus takes a transverse, pelvic or oblique presentation,
- placental nutrition, that is - the normal circulation of the fetus is impaired,
- cervical insufficiency - this means that the cervix opens early and is unable to hold the fetus. This is also the reason for the termination of pregnancy at different periods,
- when the embryo is attached in the rudimentary horn (poorly developed part of the uterus). Such a pregnancy is equivalent to ectopic, which means that an urgent interruption is required,
- premature detachment of the placenta caused by insufficient blood circulation.
Discharge during pregnancy with the two-horned uterus can disturb a woman for 9 months. In the 1 and 2 trimester may appear bloody bright red or brown. As soon as a woman suspects that something is wrong, an urgent need to see a doctor. In such cases, hospitalization and complete rest is recommended. A common cause of bleeding during pregnancy is the attachment of the ovum to the bottom of the uterus or the side wall. 3 weeks after implantation (if the embryo is attached very low), then the placenta will close the internal uterine pharynx, and as a result, the woman may experience pain in the lower abdomen and bleeding. This may indicate an abortion.
At 6-8 weeks of pregnancy, bleeding was observed in 35% of pregnant women with a diagnosis of “Two-horned uterus”, and in 45% of future moms a partial placenta previa was noted.
When bleeding occurs in late pregnancy, in the 3rd trimester, after about 30 weeks, this means that the placenta at the place of presentation is unable to stretch along with the increasing uterus and it gradually exfoliates. This is very dangerous, since childbirth can start early.
Pregnancy in the right horn of the two-horned uterus
It does not matter in which horn the fetal egg is attached, the main thing is that this area is well supplied with food, it has enough vessels and capillaries. Gynecologists say that the more the body is underdeveloped (that is, the branches are located far from each other), the more problems can be during pregnancy.
If the fertilized egg is fixed in the left or right horn, then the load on the ligaments of the reproductive organ greatly increases.
If the pregnancy began to develop in that part of the uterus where the nutrition for the embryo is insufficient, then as a result the pregnancy is terminated spontaneously.
And if twins?
Multiple pregnancy in a woman with a two-horned uterus is no exception. Moreover, multiple or identical multiple pregnancy develops much more often than in healthy women. But the organ itself does not affect the nature of fertilization of the egg. In gynecological practice, there have been cases when a woman with a two-horned uterus has a partition located closer to the cervical canal or pharynx and forms 2 separate cavities (1 case per 1,000,000).
Gynecologists regard any case of multiple pregnancy in a woman with a two-horned uterus as a high degree of risk, since abortion can occur at any time. In 90% of cases after the 30th week of pregnancy, childbirth occurs. Not an exception and rupture of the uterus, which is very dangerous for the health of women and future babies.
If you have a two-horned uterus and a multiple pregnancy, it must be borne in mind that the load on the body will be increased. Therefore, as soon as you learn about your pregnancy (even if it is the second pregnancy with a two-horned uterus), you must immediately become registered. Then you will have a better chance of a happy outcome.
If you have a two-horned uterus, but you cannot conceive or bear a child, then you need to think about a conservative treatment method. You may need surgery to restore the integrity of the uterus. Only a qualified specialist will be able to carry out competent treatment tactics (open surgery, hiteroscopy). During the operation, the partition is cut, and the uterus is “formed” into the whole cavity. As a result of such intervention in 63 cases out of 100, the reproductive function of a woman is fully restored.
Causes of development
Uterine malformation arises along with its formation during embryonic development at 10-14 weeks of gestation. Two-horned uterus is formed due to the confluence of the parameson-phrenal ducts, which form 2 sheath and vaginal cavities. Initially, they are separated by a median septum. In the process of further development, the partition disappears and the cavities merge into one. If the merging process does not take place to the end, then a two-horned uterus is formed, which has several types of morphogenesis.
This picture shows the uterus of a healthy woman and a woman with a congenital defect.
In their physiological features, the beginnings of the female genital organs are closely related to the nucleation of the kidneys and other organs of the urogenital system. Therefore, when making such a diagnosis, for example, doubling a kidney, it is necessary to undergo an examination by a gynecologist and do an ultrasound examination of the uterus to exclude or confirm duplicity, since the development anomaly of the two systems listed above often develop together.
The reason for the development of the two-horned uterus is the general state of health of the woman during pregnancy. Failure in her body, which will lead to the development of pathologies in the fetus, may result from a violation of the gas exchange process or poor nutrition.
Such diseases of the mother are considered very dangerous for prenatal development:
- Viral infections,
- Bacterial infections,
- Endocrine disorders
- Poisoning chemicals
- Radiation exposure.
It is worth noting that the two-horned uterus is considered a hereditary disease and can be formed if there is a genetic predisposition.
Varieties of two-horned uterus
Depending on the degree of cleavage, several types of uterine uterus are distinguished:
- Incomplete form bicrice. Characterized by the fact that the uterus is split only in the upper third of its body. The opening between her horns is small,
- Full form. The uterus is completely divided into 2 horns, which depart from each other at a certain angle,
- Saddle shape. With this pathology, a depression is formed in the upper part of the uterus, which is similar in shape to the saddle. According to statistics, today the saddle form of the uterus is more common than other pathologies of the female genital organs.
Symptoms of the disease
Abnormalities of the structure of the uterus are usually detected only after a woman undergoes an additional course of examination due to difficulties in conceiving a child or in the presence of other diseases of the urogenital tract that require diagnosis on an ultrasound machine.
Symptoms of the two-horned uterus may manifest as:
- Violations of the menstruation cycle. Monthly can significantly exceed the usual rate of bleeding. Their duration is more than a week, and they are very painful,
- Abortion. This inability of the female body to bear the child is due to the fact that, due to pathology, the uterus cannot allow the placenta to fully form, which plays a very important role for the baby’s life,
- Infertility. Such a symptom is very rarely an indication that a woman has such a pathology as the two-horned uterus. Usually, pregnancy does not occur due to other malformations that may also be present in a woman.
Even with a complete doubling (that is, 2 full-fledged uterus) a woman can become pregnant, and it is possible that the pregnancy will be multiple and occur in both horns at the same time, although this rarely happens.
If one of the horns of the uterus is underdeveloped, then it can cause severe and pulling pain in the lower abdomen during menstruation. Кроме того, недоразвитость часто характеризуется тем, что усложняется процесс мочеиспускания (болезненное и частое) и появляются гнойные выделения из влагалища (если рог контактирует с полостью матки и в него попадает инфекция).
It is impossible to diagnose a two-horned uterus during a routine examination in the gynecologist's chair. A doctor can only detect the presence of an abnormality in the structure of the uterus by palpation. For a more accurate diagnosis, prescribe one or a set of such studies:
- Ultrasound diagnosis (ultrasound). This method is carried out using the study of the abdominal front wall and a special transvaginal ultrasound probe, which is inserted into the vagina. This method can accurately determine the cause of the pathology,
- Hysteroscopy and hysterosalpingography. Examination of the uterus with an x-ray of the uterus, in which a special contrast agent is injected. Allows you to clearly set the type of doubling,
- Laparoscopy. A small surgical incision is made on the anterior abdominal wall through which the camera is inserted. Thanks to the image that is transmitted to the monitor in real time, you can see not only the uterus, but also nearby organs,
- Magnetic resonance imaging (MRI). One of the most expensive, but effective ways to diagnose. In addition, the patient does not experience any discomfort during the procedure.
Treatment is not always prescribed for the bicornate uterus. It is necessary only in such cases:
- Problems with conceiving and carrying a child,
- With underdevelopment of the horn of the uterus, which leads to the accumulation of menstrual bleeding in the horn, severe pain and the occurrence of inflammatory processes as a result of infection.
If the two-horned uterus does not manifest itself and does not have a negative impact on the state of health of the woman, then treatment is inappropriate.
If the pathology of the uterus does not allow to lead a full-fledged lifestyle, conceive and carry out the child, a surgical operation is performed. During the operation to correct the shape of the uterus, the doctor makes an incision where her “horns” are located, and then form a single cavity by stitching the “horn”.
You can learn more about this disease and its treatment by viewing this video:
To avoid adhesions, the patient is placed in an intrauterine device and is prescribed a course of hormonal therapy. If the operation and the postoperative period have passed without complications, then after about 8-9 months, pregnancy can be planned.
Doctors-gynecologists recommend planning a pregnancy regardless of whether there are any natural abnormalities in the structure of the female genital organs or not.
What it is
Dvorogost uterus - a defect of fetal development. The reason is the incomplete fusion of Mullerian channels, which leads to the division of the cavity into two niches. Rarely diagnosed - no more than 0.5% of patients. In most cases, double-facedness is accompanied by the presence of a single neck and vaginal tube. Less common is doubling of the cervical canal and incomplete vaginal septum.
What is dangerous two-horned uterus for a woman
Dvorogost is not included in the group of diseases that adversely affect the quality of life. Pathology does not affect the viability of the fetus and the further development of the infant.
Important! Weakly expressed anomaly does not make itself felt. The patient is unaware of the existing deviation, especially if the reproductive function is not impaired.
The risk of deviation is as follows:
- Filling (partial or complete) entry into a separate uterine cavity.
- Hematometer May occur as a result of violations of the outflow of menstrual blood due to the physiologically incorrect position of the horn. Infection of the content causes the formation of pyometra (suppuration with the subsequent development of peritonitis and septic infection of the blood).
- Bleeding They provoke anemia.
Dvorogost uterus - not a sentence. With its sufficient capacity, childbearing passes without problems. With a marked bifurcation, the likelihood of spontaneous abortion or preterm delivery increases. With such a pathology, the future mom should be observed by a specialist throughout pregnancy.