Arcuate uterus

An arcuate uterus is a mildly variant shape of the uterus. It is technically one of the Müllerian duct anomalies, but is often classified as a normal variant. It is the uterine anomaly that is least commonly associated with reproductive failure. Arcuate uterus can be characterised with ultrasound or MRI.

An arcuate uterus is characterised by a mild indentation of the endometrium at the uterine fundus. It occurs due to a failure of complete resorption of the uterovaginal septum, and is the most common Mullerian duct anomaly, affecting 3.9% of the general population 7.

General features include:

Fluoroscopy

On hysterosalpingograms there is opacification of the endometrial cavity demonstrates a single uterine canal with a broad saddle-shaped indentation of the uterine fundus.

Pelvic ultrasound

A normal external uterine contour is noted, with a broad smooth indentation on the fundal segment of the endometrium. There should not be division of the uterine horns.

MRI

A normal external uterine contour is maintained. The myometrial fundal indentation is smooth and broad, and the signal intensity of this region is isointense to normal myometrium.

  • septate uterus
    • arcuate uterus and septate uterus exist on a spectrum from least to most resorption of the uterovaginal septum, respectively
  • bicornuate uterus
    • arcuate uterus can be distinguished from a bicornuate uterus on the basis of its complete fundal unification (i.e. an arcuate uterus has a normal or slightly indented external fundal contour, whereas a bicornuate uterus has a more marked fundal indentation, ≤5 mm above the level of the uterine horns)
Abdominal and pelvic anatomy
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Article information

rID: 6974
System: Gynaecology
Synonyms or Alternate Spellings:

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Cases and figures

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    Figure 1: arcuate uterus
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    Cor T2 00
    Case 1
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    Case 2: arcuate uterus with intrauterine adhesions
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    Case 2
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    Case 4: with concurrent adenomyosis
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