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Bicornuate uterus

Case contributed by Dr Prasanta Kumar Nayak

Presentation

6 week history of amenorrhea presented with bleeding PV. She had one living child and a history of recurrent 1st trimester spontaneous abortion.

Patient Data

Age: 30 years
Gender: Female
Ultrasound

USG pelvis revealed endometrium in the region of body of uterus bifurcating cranially into two horns with intervening tissue consistent with normal myometrium. Single gestational sac with a fetal pole of 6 weeks 6 days gestational age was present. No fetal cardiac activity was seen. She subsequently had a spontaneous complete abortion. HSG done in subsequent month confirmed the finding of a bicornuate uterus (not shown here).

Case Discussion

Bicornuate uterus accounts for approximately 10% of all congenital uterine anomalies.

The importance of identifying and distinguishing from a septate uterus is important as far as management modality and prognosis is concerned.

Criteria for bicornuate uterus include

  • intercornual angle >75-105 degrees
  • intercornual distance >4 cm
  • fundal depression depth >1 cm

MR is nearly 100% accurate.

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