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Congenital uterine anomalies are malformations of the uterus that develop during embryonic
life. Congenital uterine anomalies occur in less than 5% of all women, but have been noted in
up to 25% of women who have had miscarriages and/or deliveries of premature babies. When
a woman is in her mothers womb, her uterus develops as two separate halves that fuse
together before the woman is born. The images below illustrate a normal and abnormal uterus
visualized by hysterosalpingogram.
The types of congenital uterine malformations include:

Septate: a normal external uterine surface but two endometrial cavities

Bicornuate: an abnormal, indented external uterine surface and two

endometrial cavities

Arcuate: a normal external uterine surface with a 1 cm or less indentation into

the endometrial cavity

Unicornuate: only one half of the uterus has developed

Didelphys: the two halves of the uterus remain separate

The septate uterus and bicornuate uterus are the most common congenital uterine anomalies.
The arcuate uterus is considered a variation of normal uterine development by most
obstetricians and gynecologists.

In the majority of cases, the cause of a congenital uterine anomaly is unknown. Most
women with these malformations (more than 90%) have a normal number of chromosomes,
46 XX. Between 1938 and 1971, some pregnant women were treated with diethylstilbestrol
(DES) to help prevent miscarriages and premature deliveries. Women who were exposed to
DES while in their mothers womb are at increased risk for having a congenital uterine
anomaly. At this time, there are no well-established risk factors for the development of a
congenital uterine anomaly, and there is no way to prevent development of a congenital
uterine anomaly.

Although congenital uterine anomalies are present at birth, these malformations are
usually without symptoms. Some women may have pain with their menstrual periods.
Congenital uterine anomalies typically do not cause a woman to have difficulty getting
pregnant. However, these malformations are often discovered during evaluations for
infertility or pregnancy loss.

A complete medical history and physical examination may cause an obstetrician or
gynecologists to suspect that a congenital uterine anomaly is present. However, imaging
studies, such as a hysterosalpingogram and ultrasound, or an MRI are required to visualize
the uterus and confirm that a congenital uterine anomaly is present.

There are no non-surgical treatments for congenital uterine anomalies.
Recommendations for surgical treatment of congenital uterine anomalies depend on the
particular anomaly and the womans reproductive history. If a septate uterus is diagnosed
during an evaluation for infertility and/or pregnancy loss, surgical treatment is usually
advised. Bicornuate, unicornuate and didelphic uteri rarely require surgical treatment.

Many women with a congenital uterine anomaly have no medical or reproductive
problems. Congenital uterine anomalies may increase the likelihood that a woman will have a
miscarriage or a premature delivery. If a woman has a septate uterus and has had
miscarriages, surgical treatment will improve her chances for a successful pregnancy.