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Uterine anomalies Latin anatomy

reigns
KARL OLAH, WARWICK HOSPITAL, WARWICK, UK
.......................................................................................................................................................................

U terine anomalies are present in up to

5% of the general population, and in
up to 15% of women with recurrent mis-
carriage. They are associated with adverse
pregnancy outcome, dysfunctional labour,
malpresentation and unstable fetal lie
(Hiersch et al. J Matern-Fet Neonat Med
2016;29:2573 8).
The term ‘bicornuate uterus’ is used to
describe all degrees of uterine anomaly
from a slight actuate uterus to a full dupli-
cation of the m€ullerian tract. In reality, a
term like this must convey the degree of
abnormality to allow the degree of risk
associated with the anomaly to be prop-
erly assessed. ‘Bicornuate uterus’ is mean-
ingless in this context, mainly because the
term is used so liberally. Therefore it is
vital that terms be used to give all the
information required.
Various suggestions have been made
over the years for a system of classifying
uterine anomaly (Oppelt et al. Fertil Steril
2005;84:1493 7; Buttram & Gibbons Fer-
til Steril 1979;32:40 6). These suggestions
add confusion to what is already a very
simple classification system based on the
Latin terms that we all use in everyday
gynaecology. I have never studied Latin.
However, only minimal understanding is
required to use the proper classification
of uterine anomaly. If the upper part of
the uterus is designated the ‘cornual’ area
(the upper uterus rather than the true
cornua) the mid-section is the ‘corpus’
and the cervix is the ‘collis’. Then, when
we apply ‘bi’ meaning two and ‘uni’
meaning one, we can use the terms to
describe all degrees of uterine anomaly.
For example a complete duplication
would be bicornus bicorpus bicollis.
A double uterus with a single cervix:
bicornis bicorpus unicollis. In one single
sentence the degree of anomaly is com-
municated with ease. Other terms such
as ‘arcuate’ and ‘septate’ are essentially
descriptions of the minor degrees of
duplication under the umbrella of bicornis
unicorpus unicollis.
This system of classification has
stood the test of time and should be
more widely used. The adage ‘if it isn’t
broken, then it doesn’t need fixing’
applies.
Disclosure of interests
None declared. Completed disclosure of
interests form available to view online as
supporting information. &

1064 ª 2018 Royal College of Obstetricians and Gynaecologists