Abnormalities of the uterus


What is a uterus?

The uterus or the womb is a pear-shaped organ in the female pelvis. It is 7.5cm long, 5 cm wide and 2.5cm thick. Approximately less than 5 percent of women were born with abnormalities of the uterus and some of them are not even aware that they have it.
What are the main uterine abnormalities?
a) Bicornuate uterus (2 horns)
The uterus is heart-shaped with a deep indentation at the top of the uterus (fundus).
b) Unicornuate uterus (single horn)
This is a rather uncommon condition where there is     only a single horn on the uterus. In addition, it is smaller in size in comparison to the normal uterus. There usually is also a single tube but two ovaries.
c) Septate uterus
This is where the uterus is divided by a septum which could extend till half of the uterus or all the way down to the cervix (neck of the womb)
d) Double uterus (Didelphys uterus)
This is also a rare condition where the woman has 2 uterine cavities (2 uterus). In addition, she may also
have two cervix and vaginas.
d) Arcuate uterus
In this condition, the top of the uterus is flat or convex in shaped. This is considered as a normal variant and not associated with increased risk of complications during pregnancy.
e) DES uterus
This uterine abnormality is associated with those women who was exposed to DES (diethylstilbestrol) while in the womb. DES is a treatment given in the 1960s and 70s to treatmiscarriages. The uterus is often small in size,T-shaped and there are associated with abnormalities on the cervix and in the vagina.
f) Mayer-Rokitansky-Kuster-Hauser syndrome
This is a severe congenital syndrome where the woman often has no uterus and a blind ended vagina with renal abnormalities. She will be unable to get pregnant.
How are this uterine abnormality detected?
Usually the uterine abnormality could be seen during a pelvic ultrasound. A 3D   ultrasound enhances the image of the pelvic structures. In addition, an x-ray of the uterine cavity and tubes (hysterosalpingogram)and MRI (magnetic resonance image) could also show the uterine abnormalities.
What complications could arise if I have a uterine abnormality?
It is difficult to totally predict the outcome of uterine abnormality on those women who has it. It depends on the type of uterine abnormality. In those with unicornuate uterus and DES uterus abnormalities, it may be difficult to conceive. Whereas others, no effect on fertility has been documented. Those with septate uterus may have an increase risk of miscarriage. In addition, women with uterine abnormalities may have difficulty in carrying the pregnancy till term as they often have premature labour and there is an increase in caesarean section rate as the babies maybe in an abnormal lie instead of the normal head down position. Your doctors may also ask you to scan your kidney as uterine abnormalities are often associated with kidney abnormalities. You will need to speak to your doctor regarding all the above issue depending on your specific uterine abnormality.
What treatment could be done for the uterine abnormality?
Only some of the uterine abnormalities could be treated. For example, those women   with a septated uterus could undergo an operation to remove the septum. However, the procedure itself does carry risks.

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