Pregnancy in bicornuate uterus: A case report and literature review

Abstract

Introduction: The bicornuate uterus is a rare congenital anomaly associated with an increased risk of obstetric complications such as recurrent miscarriage, preterm labor, and malpresentation; however, a successful pregnancy is attainable, but it needs close prenatal monitoring; in some cases, surgical intervention is required. Case Presentation: 44-year-old female, G10P5A4, seven weeks gestation, presented for prenatal care. She is a known case of the bicornuate uterus; she had a history of left tubal ligation, three dilatation and curettage, in addition to three C-Section. Her most recent ultrasound showed a bicornuate uterus with an intrauterine sac at the right horn and left adnexal mass. Discussion: Most cases of the bicornuate uterus are asymptomatic, diagnosed during routine evaluation; however, some cases presented with dysmenorrhea and menorrhagia. A bicornuate uterus can be isolated or associated with other anomalies such as renal agenesis and vaginal septum. Conclusion: Ultrasound is the initial diagnostic test to detect bicornuate uterus, and magnetic resonance imaging represents the gold standard diagnostic imaging study. The detection of an asymptomatic bicornuate uterus requires rigorous prenatal monitoring; however, cases of bicornuate uterus with a history of obstetric complications necessitate surgical intervention with metroplasty or laparoscopy.