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What is a unicornuate uterus?

To understand unicornuate uterus, a congenital abnormality of the uterus, it's helpful to understand how the uterus is formed. During typical fetal development, two tubelike structures, called the Mullerian ducts, fuse together to create the uterus. The upper portions form the fallopian tubes. If one of the ducts fails to develop, it may result in a single-horned uterus, called a unicornuate uterus. Usually this disorder isn't detected until later in life.

It's estimated that about one in 4,020 women in the general population have unicornuate uterus. Women with a unicornuate uterus sometimes also have a second smaller remnant of a uterus, called a hemi-uterus. This hemi-uterus may or may not be connected to the rest of the uterus. If it's unattached, menstrual blood won't be able to flow out, causing pain. If a hemi-uterus is present, it needs to be removed.

A unicornuate uterus may be able to support a pregnancy, but a cesarean section may be required. There is also an increased risk of preterm labor and miscarriage because of the small size of the uterus.

Symptoms & Causes

What are the symptoms of unicornuate uterus?

Common symptoms include:

  • reproductive difficulties
  • abdominal pain in the case of a hemi-uterus

How will unicornuate uterus affect my daughter's sex life and fertility?

A unicornuate uterus doesn't necessarily prevent a woman from giving birth. However, she may need a caesarean section. Women with a unicornuate uterus are at an increased risk for preterm labor and miscarriage. If a hemi-uterus is present, it needs to be removed. A pregnancy could possibly begin in the uterine remnant. This must be treated as an emergency because the area is too small to support a growing fetus, and the hemi-uterus could rupture. This is similar to an ectopic pregnancy, in which the fertilized egg becomes implanted in a fallopian tube.

What causes unicornuate uterus?

A unicornuate uterus forms during embryological development when the uterus doesn't form normally. The cause of this genetic abnormality is unknown.

Diagnosis & Treatments

What is the treatment for uunicornuate uterus?

During your visit, doctors will decide if it's possible to perform a laparoscopic removal of the hemi-uterus, as the hemi-uterus poses health risks in the case of a pregnancy. The hemi-uterus can only be removed if there is a normal unicornuate uterus on the other side.

How we care for unicornuate uterus

At the Boston Children's Hospital Division of Gynecology and the Center for Congenital Anomalies of the Reproductive Tract, an interdisciplinary team of pediatricians, gynecologists, urogynecologists, and colorectal surgeons will work to find the best treatment for your daughter's unicornuate uterus.

Programs & Services

Programs

Center for Congenital Anomalies of the Reproductive Tract

Program

The Center for Congenital Anomalies of the Reproductive Tract works with females up to age 22 who are born with abnormalities of the reproductive organs.

Departments

Gynecology

Department

The Division of Gynecology offers pediatric and adolescent gynecology services, ranging from routine exams to complex surgery.
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