Uterine anomalies occur in 0.1 to 0.5% of women, depending on the population. Uterine anomalies that are large enough to decrease the size of the uterine cavity (womb) are a major cause of recurring abortions, premature labor and/or abnormal presentation of the fetus during labor. Uterine anomalies are detected in 15% to 25% of women with recurrent pregnancy loss. Unfortunately, uterine anomalies are usually not diagnosed until a woman becomes pregnant.
The cause of most congenital uterine anomalies is unknown.
In the past, pregnant women were sometimes given diethylstilbestrol (DES) to prevent miscarriage. Female offspring of these women had a higher frequency than usual of uterine anomalies, as well as an increase in cancers of the female reproductive tract.
A genetic cause has not been found.
Environmental factors, as yet undetermined, may affect uterine development.
Recurrent miscarriages (spontaneous abortions)
Intrauterine fetal growth retardation
Abnormal fetal presentation (defined as any part of the fetus that presents other than the top (vertex) of the fetal head facing the cervix towards the floor)
Pelvic examination reveals two vaginas and/or two cervix (associated with uterine anomalies) or sometimes two horns are felt on the uterus.
Usually there is no sign of a uterine anomaly on a routine pelvic examination.
History of pregnancy losses or prenatal exposure to DES
Magnetic resonance imaging (MRI)
Aggressive obstetrical, nonsurgical management of patients with prior reproductive failure.
Surgery to redesign the uterus is a highly successful procedure. Postoperative success rates (i.e., term pregnancy) generally range from 70% to 80%, with premature delivery rates less than 10%.