The most impoant indication for surgical repair of a Bicornuate Uterus is :
Habitual aboion Bicornuate uterus is caused by incomplete lateral fusion of the mullerian ducts is (only the lower pas of the duct fuse, leaving the cornua separate). it is characterized by 2 separate but communicating endometrial cavities and a single uterine cervix. Failure of fusion may extend to the cervix resulting in a complete bicornuate uterus or may be paial causing a milder form. Bicornuate uterus causes : Menorrhagiadeg (because of larger bleeding surface) Spasmodic dysmenorrhea.deg But most of the cases are first recognized during pregnancy as a result of pregnancy mishap like : Aboions and premature labour.deg Malpresentations - Transverse lie is oured.deg Insufficient uterine action leading to retained placenta and PPH.deg Diagnosis -- On bimanual examination it may be possible to feel the two separate uterine horns or uterus may appear unusually wide.deg HSG is the initial diagnostic step in evaluating a possible bicornuate uterus but HSG does not differentiate between a bicornuate and septate uterus. To distinguish a septate uterus from bicornuate uterus -- USG should be done. Management : Bicornuate uterus re*uires sur al treatment onl h- it causes habitual aboions.deg "When a bicornuate or se tate uterus has caused not less than three Miscarriages and no pregnancy has resulted in a ble child, surgery may be indicated." "Surgical reconstruction of the bicornuate uterus has been advocated in women with multiple spontaneous aboions and in whom no other causative factors are identified." Surgery done is : Stressmann Metroplastydeg where an incision is made over the uterus and the two horns are sutured together to form a single cavity. After such a surgery : if woman conceives she should be taken up forEleativelaCaat 38 weeks of Gestation.deg
Infeility
Dysmenorrhoea
Menorrhagia
Habitual aboion