According to Dr. Shilva, “Bicornuate uterus is the most common congenital anomaly of the uterus with an estimated incidence of around 1-5 per 1000 women. It is also associated with an increased risk of spontaneous abortion, cervical incompetence, preterm labor, breech presentation and retained placenta. Women with a bicornuate uterus are born with it, but they might not know they have it unless they undergo an ultrasound or another imaging test. The patient, 25 yr old, Maha Devi was experiencing infertility for the last 7 years. Her condition was diagnosed through a hysterosalpingography – a real-time form of x-ray called fluoroscopy to examine the uterus and fallopian tubes of a woman who is having difficulty becoming pregnant. This test highlighted the shape of the uterine cavity and the fallopian tubes. It showed no issues in infertility and showcased a heart shaped uterus.”
Dr. Shilva adds, “A bicornuate uterus may cause infertility and may also increase the raises your risk of having a miscarriage later in your pregnancy and delivering your baby early. Some researchers suggest that these problems happen because of irregular uterine contractions or reduced uterine capacity. Additionally, babies born to mothers with a bicornuate uterus have a greater chance of developing birth defects compared to those born to women without the condition. In fact, this risk was four times higher in one study. Hence women expecting with a bicornuate uterus are classified under High-Risk Pregnancy cases.”
Dr. Shilva recommended intrauterine insemination (IUI) procedure to Maha Devi. She was able to conceive in the first cycle. Her medical condition was closely monitored through regular scans. Maha was also provided prophylactic cervical cerclage – also known as a cervical stitch, a treatment for cervical incompetence or insufficiency when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. This complication was due to the bicornuate uterus condition.
Dr. Shilva shares, “Serial monitoring of the cervical length started at 12 weeks which showed gradual shortening of cervical length – 2.2 cm at 14 weeks. The prophylactic cervical cerclage helped ensure that no preterm delivery was induced.”
At 37 weeks, Maha Devi experienced labour pain and was taken in for a cesarean delivery. A healthy baby girl weighing 3 kg was born.
Maha Devi shares, “Dr. Shilva was there to guide me when I felt alone and dejected. I would like to thank her for her patience, compassionate care, and guidance. Without her able assistance, I would never have been able to complete my family.”