What Is an Arcuate Uterus?
An arcuate uterus is a type of uterine irregularity in which the top of the uterus is indented. It is a birth defect that develops when the baby is in the mother’s womb. A normal uterus looks like an upside-down pear. The arcuate uterus looks very similar to a normal uterus, but it has a slight bent or dip at the top of the uterus. This condition typically does not affect pregnancy and does not cause any severe health complications.
How Common Is the Arcuate Uterus?
An arcuate uterus is rare in occurrence. It is usually classified as a variation of the normal uterus instead of an irregularity. In most cases, an arcuate uterus does not cause symptoms and is not connected with any pregnancy complications or health outcomes.
What Is the Cause of the Arcuate Uterus?
An arcuate uterus is a congenital anomaly of the Mullerian duct. Typically, the Mullerian ducts fuse to form a uterus and two fallopian tubes. But when these ducts fail to fuse together, it can result in uterine abnormality. There is a dent at the top of the uterus in an arcuate uterus where the Mullerian ducts did not fuse.
What Are the Symptoms of the Arcuate Uterus?
In many cases, there are no symptoms caused due to the arcuate uterus, so there are no reproductive issues resulting in normal pregnancy. But in some cases, this condition has been associated with a higher risk of premature birth, miscarriage, and malpresentation. Some studies have shown that miscarriages due to the arcuate uterus are more common during the second trimester.
Can Women With Uterus Abnormalities Eventually Become Pregnant?
Mullerian anomalies that affect fertility can be corrected, thus enhancing a healthy and successful pregnancy. Women with a birth defect of reproductive organs and who have not been able to become pregnant within six months should consult a gynecology specialist skilled in reproductive surgery. Most surgery can repair the defect, eliminate discomfort during menstruation or sexual intercourse, and improve fertility and pregnancy outcomes.
Does the Arcuate Uterus Cause Any Pregnancy Complications?
An arcuate uterus is the most common form of abnormality. However, there is evidence that an arcuate uterus will not affect the chances of getting pregnant and will not increase the chance of having a miscarriage when the embryos are transferred following an IVF (in vitro fertilization) cycle. But in some cases, the arcuate uterus too can be a cause of abortions. Most pregnancies go beyond 36 weeks in arcuate pregnancy if it is not linked with cervical incompetence. After a miscarriage, plan for the subsequent pregnancy for at least six months, and the medical experts recommend taking folic acid for three months around the planned pregnancy, once all the tests have turned normal. At around the third month of pregnancy, get repeated ultrasound scans to check there is no early dilatation of the cervix (mouth of the uterus). If there is dilation, stitches can be done during the fourth month of pregnancy. Due to the arcuate uterus, there may be chances of an abnormal position of a baby, such as a transverse position in the later stage of pregnancy, or an oblique position, which does not cause big complications. If such changes in position occur, a cesarean delivery will be recommended. If the position is normal without any complications, like the head positioned downwards, then normal delivery is recommended. That can be suggested only in the 37 to 38 weeks of pregnancy.
How Is the Arcuate Uterus Diagnosed?
A doctor will first do a physical examination and then take a history of the symptoms. There are different types of diagnostic tests to identify the abnormality in the shape of the uterus, which helps to provide the best course of action and treatment. Sometimes there will be a need to conduct more than one of the following tests, which include the following:
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Sonohysterogram (SIS) - In this test, a catheter is placed in the uterus to fill and enlarge the uterine cavity with saline. Then a transvaginal ultrasound is performed while the catheter is inside to visualize the uterus, cervix, and ovaries.
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Magnetic Resonance Imaging (MRI) - A MRI test provides a good image of the uterus and associated structures. It is a very accurate test to diagnose most uterine abnormality issues.
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Laparoscopy or Hysteroscopy - In this test, a thin tube with a camera is inserted inside the woman’s abdomen through a very small incision or through the vagina and cervix to view the uterus. The images will be visible on a computer screen. If any surgical correction needs to be done, then it can be done at the same time with specialized surgical instruments inserted through the tube.
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Hysterosalpingogram (HSG) - During this test, a contrast dye is passed into the cervix and uterus. Then X-rays of the uterus and the fallopian tubes are taken. With the help of the dye, better images of these organs can be viewed.
If any abnormalities in the tests are detected, the doctor will suggest the appropriate treatment plan.
What Is the Treatment for the Arcuate Uterus?
Surgery is the only treatment to correct the abnormalities in the shape of the uterus, such as the arcuate uterus. But many women with such abnormalities do not require the issue to be corrected with surgery. Normally, surgical correction is recommended if the woman has compromised fertility or had recurrent miscarriages due to uterine abnormality. Surgery may also be recommended if the patient experiences uncomfortable pain regularly. When surgeries are done, the doctors will most often perform minimally invasive surgery with hysteroscopy or laparoscopy.
What Are the Risks Associated With an Arcuate Uterus?
Women with an arcuate uterus will have a higher risk for endometriosis. Usually, women with uterine anomalies have a higher chance of endometriosis. However, the strong correlation between an arcuate uterus and endometriosis is not clear.
Conclusion -
The arcuate uterus is a rare congenital anomaly of the uterus. It occurs when the Mullerian ducts fail to fuse. Most women do not experience any symptoms due to this uterine abnormality. But some women have symptoms like miscarriage and premature delivery. However, the defects can be corrected surgically for a positive outcome.
