Bicornuate uterus and miscarriage risk

In a bicornuate uterus, the upper part of the womb is divided into two spaces. Pregnancy outcomes can differ according to the depth of that division, where implantation occurs, the condition of the cervix, other health factors, and previous pregnancy history. This uterine shape is associated with a greater possibility of pregnancy loss than a typically shaped uterus, yet many people with it carry a pregnancy forward. A population estimate therefore cannot say what will happen to one person.

Arrange an obstetric review if you are pregnant, planning pregnancy, or have experienced a loss. Bring any ultrasound reports and a clear history of earlier pregnancies, including when each loss or birth occurred. The clinician can confirm whether the uterus is bicornuate rather than another uterine shape and decide which imaging is suitable. Ultrasound is commonly used in pregnancy; pelvic MRI can provide more detail about anatomy in selected situations. Follow-up should be tailored to the confirmed shape and your own history rather than to a general rate.

Contact your maternity or early-pregnancy service for any vaginal bleeding, a new gush of fluid, or cramping that persists. Get urgent medical help for heavy bleeding, severe abdominal pain, pain focused on one side, shoulder pain, faintness, collapse, fever, or feeling acutely unwell. Bleeding in pregnancy has several possible causes and does not by itself confirm miscarriage, so assessment may include examination, ultrasound, and blood tests.

Ask what imaging confirmed the diagnosis and whether a septate uterus or another variation has been excluded, because management may differ. You can also ask whether your pregnancy history changes the monitoring plan, what symptoms should trigger a same-day call, and whether review before another pregnancy would be useful.