Bleeding in pregnancy with a bicornuate uterus

A bicornuate uterus is divided into two upper cavities. Bleeding can occur for reasons that also affect pregnancies without this uterine shape, including changes around the cervix, a collection of blood near the pregnancy, infection, pregnancy loss or a placental problem. The colour of blood alone cannot identify the cause.

Assessment may include questions about pain and flow, examination, ultrasound, fetal heartbeat monitoring when appropriate, and blood or urine tests. The clinician will consider where the pregnancy and placenta are located. Pelvic MRI is not usually the first investigation for acute bleeding, but it may help define uterine anatomy in selected non-emergency situations.

Contact your maternity unit or clinician promptly, even if spotting has stopped. Note when it began, whether it is increasing, whether there are clots or fluid, and whether you have cramps, one-sided pain, dizziness or fever. Use a pad rather than inserting anything into the vagina while awaiting advice, because this makes the amount easier to observe.

Know your blood group if it is available in your records, and tell the clinician about medicines, previous pregnancy complications and recent intercourse or procedures. Do not stop prescribed medicine unless the treating team specifically advises it.

Go to emergency maternity care now for heavy bleeding, severe abdominal or shoulder pain, fainting, marked weakness, breathing difficulty, fever with feeling very unwell, or bleeding with fluid leakage or contractions. Later in pregnancy, urgent assessment is also needed if your baby's movements are clearly reduced. Do not drive yourself if you feel faint or unstable.

Ask whether the scan identified the source of bleeding, where the placenta is positioned, whether the cervix needs follow-up and what activity or medicine advice applies to you. Request clear instructions about which changes should bring you back immediately and when the next ultrasound or clinic review is planned.