The uterus or womb is a muscular organ where pregnancy occurs, and the largest of the organs of the female reproductive system. Its function is to receive and feed the baby throughout the course of pregnancy, increasing in size as the fetus develops.
In most women, the uterus develops normally, placing itself in the pelvis between the vagina and the fallopian tubes. However, in some rare cases, it does not develop properly, resulting in some malformation. We talk to you about uterine malformations, the types that exist and how they can affect a woman's fertility.
Uterine malformations: what they are and why they happen
The uterine malformations or Müllerian malformations, are the result of an abnormal development of the Müllerian ducts during embryogenesis, which is the process that begins after fertilization and is one of the first stages of human development. This process lasts approximately eight weeks, concluding when the embryo finishes its first phase of development and begins to be called a fetus.
In Babies and more Problems that can affect the uterusmost of uterine malformations are congenital and even in some cases are hereditary, but they can also be acquired as a result of fetal radiation exposure, certain infections or the consumption of certain medications during pregnancy, such as diethylstilbestrol, a synthetic estrogen used in the 1970s to reduce the risk of abortion in the United States and other countries, including Spain.
According to a 2008 study on the prevalence of uterine malformations, approximately 6.7% of women around the world have some malformation in the uterus, although it is difficult to know exactly since Some women may have it and not know it, since they do not always have symptoms.
In fact, some women with a type of uterine malformation discover that they have it until they have problems having a baby, although the fact of having a malformation does not necessarily imply that you are going to have problems conceiving and giving birth.
Symptoms and diagnosis of a uterine malformation
As we have mentioned, in some cases women do not realize they have it because their reproductive system works normally, however, there are some symptoms that could indicate a uterine malformation:
- Amenorrhea or absence of menstruation
- Dysmenorrhea or painful menstrual periods
- Menorrhagia or menstrual periods too abundant
- Infertility
- Recurrent pregnancy loss
- Chronic pelvic pain
- Pain during sex
- Premature delivery
- Complications during childbirth
- Low weight in the newborn
The symptoms and the frequency or intensity of these It will depend on the severity and type of uterine malformation that occurs. As we have seen, some are detected until a pregnancy has already taken place and certain complications occur.
In order to correctly diagnose the presence of a uterine malformation, certain studies or exams, as:
- Ultrasound
- Laparoscopy and hysteroscopy
- Magnetic resonance
- Hysterosalpingography
Types of uterine malformations
Unicorne uterus
He unicorne uterus or unicorn uterusIt is a uterine malformation in which the uterus is half the size of a normal one and only has a fallopian tube and an ovary. It is possible to have two ovaries, but only one is connected to the uterus.
Bicorne uterus
The bicorne uterus is one of the most frequent congenital malformations of the uterine cavity and It is characterized by a deep recess in the upper part, which causes the uterus to have a heart shape or form two horns.
Its lower part (or caudal part) is normal, but the upper part is divided in two. The cleft in the upper part may be more or less deep, but there is always some degree of communication between the two horns. This cleft can be partial, covering a third, half or two thirds of the uterine cavity, or complete reaching the cervix and doubling it, called Bicorne bicollis uterus.
Didelfo Uterus
He didelfo uterus or double uterus It is a uterine abnormality characterized by having two uterine necks, two vaginas and two separate semi-uterus, whose size is smaller than normal and functioning independently.
In Babies and more A mother has twins 26 days after the birth of her first child: a strange case of a didelfo wombThis can be corrected by reconstructive surgery in which both uterus and It is the one that most relates to a viable pregnancy. We have even shared several cases of women with didelfo or double uterus who have had multiple births.
Septate uterus
He septate or partitioned uterus It is one in which the uterine cavity is divided into two parts by a central septum or muscular wall called the septum and is also one of the malformations of the uterus that occurs most frequently. It can extend partially into the uterus or reach the cervix.
Uterus arcuato
He uterus arcuate It is considered a variety of the septate uterus, with the difference that in it the septum does not exist, but a convexity or a concave dimple can be seen at the bottom of the uterus, which suggests the formation of two cavities.
Vaginal agenesis (absence of uterus)
Finally the Mullerian agenesis, vaginal agenesis or Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is the most severe of uterine malformations and is characterized by the absence of a uterus. It is a rare congenital disease that affects one in 5,000 women, and its main symptom is the absence of the first rule of the menstrual cycle.
Treatment
The treatment or solution is different for each uterine malformation, as this It will depend on the type and severity that each woman presents. In some, such as the septate uterus, surgery will be necessary to correct the malformation.
In the rest of them, surgery will probably not be necessary, but it may be necessary to resort to some assisted fertility treatment, such as in vitro fertilization, since uterine malformations they can affect the transport of ovules and sperm, as well as the implantation of the embryo.
The only case in which a pregnancy is not possible is when the woman has vaginal agenesis, due to the absence of a uterus. However, there are currently two possible solutions: Surrogacy, or a uterus transplant, of which we recently announced the first successful case in which a woman donated her uterus to her sister with vaginal agenesis, managing to conceive and give birth to a baby after an in vitro fertilization.
In Babies and more A woman gives birth after receiving a uterus transplant from her twin sister: first case in the worldDo uterine malformations affect the possibility of having children?
Although some of them can complicate the fertility of some women, it is not so in all cases and this will depend on the malformation that occurs. In general, Uterus malformations are associated with some complications of pregnancy and childbirth, such as repeat abortions, premature births, postpartum hemorrhage, suffering or loss of fetal well-being, fetal death and poor position of the fetus at the time of delivery.
However, in most cases, pregnancy may be possible, but it probably requires special care and measures, which will depend on the type and severity of the pregnancy. uterine malformation That is present.
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