Bicervical bicornuate uterus with patent cervix and vagina

Bicervical bicornuate uterus with patent cervix and vagina is a congenital uterine malformation classified among Müllerian duct anomalies. In this condition, the uterus has two separate uterine horns (bicornuate) and two distinct cervices (bicervical), while both cervical canals remain open (patent) and the vagina is single and normally formed. This anomaly results from incomplete fusion of the paired Müllerian (paramesonephric) ducts during embryonic development, typically between the 6th and 9th weeks of gestation. The condition primarily affects the female reproductive system. Many individuals with this uterine anomaly may be asymptomatic and the condition may only be discovered incidentally during imaging studies, gynecological examination, or evaluation for reproductive difficulties. However, some affected women may experience adverse reproductive outcomes including recurrent miscarriage, preterm labor, malpresentation of the fetus, and other obstetric complications. Menstrual irregularities may also occur in some cases. The condition is typically diagnosed through imaging modalities such as pelvic ultrasound, hysterosalpingography, MRI, or direct visualization during laparoscopy or hysteroscopy. Treatment depends on the clinical presentation and reproductive goals of the patient. Many women with this condition can have successful pregnancies with appropriate obstetric monitoring, and no surgical intervention may be necessary. In cases of recurrent pregnancy loss attributed to the uterine anomaly, surgical metroplasty (Strassman procedure) may be considered to unify the two uterine horns, though this is not routinely performed. Management is individualized and typically involves close collaboration between gynecologists and reproductive medicine specialists.

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