Uterine malformations: pregnancy remains possible

In some women, the uterus has abnormalities. Often found as part of a fertility assessment, repeated miscarriage or premature delivery, these malformations are not a contraindication to pregnancy and can be managed.

What is the uterus?

  • Body belonging to the reproductive system of women, the uterus is a kind of pocket in which the embryo will implant and develop throughout the pregnancy. Some women may have a malformation of the uterine cavity.

What are the main malformations of the uterus?

  • There are several types of abnormalities of the uterus. The main ones are the bicornous uterus, the hypoplastic or atrophic uterus, the unicorn uterus and the cloisonné uterus. Depending on the type of malformation, the uterus has an abnormality in its shape or size, which can be detrimental to the continuation of the pregnancy until the end, especially in the context of the atrophied uterus (small uterus) or partitioned (a partition separates the uterus into two half cavities).

How to diagnose them?

  • In France, it is estimated that between 1 and 2% of women have a malformation of the uterus. Some will never know because their ability to start and continue a pregnancy to the end will not be affected.
  • Disorders of chronic menstruation - amenorrhea (absence) or dysmenorrhea (very painful menstruation) -, dyspareunia - pains during sexual intercourse -, fertility disorders, repeated miscarriages or premature delivery may, on the other hand, suggest a malformation of the uterine cavity. Their diagnosis will be confirmed by pelvic ultrasound or X-ray.

Can they be treated?

  • In some cases, the small size of the uterus prevents the continuation of the pregnancy until the end. To remedy the repetition of miscarriages, an enlargement surgery can then be performed.
  • But in many cases, these malformations do not prevent the continuation of a pregnancy. They require increased surveillance and pathological follow-up by an obstetrician in order to limit the risks of intrauterine growth retardation as well as the risks of premature delivery.

Frédérique Odasso