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Abnormalities of the uterus and treatment – Part 1

The uterus in its normal form is a pear shaped organ that is placed in the pelvis area of the female body. The length of the uterus is about 7.5cm and the width is about 5cm, with the depth being about 2.5cm deep. The interior of the uterus is hollow and the walls are thick and muscular. The lower end, say about 1/3rd of the womb dips down into the vagina and is known as the cervix. Fundus is the upper portion of the uterus. This is exactly where the zygote develops into a baby. There are 2 fallopian tubes each of which are connected to an egg filled ovary. They enter the womb at the top on either side.
When the womb/uterus leans forward above the bladder then it is called anteflexed or anteverted. Tilted uterus is common in some women. It is also called retroverted uterus wherein the uterus leans away and not over the bladder. It affects the position of the uterus and not the structure of the womb. Around 1 in 6 women are known to have tilted uterus. It does not affect conceiving as the sperm’s ability to get into the fallopian tubes has no effect due to its position.

An abnormal uterus

When the structure of the uterus is not normal then there is a malformation or an abnormality in the uterus. 1 in 100 women are known to have uterine abnormality. Pregnancy in an abnormal uterus depends on the type and extension of abnormality. Not many women know of the abnormality until an ultrasound takes place. Depending on the type, it is assessed whether the mother shall be able to carry her baby for full tenure of 9 months of pregnancy.

Symptoms of a uterine abnormality
• Never had a period
• Recurrent miscarriages
• Infertility
• Preterm labor
• Abnormal baby positioning
• Breach baby
• Pain during insertion of a tampon
• Pain in sex
• Menstrual pain

The uterine abnormalities are as below:
• Agenesis: This is a rare condition and it is known to affect only 1 in 4000. In this abnormality, the vagina is not formed properly. It may be short; the uterus may be small or does not exist at all. This is recognized where there are no periods occurring in girls. Sex is uncomfortable for such girls. Treatment can be done via surgery and counseling. Such woman can have a baby only through surrogacy.
• Uterus didelphys: When the uterus consists of 2 interior cavities then this condition occurs. Each of the cavities has its own vagina and cervix implying there are 2 vaginas and 2 of the cervixes. This is also not a common case and is observed in 1 in 350 women. The conceiving and pregnancy is not a big issue in such an abnormality.
• Unicornuate uterus: The size of the uterus is half of the usual uterus and has a single fallopian tube. It is called a uterus with one horn. This is a rare condition and observed in 1 in 1000 women. It grows in the initial stages of life when there is abnormal growth of tissues that form the womb. There shall be 2 ovaries if you have this condition. With one grown horn, there is no harm in conceiving; however the risk of miscarriage can be high in such a case.
• Bicornuate uterus: This abnormality has uterus of a heart shape instead of pear shape. At the top there is a deep indentation. The uterus comes with 2 horns due to its shape. Less than 1 in 200 women have this type of uterine abnormality. There is no effect on fertility but a risk of miscarriage is high in this type of abnormality of uterus.
• Arcuate uterus: This uterine abnormality has a dip or indentation at the top but it appears like a usual uterus. 1 in 25 women are affected by this abnormality. Conceiving is not a problem in such a case.

Read more in the next part of this post (Abnormalities of the uterus and treatment – Part 2)

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