Ask An Expert: Divided Uterus

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Ask An Expert: Divided Uterus

Question:

What does the phrase "divided uterus" mean? What is the next step after diagnosis for someone with this condition?

Answer:

A defect in embryologic development may result in a "divided uterus," or duplication of the genital tract. The female genital structures normally form in the fetus when two tubes fuse together in the midline of the lower body cavity. The upper ends of the ducts remain separate and give rise to the fallopian tubes. The fused lower part becomes the uterus and vagina.

If the tubes fail to fuse completely, structural abnormalities will result. Partial failure of fusion causes a midline wall, or septum, within the uterine and vaginal cavities. Complete failure of fusion results in a woman having two distinct genital tracts with two uteri and two vaginas.

Treatment of these conditions depends on whether symptoms or problems occur. Occasionally, the defect causes a blockage preventing flow of menstrual fluids. The trapped secretions cause pain and swelling and surgery is necessary for relief. Structural abnormalities may also impair fertility. The uterus may not be able to expand normally with pregnancy, resulting in a risk of miscarriage and premature delivery.

If a structural abnormality is suspected, ultrasound and other radiology studies will assist the physician in determining the location and extent of the defect. The implication of the findings can then be reviewed with the patient so treatment can be planned to address her reproductive needs.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

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Last updated:	January 24, 2007