What Is a Heart-Shaped Womb?

Alicia Sparks

A heart-shaped womb is a type of uterine anomaly that causes a woman’s womb to be shaped more like a heart than the natural pear shape a healthy womb presents. Statistically, this kind of anomaly, also known as bicornate womb or bicornate uterus, is present in few women. Generally, bicornate uteri don’t present the affected women with any problems until they become pregnant or try to deliver their babies. Pregnancy and delivery complications are often the only reasons women and their doctors discover the heart-shaped wombs. For this reason, it’s possible that more women than studies show have bicornate wombs.

Having a heart-shaped womb may cause birth defects or premature labor.
Having a heart-shaped womb may cause birth defects or premature labor.

A woman’s womb becomes shaped like a heart when an indentation at the top part of the uterus, called the fundus, creates two distinctly separate sides, often referred to as horns. Most healthy wombs are shaped like pears, but the horns of a bicornate womb make it look like a heart. This defect takes place when the woman is still in the womb herself, and her embryonic female genital tract fails to develop properly. Research suggests that approximately one in every 250 women in the United States has some sort of uterine anomaly, including a bicornate womb. Given that many uterine anomalies aren’t diagnosed until another related or unrelated problem presents itself, some experts believe such research doesn’t accurately represent the number of women with uterine anomalies.

Having a heart-shaped womb could require delivery by C-section.
Having a heart-shaped womb could require delivery by C-section.

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The majority of complications associated with a heart-shaped womb are related to pregnancy and delivery complications. Usually, having a heart-shaped womb doesn’t make it difficult for a woman to become pregnant, but it can make it difficult for her to carry the baby full term. If the baby implants itself in the largest part of the womb, rather than in one of the two horns, the woman might have a full-term pregnancy but the baby might be breech or transverse and could require a Cesarean section delivery. Also, having a heart-shaped womb can affect baby development, causing fetal growth retardation, premature labor, or other birth defects. Of the three, premature labor seems to be the most common.

A heart-shaped or bicornuate uterus could make it challenging for a woman to carry her pregnancy to full term.
A heart-shaped or bicornuate uterus could make it challenging for a woman to carry her pregnancy to full term.

Typically, a woman and her doctor won’t know she has a heart-shaped womb until she becomes pregnant and has complications during her pregnancy or delivery. This is because the majority of noticeable symptoms of a heart-shaped womb involve pregnancy and delivery complications. Even so, there are methods of diagnosing, or discovering, a bicornate uterus that don’t involve pregnancy. Such methods include gynecologic sonography, hysterosalpingography, and hysteroscopy. Since doctors usually don’t perform these procedures unless other problems, such as infertility, are present, most women aren’t aware of the problem until pregnancy.

Bicornate uteri typically do not cause any problems for affected women until they try to deliver a baby.
Bicornate uteri typically do not cause any problems for affected women until they try to deliver a baby.

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