Heart Shaped Uterus

Commonly referred to as a heart shaped uterus, technical name being bicornate, is a uterus composed of two “horns” separated by a septum. (Literally in the shape of a heart!) It is a type of uterine malformation which occurs during embryogenesis. For my technical readers, Wikipedia says ‘the fusion process of the upper part of the paramesonephric ducts are altered and as a result, the lower part of the uterus is unitary while the upper part is bifurcated.’ Basically, when my Mom was pregnant and I was growing and developing in her belly, the process that normally takes place for kidney formation was altered, as a result so was my uterus, since there is a connection between development in females. I was one of the lucky 0.1-0.5% of women in the U.S. born with a heart shaped uterus. (Note, this statistic may be understated since some abnormalities go undetected, especially if a woman  doesn’t have children and never has a sonogram of her uterus.)

How did I discover I had a bicornate uterus? Shortly after starting my first full time job after college I switched over my insurance from my parents to my own policy, through my employer. I had seen an OB-GYN at school for annual exams, but I now needed to select one closer to home. During my first appointment my Doctor spoke with me about my medical history and asked about my menstrual cycles. I told her that I had been suffering for years from horrible menstrual cramps, heavy bleeding, feelings of nausea, vomitting and severe pain to the point I was in bed and completely out of commission for the first 1-2 days of my cycle. She sent me for a scan of the area to check things out. She was expecting cysts on my ovaries, which come and go. During the scan the technician asked me if I had pain on one side or both and starting asking about my kidneys. I told her that about 6 months earlier, during my senior year of college, I had severe pain in my side/back, which I originally thought was the flu. It turned out to be a UTI/kidney infection. She didn’t say much else and I went on my way.

A week or so later I met with my OB-GYN to review the results and to say I was in utter shock is an understatement. Had I known what she was about to say I would have brought my Mom or boyfriend at the time. In a very calm manner she explained to me that I was born with only one kidney and rather than a circular shaped uterus, mine was almost cut into two and is shaped like a heart. She explained that there was nothing my Mom could have done wrong during her pregnancy with me, these things just happen. She also said that had my Mom received an anatomy scan as they do today during pregnancy at 20 weeks, she would have known-which would have probably led to me not partaking in gym class or sports growing up. You can live with one kidney, some people are born this way, like me, while others donate kidneys to help save the lives other others. I’m perfectly healthy, thank God! I need to see a nephrologist (kidney specialist) twice a year to check my kidney functions. They want to ensure the one kidney is working well-actually it is perfect and is compensating for the missing one. Keeping a healthy diet, limiting salt, and maintaing a good blood pressure level are important. Since learning this information I have to say I am a bit more careful and think twice about skiing or wanting to go sky-diving potentially, to avoid any issues that could come up in the future.

The other finding was the shape of my uterus. At 22 years of age, marriage and kids were not on my brain. I was focused on my career, going out with friends and traveling the world (not too much has changed in this regard!). Although I wasn’t planning to have children for years to come, my OB-GYN shared some information with me regarding the technician’s findings. What this meant to me and what I kept in the back of my mind was any future pregnancies would be considered high risk, I would be monitored closely, I wasn’t expected to have issues getting pregnant (although an unknown as I never tried), but I could have issues holding and carrying a pregnancy given my uterus was half the size of a normal one. My Doctor reassured me that if this became an issue and I was to miscarry a lot there is a procedure she could perform to create a larger uterus, joining the two halves together. 

After my appointment I went to my parents house, where I was living after college, where my Mom served me chili. Chili! Chili with kidney beans! Talk about irony?!?! I was coming home with news of my one kidney and a malformed uterus and there were 100 kidney beans in my bowl. Not funny at the time and I think my Mom felt bad. I was pretty upset, mostly about the kidney and I somehow convinced myself I couldn’t have children–not the case, obviously! Looking back I have gone on to lead a similar lifestyle to the one before the news; eating healthy, staying active,  checking in frequently with Doctors- now with the added precautions for physical activity. After seeing a nephrologist I also met with a Urologist, who performed exploratory surgery in trying to look for kidney remnants, etc.

Fast forward 8 years later, I was about to get married and knowing my now husband and I wanted to try for a baby immediately, we met with my OB-GYN (a new practice, which I switched to about 6 years ago) for a family planning meeting. Throughout the years I would ask questions about my uterus, and my optimistic OB-GYN would always keep a positive attitude while still sharing the known risks and obstacles. In his office a month before our wedding we talked mostly about when I was predicted to ovulate and certain things I could do increase my chances of getting pregnant. Fortunate for us we were so blessed that during our 2 week honeymoon I got pregnant. Still to this day I cannot believe it happened exactly when we wanted it to and everything worked out beautifully with me carrying and delivering a healthy baby boy.

After 3 at-home positive pregnancy tests I called and make an appointment with my OB-GYN. In his office he confirmed I was pregnant and we discussed my risks and precautions I should be taking. I was already taking prenatal vitamins to prepare my body and I would continue. I was set-up with a high risk doctor that would meet with me monthly as well as my regular OB-GYN (until the end when appointments became more frequent). I was told to pretty much avoid the gym, other than walking, so I put my membership on hold. The risks would heighten as I reached 20+ weeks, since my uterus is half the size, the concern is risk of miscarriage and preterm labor, if the baby doesn’t have much more room to grow. Luckily, my uterus kept expanding and expanding and each week and after week 20 I was happier an happier. Initially I was hesitant to share my pregnancy news with anyone because I thought I would never make it (the time I spotted didn’t help either- but all was fine!). My high risk doctor told me she would be happy if I reached 26-28 weeks, which seemed SO early to me. Against the odds, I went to 41 weeks and had to be induced because not only did my uterus grow to hold him, he was so comfy he didn’t want to come out. The other concern is a breeched baby. Again, fortunately for me, my baby turned around 30-31 weeks or so and stayed head down. For the 30 weeks prior I was convinced, based on other cases, I would have a C-Section, but I didn’t.

This is my story, which I hope in sharing gives some optimism to those women who find themselves with a heart shaped uterus. I’ll end with sharing something my boss told me when I shared this with him. He said to me “your uterus right now has about half the room for 1 baby, which is similar to a woman who is carrying twins.” That gave me hope early on and stayed with me through my pregnancy. 

XO

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