Internal Features Of A Double-Horned Or Bicornuate Uterus

Description

Bicornuate uterine anatomy is centered on a broad fundus that separates into two uterine horns, each containing its own endometrial chamber divided by a midline septum that extends inferiorly within the uterine body. From an anterior cutaway perspective, the paired cavities sit superolateral to one another, converging toward the midline as they approach the lower uterine segment and cervix. The endometrium lines both chambers, while the surrounding myometrium forms the external contour; the septum appears as a fibromuscular ridge projecting into the uterine cavity. Tubal ostia would be expected near the superolateral margins of each horn, oriented toward the uterine tubes. This configuration reflects a Müllerian duct fusion anomaly, and the distinction between a bicornuate uterus and a septate uterus matters because management differs. Recurrent pregnancy loss, preterm birth, malpresentation, and fetal growth restriction are commonly discussed in this context, but they do not share a single mechanism, and the internal contour of the cavity often drives counseling and procedural choice. Surface contour and cavity shape are key. A fixed anterior view that emphasizes the bifid cavity and partial septation supports teaching the imaging criteria used on 3D ultrasound or MRI, and it maps directly to what the clinician expects during hysteroscopy and laparoscopy when correlating the intracavitary septum with the external fundal indentation. Use this illustration in embryology and reproductive anatomy modules, in OB-GYN lectures on congenital uterine anomalies, or in journal and textbook figures comparing bicornuate, didelphys, and septate uteri. It also fits patient-facing counseling materials in fertility clinics when explaining why hysteroscopic septum resection may not address a true bicornuate configuration and why abdominal metroplasty is reserved for selected cases. Anatomical accuracy verified by SciePro's Medical Advisory Board.