Patient evaluated 7 days after delivery. The pregnancy was located in the left uterine horn. Postpartum ultrasound examination was performed to assess uterine morphology.
B-mode ultrasound demonstrated a postpartum uterus with expected involutional changes. 3D ultrasound acquisition with advanced rendering techniques enabled detailed visualization of uterine anatomy.
Multiplanar reconstruction (CMPR) and enhanced rendering clearly depicted two symmetric uterine horns separated by a deep fundal cleft. Two distinct endometrial cavities and two cervical canals were identified, consistent with a bicornuate uterus bicollis.
The pregnancy was previously located within the left horn, which appeared appropriately enlarged in the postpartum setting. The use of 3D imaging and modern rendering techniques was essential for accurate characterization of the uterine anomaly.
Final diagnosis:
Bicornuate uterus bicollis.
Differential diagnosis:
Septate uterus, didelphys uterus, arcuate uterus (less likely given the deep fundal cleft).
Teaching points:
3D ultrasound with multiplanar reconstruction is crucial for differentiating Müllerian anomalies. Identification of an external fundal cleft and two পৃথinct cervical canals supports the diagnosis of bicornuate uterus bicollis. Postpartum imaging may further highlight uterine asymmetry depending on the horn involved in pregnancy.
Injury/disease information:
A bicornuate uterus bicollis is a congenital Müllerian duct anomaly characterized by incomplete fusion of the ducts, resulting in two uterine cavities and two cervices. It may be associated with reproductive complications such as miscarriage, preterm delivery, and malpresentation, although successful pregnancies can occur, often within one uterine horn.
