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Ask DR PRABIR KUMAR DAS Your Own Question
DR PRABIR KUMAR DAS
DR PRABIR KUMAR DAS, CONSULTANT GYNAECOLOGIST
Category: OB GYN
Satisfied Customers: 1886
Experience:  MBBS(CAL)MD(G&O)
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, I had an ultrasound at 6 weeks which showed a foetus

Customer Question

Hi,
I had an ultrasound at 6 weeks which showed a foetus with a heartbeAt and had attached itself to the right side of my uterus. At ten weeks we discovered that I had had a silent miscarriage at 9 and a half weeks. I had a d/c the next day. The registrar who performed the d and c said that the cavity on the right side was large and that I only had one neck to my womb and one cervix. The ultrasounds which I had had to discover I had had a silent miscarriage revealed that there was a dip at the top of my uterus and so appears bicournate. I am keen to try ASAP to get pregnant as i fell very quickly after being on the pill for seven years. Could you advise what my next step could be
Submitted: 2 years ago.
Category: OB GYN
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Hi
Common complications of bicornuate uterus during pregnancy are recurrent pregnancy loss and malpresentation and premature birth.
Surgical correction will be the best option for you.
Thanks
Customer: replied 2 years ago.
What surgery would you advise. Are there any procedures which you recommend for a bicornate uterus. What is the best way to diagnose it?
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Thanks for your response.
The best way to diagnose bi cornuate uterus is HCG (hystero salpingo gram)
Surgical correction of the uterus (metroplasty) is the recommended approach for treatment of the septate or bicornuate uterus. At the time of metroplasty, the distinction between bicornuate and septate uterus must be clear. If the surgeon is not absolutely confident of the diagnosis prior to surgery, then laparoscopy should be performed as the first step. If the diagnosis of septate uterus is made by finding a normal external uterine configuration, the septum can usually be removed by hysteroscopy while the patient is still under anesthesia. However, if the external configuration is "rabbit-eared" suggesting a bicornuate uterus, surgical correction is performed by laparotomy (open abdominal surgery) at which time the abnormal uterine cavity is surgically united. In the first case, pregnancy can be attempted relatively soon after surgery, and the prognosis for a successful pregnancy is excellent. In general, the woman is allowed to have a normal labor and vaginal delivery. However, after surgery for a bicornuate uterus, it is generally recommended that patients wait at least three months before conceiving, and that cesarean section be performed for delivery. This recommendation is based on an increased risk of uterine rupture during labor for women who have had surgical correction of a bicornuate uterus. No surgical procedure has been shown to be effective in the treatment of either unicornuate uterus or uterus didelphys.
Thanks
Customer: replied 2 years ago.
I have had one miscarriage, is this a treatment I can request to have in order to be proactive to protect future pregnancies and is it performed on the nhs
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Yes
You should ask for metroplasty.In so many studies it is found that chance of miscarry falls markedly after operation.
Customer: replied 2 years ago.
If my uterus is diagnosed as bicournate how long would I have to wait for surgery?
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Thanks
I already mentioned you have to wait at least 3 months after the operation.
Customer: replied 2 years ago.
Sorry, not to try and get pregnant but how soon would they consider performing a metroplasty once they were able to diagnose whether I have a bicournate or septate uterus
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
It can be done after normal investigation result and anesthetic check up.
Thank you
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Do you have any query? Please ask if any.
Customer: replied 2 years ago.
Do they perform metroplasty's on the nhs in Wales as it has been suggested to me that there is no surgical correction available for a bicournate uterus.
Regards
Hayley
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Hello
After a long time!
Yes metroplasty is done in Wales NHS.You can check their website please.
Customer: replied 2 years ago.
Can I request to have this treatment?
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Yes.
visit www.wales.nhs.uk
You can make an appoinment.
Customer: replied 2 years ago.

Can't find any information on this website nhswales about requesting a metroplasty - do you know if they do 3d transvaginal ultrasound on the nhs too?

Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Have you found this site?
You create an account and after that you send a request describing your need like the name of the surgery. They will contact you with all details within 24 hours. You can make a call also.
Customer: replied 2 years ago.
Thank you. Would you recommend a 3d transvaginal ultrasound to diagnose my uterus abnormality?
Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
I will recommend HSG ( hystero salpingo gram) for confirmation. 3d tvs is also a good alternative.
Customer: replied 2 years ago.

What about mri scan. I had an (2d) ultrasound yesterday following my miscarriage and the consultant felt that my uterus was only slightly bicournate. He also felt that from that ultrasound it was the minimal measurement of a bicournate uterus - how is this so? What would you advise.

Expert:  DR PRABIR KUMAR DAS replied 2 years ago.
Hello
From their report it seems to be mild degree of bicornuate uterus which may not require surgical correction. HSG can give more information regarding the shape of uterus.
Thank you