As noted above, the uterus forms as two tubes and comes to the midline and forms as one. A woman with two uteri may have one cervix or two cervices as noted above. A woman with two uteri can have normal reproductive function but she is at increased risk for premature delivery of a fetus and she is also at increased risk of breech presentation which may necessitate a cesarean section.
A unicornuate uterus is one half of a uterus that forms with a cervix and is usually connected to the vagina. This uterus will function normally although the woman is at risk for premature delivery of a fetus and for breech presentation which may necessitate a cesarean section. Sometimes with a unicornuate uterus there is a second smaller hemi-uterus which is obstructed, meaning that the endometrial cavity within the obstructed uterus does not have a means for the blood to egress or leave the body. This can result in pain. It may be difficult to diagnose an obstructed unicornuate uterus and it may only be diagnosed with the utilization of ultrasound, MRI or a laparoscopy. An obstructed hemi-uterus can be removed if there is a normal unicornuate uterus on the other side. The resection of the obstructed hemi-uterus can be performed laparoscopically.
A uterus may have a normal shape but it may have a wall in the center dividing it into two cavities. This can be surgically corrected. Women with a septate uterus are also at risk for premature labor and breech presentation.