Uterus arcuate

Class VI Arcuate uterus (7%) Mostly compatible with normal-term gestation ... 

Defintion Arcuate uterus is the result of a near complete regression of the uterovaginal septum forming a mild and broad saddle-shaped indentation of the fundal endometrium [13]. 

Differentiation from bicornuate uterus is based on the complete fundal unification however, a broad-based septate uterus is difficult to distinguish from an arcuate uterus. There is much controversy as to whether an arcuate uterus should be considered a real anomaly or an anatomic variant. Fact is that MRI may detect this abnormality but, typically, it is not clinically significant because arcuate uterus has no significant negative effects on pregnancy outcome. 

Formerly this MDA was classified as the mildest form of either a bicornuate or septate uterus. In 1988, the American Fertility Society issued a separate classification of arcuate uterus. Arcuate uterus should be considered a normal variant and it has no effect on fertility. 

HSG of the arcuate uterus reveals a broad smooth indentation into the fundal cavity, which causes a saddle-shaped appearance (Fig. 16.2l). The indentation is approximately one-fifth the height of the uterus. 

Fig. 16.21. Class VI. HSG shows minor indentation of the fundal uterine cavity indicating an arcuate uterus. Note normal filling of the fiillopian tubes with evidence of free spill into the pelvic peritoneum...

Fig. 7.4a-f. Schematic presentation of classes 111, IV, and V. a Uterus didelphys (class 111) b-d bicornuate uterus (class IV) b complete, c partial, d arcuate e,f septate uterus (class V) e complete, f partial... 

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