Uterus with depression at the fundus is called:
A. Arcuate uterus
B. Bicornuate
C. Septate uterus
D. Uterus didelphys
Correct Answer : A. Arcuate uterus
Explanation: A uterus with a depression (or indentation) at the fundus is called a bicornuate uterus (when the indentation is significant and creates two distinct “horns”) or an arcuate uterus (when the depression is mild and the fundus is only slightly concave).
Key distinctions:
• Arcuate uterus: Mild fundal indentation (almost flat or slightly concave fundus). Considered a normal variant in many cases.
• Bicornuate uterus: Deeper fundal indentation (usually >1 cm), giving the uterus a heart-shaped appearance with two separate endometrial cavities merging lower down.
• Septate uterus: The fundus is normally convex outwardly, but a septum divides the cavity internally (distinguished on imaging, especially MRI).
So the most common direct answer in medical exams and textbooks for “uterus with depression at the fundus” is arcuate uterus (mild) or bicornuate uterus (more pronounced).
If the question expects one term, arcuate uterus is the classic answer for a simple fundal depression/indentation.
Other Options Details
Here are clear descriptions of each Müllerian duct anomaly (congenital uterine abnormalities) listed in your options:
A. Arcuate uterus
• Mildest form of uterine anomaly, often considered a normal variant rather than a true malformation.
• The fundus (top) of the uterus has a small, smooth indentation or “dip” (usually <1 cm deep) toward the uterine cavity.
• The outer contour of the uterus is normal (convex or almost flat).
• Usually does not cause fertility problems or increased miscarriage risk.
• On imaging (ultrasound or MRI): looks like a mild heart-shaped cavity, but external shape is normal.
B. Bicornuate uterus
• Results from incomplete fusion of the two Müllerian ducts.
• The uterus is divided into two “horns” by a deep cleft (>1 cm) in the fundus.
• Two distinct endometrial cavities that join together near or at the cervix (partial or complete).
• External fundal contour shows a deep indentation (two separate horns visible externally).
Types:
• Bicornuate unicollis: one cervix
• Bicornuate bicollis: two cervices (less common)
• Associated with higher risk of miscarriage, preterm birth, and breech presentation.
C. Septate uterus
• Most common clinically significant uterine anomaly.
• Caused by incomplete resorption of the midline septum after Müllerian duct fusion.
• External fundal contour is normal (convex or flat) — this is the key difference from bicornuate.
• A fibrous or muscular septum divides the uterine cavity partially (partial septate) or completely down to the cervix (complete septate).
• Highest risk of recurrent miscarriage (due to poor vascularity of the septum).
• Treatable surgically by hysteroscopic septum resection (good prognosis after surgery).
D. Uterus didelphys
• Complete failure of fusion of the two Müllerian ducts.
• Two completely separate uteri, each with its own endometrial cavity and cervix (double uterus and double cervix).
• Often associated with a longitudinal vaginal septum (may be partial or complete).
• Each uterus is usually smaller than normal and has one fallopian tube.
• Higher risk of miscarriage, preterm delivery, and kidney anomalies (especially unilateral renal agenesis on one side).
• Women can sometimes carry pregnancies successfully in one of the two uteri.
Quick comparison table for clarity:
Feature Arcuate Bicornuate Septate Didelphys
External fundal contour Normal Deep cleft (>1 cm) Normal Two separate uteri
Endometrial cavities One Two (joined at cervix) One, divided by septum Two completely separate
Cervix One Usually one (can be two) One Two
Miscarriage risk Normal Increased Very high Increased
Surgical correction Not needed Sometimes (metroplasty) Yes (hysteroscopic) Usually not
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)