Pregnancies in a bicornuate (heart shaped) uterus are usually considered high-risk and require extra monitoring because of association with poor reproduction potential. A bicornuate uterus is associated with increased adverse reproductive outcomes like:

1. Recurrent pregnancy loss. The reproductive potential of a bicornuate uterus is usually measured by live birth rate (also called fetal survival rate). This rate is estimated around 63% for a bicornuate uterus.
2. Preterm delivery. With a 15 -25% rate of preterm delivery. The reason that a pregnancy may not reach full-term in a bicornuate uterus often happens when the baby begins to grow in either of the protrusions at the top. A short cervical length seems to be a good predictor of preterm delivery in women with a bicurnuate uterus.
3. Malpresentation (breech birth or transverse presentation). A breech presentation occurs in 40-50% pregnancies with a partial bicornuate uterus and not at all (0%) in complete bicornuate uterus.
Previously, a bicornuate uterus was thought to be associated with infertility , but recent studies have not confirmed such an association.