A Rare Presentation of a T-shaped Uterus in the Post-diethylstilbestrol Era: A Case Report and Literature Review

The T-shaped uterus is a rare congenital uterine anomaly characterized by a narrowed endometrial cavity with lateral constriction, deviating from the typical triangular shape. Historically, this anomaly has been strongly associated with in-utero exposure to diethylstilbestrol (DES) in the mid-20th century; however, since the discontinuation of DES, no primary cause has been identified. We present the case of a 29-year-old female with a history of recurrent pregnancy loss found to have a T-shaped uterus on sonohysterography. The patient was subsequently referred for surgical evaluation. In patients with recurrent pregnancy loss and nonsignificant inherited and acquired thrombophilia workups, structural uterine abnormalities should be considered in the differential diagnosis. While a T-shaped uterus is associated with infertility and adverse pregnancy outcomes, further research is needed to determine the role of surgical correction in improving reproductive outcomes.