Septate uterus

Overview

A septum is a thick or thin fibrous or muscular band of tissue. The meaning of septate uterus is the presence of such septum inside the uterus dividing the inner cavity of the uterus; and it is present in some women since birth.

Women with a septate uterus are at an increased risk of miscarriage. Because if pregnancy implants near the septum; it can not get the proper support for growth.

Septate uterus can be effectively treated with hysteroscopic surgery.

CAUSES OF SEPTATE UTERUS

There are no known causes of septate uterus ;but it is said to be a genetic abnormality.

It happens when a female baby is developing inside the mother. All uteri begin development as two tubes which eventually fuse and become one uterus at the midline. Whenever there is a failure of fusion of these tubes; a septum develops making a septate uterus.

TYPES OF SEPTATE UTERUS 

Septate uterus can be divided into three types:

1. Partial septate uterus: When the septum is only inside the uterus.
2. Complete septate uterus: When the septum extends upto the cervix or the lower part of the uterus.
3. Septate uterus and vagina: When the uterine septum extends up to the vagina.

COMPLICATIONS OF A SEPTATE UTERUS

Women with septate uterus can have a normal and healthy full term pregnancies but it may add complications in pregnancy. These include:

1. Miscarriages; estimated rate of miscarriage in septate uteri is 20 to 25 or as high as 40 per cent.
2. Premature labor
3. Breech or transverse presentation where the chances of caesarean section are high.
4. Bleeding complications after delivery
5. Adherent placenta

SYMPTOMS OF A SEPTATE UTERUS

Apart from miscarriage or recurrent miscarriges; there are no symptoms of a septate uterus. It is usually diagnosed when a infertility work up is being done or an incidental finding on ultrasound.

DIAGNOSIS OF A SEPTATE UTERUS

1. History of recurrent miscarriages raising suspicion of a septate uterus.
2. Sonography especially a 3 D ultrasonography is more accurately suggestive of septate uterus.
3. Hysteroscopy
4. MRI

TREATMENT OF A SEPTATE UTERUS

If a woman does not wish to have children, there is no need to  undergo treatment for a septate uterus as it does not pose a health risk. However, if a woman with a septate uterus would like to have children, then she may choose to have surgery. Surgery will significantly increase chances of a successful pregnancy.

The treatment of a septate uterus is surgery called hysteroscopic septal resection or hysteroscopic metroplasty.

Hysteroscopic septoplasty  involves using a hysteroscope to see the septum and then cut it with a very tiny pair of hysteroscopic instruments . A very thick and fibrous septum my warrant the use of current given by high frequency elecrosurgical  generators ; best for the safety of the patient.