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:
- Partial septate uterus: When the septum is only inside the uterus.
- Complete septate uterus: When the septum extends upto the cervix or the lower part of the uterus.
- 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:
- Miscarriages; estimated rate of miscarriage in septate uteri is 20 to 25 or as high as 40 per cent.
- Premature labor
- Breech or transverse presentation where the chances of caesarean section are high.
- Bleeding complications after delivery
- 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
- History of recurrent miscarriages raising suspicion of a septate uterus.
- Sonography especially a 3 D ultrasonography is more accurately suggestive of septate uterus.
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.