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Women Specific Issues
Updated on 9 October 2023
In the world of women's health, there are countless conditions that can impact fertility and reproductive well-being. One such condition is the septate uterus, a condition that affects the shape and structure of the uterus. While it might sound intimidating, understanding the symptoms, risks, and treatment options is crucial for those who may be dealing with this condition or seeking to expand their knowledge.
Septate uterus means the uterus is divided by a wall known as a septum. This wall can either partially or completely separate the uterus into two distinct cavities. The septum is formed during fetal development and is caused by the incomplete resorption of the tissue that divides the uterus in early stages. This condition is estimated to affect about 1% of women.
In most cases, women with a septate uterus do not experience any symptoms. However, some women may experience recurrent miscarriages or infertility issues. Additionally, there may be an increased risk of preterm labor and malpresentation of the fetus during pregnancy. It is important to note that these symptoms are not exclusive to a septate uterus and can be caused by other factors as well.
It is crucial to understand the difference between septate and bicornuate uterus, as they are often confused due to their similar appearance. While both conditions involve a division of the uterus, a bicornuate uterus has two distinct uterine horns, whereas a septate uterus has a single, divided cavity.
The main difference lies in the presence of a single cervix in a septate uterus, compared to two cervices in a bicornuate uterus. This distinction is important as it can impact the management and treatment options for each condition.
The ability to have a successful pregnancy with a septate uterus largely depends on the extent of the septum and its impact on the uterine cavity. In cases where the septum is small and does not significantly affect the implantation of the embryo, women can have successful pregnancies without any complications.
However, for those with a larger septum, the risk of miscarriage and other pregnancy complications increases. It is essential to consult with a healthcare provider to assess the individual situation and determine the best course of action.
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Let us now understand the risks that a pregnancy with such a condition carries:
Women with a septate uterus have a higher risk of experiencing recurrent miscarriages compared to those with a normal uterus. The presence of the septum can interfere with the implantation of the embryo or lead to insufficient blood supply, resulting in pregnancy loss.
The presence of a septate uterus increases the risk of preterm labor. The septum can cause the uterus to stretch unevenly, leading to premature contractions and potentially early delivery.
A septate uterus can also increase the likelihood of the fetus being in a breech or transverse position. The presence of the septum restricts fetal movement, making it difficult for the baby to assume the optimal head-down position for delivery.
Placental abruption, where the placenta separates from the uterine wall prematurely, is more common in women with a septate uterus. The presence of the septum can disrupt the blood supply to the placenta, increasing the risk of this serious complication.
While not directly related to pregnancy, a septate uterus can also be associated with infertility. The presence of the septum can affect the implantation of the embryo or interfere with the fallopian tubes' function, making it more challenging to conceive.
Septate uterus can be diagnosed through various imaging techniques, with ultrasound being the most common. During a septate uterus ultrasound, a transvaginal probe is used to visualize the uterus and identify the presence of a septum.
Other imaging techniques, such as magnetic resonance imaging (MRI) or hysterosalpingography, may be employed for a more detailed evaluation. It is important to consult with a healthcare provider experienced in reproductive medicine to ensure an accurate diagnosis.
There are a few treatment options available for this condition such as:
Hysteroscopic septum resection is the most common and effective treatment for a septate uterus. It is a minimally invasive procedure performed under general anesthesia. A hysteroscope, a thin, lighted tube, is inserted through the cervix to visualize and remove the septum using specialized surgical instruments. This procedure has a high success rate and allows for a relatively quick recovery.
Laparoscopic septum resection is another surgical option for treating a septate uterus. It involves making small incisions in the abdomen and inserting a laparoscope, a thin tube with a camera, to visualize the uterus. The septum is then excised using surgical instruments. This procedure may be recommended for cases where the septum extends beyond the uterine cavity and requires removal from the outside.
In cases where the septum is small and does not significantly impact fertility or pregnancy outcomes, expectant management may be an option. This approach involves monitoring the woman's reproductive health closely and addressing any complications as they arise. It is important to note that expectant management may not be suitable for everyone and should be discussed with a healthcare provider.
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Women with a septate uterus may experience symptoms such as recurrent miscarriages, infertility, preterm labor, malpresentation of the fetus, and placental abruption. Treatment options include hysteroscopic or laparoscopic septum resection, or expectant management in cases of a small septum. It is important to consult with a healthcare provider to determine the best course of action based on individual circumstances.
1. Rousseau L, Brichant G, Timmermans M, Nisolle M, Tebache L. (2021). Daily practice management of septate uterus: reproductive outcome after septoplasty. Facts Views Vis Obgyn.
2. Selvaraj P, Selvaraj K. (2010). Reproductive outcome of septate uterus following hysteroscopic septum resection. J Hum Reprod Sci.
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