CareNine:
Septate uterus: how does it impact pregnancy?

A septate uterus is a congenital uterine deformity that occurs during foetal development. In this condition, a membrane called the septum divides the inner portion of the uterus, creating two separate chambers. Some women may not realise they have a septate uterus, even while giving birth.

A septate uterus doesn’t require immediate treatment unless there is a repetitive miscarriage pattern. Treating this can improve pregnancy rates. It is one of the most common uterine anomalies and there is no definite cause for it.

Symptoms of septate uterus

• Recurrent miscarriages: Multiple miscarriages may indicate a septate uterus.
• Painful periods: Some women experience severe menstrual cramps.
• Pelvic pain: Frequent pelvic pain can also indicate septate uterus.
• No symptoms: Many women have no symptoms and get diagnosed only when facing pregnancy issues.

Impact on pregnancy

• Fertility: A septate uterus usually doesn't affect fertility and many women conceive without difficulty.
• Miscarriage: Studies suggest a higher risk of miscarriage in women with a septate uterus, possibly due to the septum affecting implantation or blood flow.
• Preterm birth: The septum might limit space for the baby to grow, potentially leading to earlier delivery.
• Intrauterine Growth Restriction (IUGR): A divided cavity could restrict nutrient and oxygen supply to the baby, impacting growth.
• Abnormal foetal position: The septum might influence the baby's position in the uterus, increasing the likelihood of breech presentation (feet first).
• Caesarean delivery: Breech presentation or other complications might necessitate a C-section delivery.

Diagnosis and management

• A septate uterus is often diagnosed during routine prenatal scans like ultrasounds. An MRI can further accurately identify the problems of the uterus.
• If detected, your healthcare provider will discuss the potential risks and likely recommend regular monitoring throughout your pregnancy.
• Depending on the septum's location and size, additional scans or specialised care might be needed.
• To confirm the diagnosis, you may also have to go for a hysterescopy.

Who needs treatment for a septate uterus?

• Not all women with a septate uterus require treatment.
• If you have a history of recurrent miscarriages (two or more), your doctor might recommend a surgical procedure called hysteroscopic metroplasty.
• This minimally invasive procedure removes the septum to create a single uterine cavity.

What can be the complications of treating a septate uterus?

There are some issues involved with removing the septum from a uterus, such as:

• Infection
• Perforation of the uterus
• Abnormal bleeding
• Cervical damage

Managing pregnancy with a septate uterus

• Frequent prenatal visits help monitor the pregnancy closely.
• Go for high-risk pregnancy care for complete care till delivery.
• Opt for regular ultrasounds to monitor the baby’s growth and position.
• A planned caesarean section may be recommended to avoid complications during labour.

iving with a septate uterus

• Many women with a septate uterus have healthy pregnancies with proper monitoring and care.
• Maintaining a healthy lifestyle with a balanced diet, regular exercise and folic acid intake is crucial.
• Open communication with your healthcare provider about any concerns is essential.

A septate uterus doesn't have to be a barrier to a healthy pregnancy. With early diagnosis, proper prenatal care and potential treatment options, women with this condition can experience successful pregnancies and childbirth.

Sources:
Boston Children’s Hospital
Cleveland Clinic
Healthline