Having a septate uterus is a very common malformation in women. What are the symptoms of a septate uterus? How is it diagnosed? Find out everything you need to know in this article.
What is a septate uterus?
There are different types of uterus in women. The partitioned uterus is characterized by a partition that divides the uterine cavity in two, depending on the height and shape of the partition.
The first form is the cervical septate uterus: in this case, the septum is located at the cervix (the neck is the lower part of the uterus). The second form is the corporal septate uterus, in which case the septum is located at the bottom of the uterus.
The third form is called the subtotal septate uterus. In this case, the septum runs from the bottom of the uterus down to the isthmus (the part before the cervix).
Finally, the last form of partitioned uterus is the total partitioned uterus. In this case, the septum runs from the bottom of the uterus to the cervix, and sometimes even into the vagina. This is also known as a complete urethrovaginal septum.
Is it normal to have a septated uterus?
As explained above, the septate uterus is the most common malformation today. It accounts for 55% of all mullerian malformations. Scientists have not really been able to find the cause. The most likely cause is genetic, as in many cases (1 in 5) it is associated with polycystic ovary syndrome (PCOS).
What are the causes of compartmentalized uterus malformation?
The causes of this uterine malformation go back to embryogenesis. It is during embryo formation that the malformation occurs.
The uterus is formed by the fusion of the Müllerian ducts. The two ducts fuse between the 10th and 13th weeks. However, in the case of a partitioned uterus, a malformation and a fusion defect can be observed at this stage.
What are the effects of a septate uterus on the body and health?
Although this type of anomaly is very common, it can affect health in a number of ways.
On pregnancy
The uterus is where the fetus develops during pregnancy. Having a partitioned uterus can have consequences for the smooth progress of pregnancy, fertility and fetal development.
There are several possible risks:
- First of all, the risk of miscarriage is very high with a septate uterus, and even higher, whether late or early;
- The risk ofpremature delivery is also higher, as the fetus can run out of room and trigger premature contractions;
- A breech birth (when the baby has not been able to turn around) is also more risky;
- With a closed uterus, it is also more difficult to envisage medically-assisted procreation, as implanting an embryo in this case is more delicate.
Pregnancy with twins can give rise to complications, and requires increased monitoring.
Of course, it's not impossible to carry a pregnancy to term, but it does require special monitoring and rest, and sometimes bed rest to avoid premature arrival of the baby.
On menstruation
A cloisonné uterus does not have any particular consequences or on menstruation.
How is a septate uterus diagnosed?
Diagnosis begins with the detection of symptoms, such as :
- Pain or discomfort during intercourse;
- difficulty in inserting sanitary protection tampons or menstrual cups;
- Repeated miscarriages;
- premature delivery.
When a woman is prone to recurrent miscarriage (more than 3 miscarriages), late miscarriage (after 14 weeks), or premature delivery (before 30 weeks), a septated uterus can be assumed.
In these situations, or when these symptoms are observed, you should contact medical staff for diagnosis. Diagnosis can be made using3D ultrasound. It is also advisable to seek specialist advice to carry out a complete work-up and rule out other malformations or pathologies such as bicornuate uterus, cord uterus or hypoplasia.
In some cases, an operation can be envisaged to enable the patient to embark on a new pregnancy project.
This operation is performed under hysteroscopy and ultrasound. Between the 4th and 6th week after the operation, check-ups are carried out to ensure that healing is going well. The patient can then become pregnant again.
Sometimes, a septate uterus presents no real symptoms and is discovered during an infertility check-up.
How is a septate uterus treated?
When a septate uterus is diagnosed, the proposed treatment is surgical. Even more so in women who are considering pregnancy. This surgical procedure is called metroplasty.
The operation consists in removing the partition that separates the uterus in two. It's a simple operation performed under hysteroscopy. The operation lasts just one day, on an outpatient basis.
After the operation, regular checks are carried out under hysteroscopy to verify healing. A few months later, pregnancy can be considered.
On the other hand, if the diagnosis is made while a pregnancy is already in progress, surgery is impossible, and only preventive treatment can be considered, to avoid premature delivery.
