He septate uterus, or also known as septum, is the most frequent uterine malformation. This anomaly is the consequence of an embryonic defect of the uterus when the Müllerian ducts (structures derived from the urogenital fold) fuse.
Despite being one of the most common birth defects in women and that is usually diagnosed when you want to get pregnant, with the appropriate medical intervention it has a very good prognosis.
“What produces the septate uterus is a division of the uterine cavity (which has a triangular shape) into two halves,” explains the doctor to this portal. John Louis Delgadoof the (SEGO).
Although it does not produce any symptoms, during pregnancy it has important risks:
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Increases spontaneous abortions
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increases the risk of preterm or immature labor
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Placental abruption (fundamental organ of pregnancy that provides oxygen and nutrients).
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It also increases the risk of the baby coming breech, making it difficult to deliver at delivery, and may require a Caesarean section scheduled.
Could be partial septum uteruswhich only divides one part, or completewhen the division is complete and “we see that the baby and the placenta are between two cavities”.
When and how is a septate uterus diagnosed?
“The ideal is to diagnose a septate uterus in a pregestational stagebefore pregnancy, but it is common for it to occur after a woman has suffered several miscarriages or a premature birth,” says the specialist.
This malformation cannot always be diagnosed in a routine review, although it is easier with a three-dimensional one.
“In the first instance, today, it would be easy to diagnose thanks to 3D gynecological ultrasounds.”
To confirm it, perform:
- hysteroscopyused to visualize the inside of the uterus
- laparoscopyintroducing an optic from the navel to see the uterus from the outside, which makes it possible to differentiate this malformation from other pathologies such as a double or bicornuate (heart-shaped) uterus.
- Magnetic resonanceas the main non-invasive method.
How is the treatment?
As has been discussed, the septum uterus no symptomsNo pain, no discomfort during menstruation. However, once it has been diagnosed, and which would normally be during a routine check-up in which a 3D ultrasound has been performed, it can be easily treated.
Hysteroscopy, which is used to diagnose this anomalyalso serves to treat it “with an electrical cutting system to section the septum and leave the cavity open. It is a fibrous tissue that is removed very easily”.
It is an outpatient intervention, in most cases, and only requires locoregional anesthesia (which is administered in a certain area, near the nerve root).
“If it is diagnosed during pregnancy and it is a young woman, you have to be extremely vigilant, looking at the markers of premature labor (such as measuring the length of the cervix) and monitoring placental infection,” specifies the gynecologist Delgado.
For this reason, in the case of a woman who has not undergone a complete gynecological check-up and wants to become a mother, a review with a specialist to rule out the presence of a septate uterus that may complicate the pregnancy.