What Is a Septate Uterus?
Müllerian duct abnormalities are a rare disorder in women but have been known to lead to episodes of infertility, fetal growth retardation, and miscarriage in many cases. Researchers distinguish 7 types of anomalies, each with distinctive and variant characteristics. Today we’ll talk about one of the most common: Septate uterus.
The exact causes of a septate uterus aren’t known, nor do experts know how common it is. According to some estimates, up to 35% of uterine anomalies are explained by a septate uterus. The incidence may be higher, as it doesn’t always generate symptoms or complications in women. We’ll teach you in a simplified way what it is and the treatment options that are available.
The characteristics of a septate uterus
The term septate uterus refers to cases where there’s a membrane that’s in the middle of the uterus (called a septum) that divides the internal portion of it. This is a kind of band of fibrous and muscular tissue, and it can be both thick and thin. The deformity is characterized by the fact that the uterus is divided into two parts.
This anomaly shouldn’t be confused with a bicornuate uterus. Although cases have been reported in which both manifest at the same time, the truth is that they’re different uterine anomalies. There are three types of septate uteri:
- Partially septated uterus: When the division of the septum doesn’t reach the cervix
- Completely septated uterus: When the division of the septum reaches the cervix
- Septate uterus and vagina: When the division of the septum goes beyond the cervix and reaches the vagina
Importantly, the external contour of the uterus doesn’t develop clefts, a feature that distinguishes it from other uterine anomalies. In very simple terms, this anomaly divides the uterus into two parts separated by tissue.
This condition is also known as a uterine septum, and it’s most often diagnosed when a woman is trying to get pregnant or during a routine exam.
The symptoms of a septate uterus
A septate uterus doesn’t cause symptoms. Women can live decades without knowing they have this abnormality, and it isn’t until they try to get pregnant that any problems appear.
The main indication of a septate uterus (and of other uterine abnormalities in general) is recurrent miscarriages. When a specialist begins the process to find their causes, they find this uterine anomaly.
Outside of this, it usually doesn’t produce symptoms, although some women may have painful periods and pelvic pain.
These symptoms are rare, so most women won’t experience any signs of an abnormality in the uterine area. When both symptoms appear, the woman may not recognize them as such, as they’ve always had them.
The causes of a septate uterus
The causes of a septate uterus are unknown. The condition is present from birth, so it manifests itself during embryonic development. All uteri develop by means of two ducts (referred to as the Müllerian ducts) which eventually fuse to create a completely hollow cavity.
In women with this anomaly, the ducts fail to fuse correctly. Rather, they create a membrane of tissue in the middle of the uterus that divides it into two parts. It’s not a condition that can be prevented, as it’s present from birth. The exact catalysts that give rise to the anomaly haven’t been found either.
Treatment options
As a septate uterus is related to spontaneous miscarriages, premature labor, hemorrhagic complications after childbirth, and other major sequelae, when detected, it must be corrected.
Fortunately, this uterine anomaly can be resolved through an intervention known as hysteroscopic metroplasty. There are other alternatives available, but this is the most widely used in the clinical setting.
It’s an outpatient intervention that lasts approximately one hour. During the procedure, the septum is cut and removed from the uterus. As the septum can’t grow back, the uterus is completely hollow. This facilitates a healthy pregnancy and eliminates (if any) possible symptoms associated with the abnormality.
Specialists recommend a period of two months before trying to get pregnant after undergoing treatment. This time is meant for recovery, so it’s best to refrain from seeking to become pregnant. As with any uterine intervention, there’s a risk of infection and perforation of the uterus, although these complications are rare.
In summary, a septate uterus is a congenital anomaly that often interferes with a healthy pregnancy. It’s not characterized by symptoms, except for recurrent spontaneous abortions. There are several ways to approach it, and most women can become pregnant after the intervention. It’s one of the most common uterine anomalies that have been described so far.
- Chandler TM, Machan LS, Cooperberg PL, Harris AC, Chang SD. Mullerian duct anomalies: from diagnosis to intervention. Br J Radiol. 2009;82(984):1034-1042.
- Osazuwa H, Ejenobo D. Twin gestation in a septate bicornuate uterus. Case Rep Obstet Gynecol. 2012;2012:563085.
- Rousseau L, Brichant G, Timmermans M, Nisolle M, Tebache L. Daily practice management of septate uterus: reproductive outcome after septoplasty. Facts Views Vis Obgyn. 2021;13(3):253-259.