A uterine septum is an abnormal structure in the uterus that can increase the risk of miscarriage during pregnancy. It is formed during embryonic development and may cause no problems unless a patient is trying to conceive. Medical imaging can reveal the size of the septum, and surgery may be recommended for patients experiencing recurring pregnancy loss. The odds of having a uterine septum are unknown, and patients may want to seek advice from an experienced obstetrician.
A uterine septum is an abnormal structure that partially or completely runs through the center of the uterus. A patient with this abnormality is said to have a septate uterus. Patients usually do not have any problems with the uterine septum unless they are trying to get pregnant, when the structure can increase the risk of miscarriage in some patients. It is possible to become pregnant with a septate uterus and carry the baby to term, and the success of a pregnancy can vary depending on a number of factors, including the precise size and location of the septum.
In the process of embryonic development, the uterus is formed from two structures known as the Müllerian ducts. During healthy embryonic development, the structures fuse and the septum dissolves, starting at the base of the uterus and moving up. In some people, for unknown reasons, the septum doesn’t dissolve. It may partially disappear, causing the uterus to assume a characteristic heart shape, or it may remain in place, leaving the woman with two uteri and a matching set of cervices.
Patients with a uterine septum have a small chance of also having kidney abnormalities. The patient may only have one kidney, which may not be a problem unless the patient’s kidney function is strained. Other patients have skeletal problems in association with the uterine septum. In most cases, all of these problems go unnoticed until a patient receives ultrasound tests during a pregnancy or a fertility evaluation to find out why she is not pregnant.
Medical imaging studies can reveal the uterine septum and provide insight into its size. If the septum doesn’t seem to be interfering with your pregnancy, a doctor will usually recommend leaving it in place. For patients experiencing recurring pregnancy loss due to the structure, the doctor may recommend surgery to remove the septum. In this operation, the doctor will take care of removing the septum without compromising the nearby structures. The patient will need to make a full recovery before attempting pregnancy.
The odds of having a uterine septum are not known, because this structure is only identified and studied when it becomes a problem. It can be present in many members of the general population who are unaware of it. Patients diagnosed with a septum may want to consider meeting with an obstetrician or obstetrician who has extensive experience with a septate uterus to get advice on how to manage the problem.
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