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Septate Uterus

What is a septate uterus?
A septate uterus may be diagnosed during a routine gynecological exam. However, sometime a septate uterus is not discovered until after a woman experiences reproductive problems. Infertility is occasionally a problem in women with a septate uterus, but miscarriage is the most frequent complaint. Miscarriage most commonly occurs in the first trimester and is thought to be related to inadequate blood supply to the uterine wall at the site where the fetus is growing. However, metroplasty is highly successful in restoring reproductive function to women with a septate uterus. The clinical literature shows that approximately 80% of women who have undergone surgery to remove the septum and reshape the uterus have successfully carried a pregnancy to term. Surgical removal of the septum also allows for more comfortable intercourse. Correction of a septate uterus is not necessary if a woman does not wish to have children or if the condition does not cause problems during pregnancy. A woman may in fact wish to wait and see what happens during conception before deciding on surgery.

Diagnostic procedures 
If a woman experiences repeated first semester miscarriage, the physician may use the following techniques to identify a septate uterus:

  • Bimanual exam (routinely performed during a pelvic exam)
  • Ultrasound 
  • Hysterosalpingogram 
  • MRI

Treatment Correction of a septate uterus involves: Surgically excising the septum dividing the uterus via metroplasty. The procedure can be performed either hysteroscopically or through an abdominal incision (laparotomy). Hysteroscopy is associated with a shorter recovery time and a lower incidence of adhesion formation. Estrogen may be prescribed post-operatively. Special obstetrical measures such as delivery via a caesarian section are not usually necessary following a hysteroscopic metroplasty.

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