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Uterine Septum - How a Septate Uterus Affects Miscarriage / Pregnancy Loss Risk

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Updated December 11, 2007

Importance of a Septate Uterus:

Women with a septate uterus have a band of tissue called a septum running down the middle of their uteri. Septate uterus is a type of congenital uterine malformation that results from a problem in the formation of the woman's uterus during her own prenatal development.

A uterine septum increases the risk of miscarriages and can be a factor in recurrent miscarriages.

Septate Uterus and Miscarriages:

Typically, the septum is fibrous tissue without much of a blood supply. So pregnancies that implant on the septum are thought to be at higher risk of miscarrying because the placenta cannot develop properly and access nutrients.

Women with septate uteri who do not miscarry may be at increased risk for preterm labor and having a premature baby.

Odds of Miscarriage for a Woman With a Septate Uterus:

Different studies have found different figures, possibly due to the sensitivity of the technique used for diagnosis, but miscarriage rates in women with septate uteri seem to be somewhere between 25% to 47%.

Number of Women With a Septate Uterus:

Findings vary heavily, again possibly due to diagnosis technique, but anywhere from 8% to 23% of women with recurrent miscarriages may have some type of uterine malformation. About one-third of women with congenital uterine malformations have a septate uterus.

Septate Uterus Diagnosis:

Doctors can sometimes detect clues that a woman has a uterine septum by indicators on ultrasound, but usually the means of diagnosis is by a hysterosalpingogram (HSG) or a hysteroscopy. On an HSG, septate uterus can sometimes be misdiagnosed as a bicornuate uterus.

Septate Uterus Treatment:

Treatment is via surgery –- most commonly resection during a hysteroscopy.

Deciding Whether to Seek Treatment When You Have a Septate Uteri :

The decision to seek treatment is obviously a personal one, and having any type of surgery can be scary. Merely having a uterine septum does not impact a woman’s health most of the time except for increasing risk of miscarriage.

Getting surgery to correct a septate uterus does appear to improve chances for a successful pregnancy. Figures vary, but the most drastic was a study that found treatment of uterine septa improved positive outcomes (giving birth and infant survival) from 4.4% to 87.5%.

Sources:

Acien, Pedro. "Reproductive performance of women with uterine malformations." Human Reproduction 1993. 122-126. Accessed 4 Dec 2007.

Gaucherand, P., A. Awada, R.C. Rudigoz, and D. Dargent, "Obstetrical prognosis of the septate uterus: a plea for treatment of the septum." European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1994. 109-12. Accessed 4 Dec 2007.

Lin, Paul C. "Reproductive Outcomes in Women With Uterine Anomalies." Journal of Women's Health 2004. 33-39. Accessed 4 Dec 2007.

Raga, Francisco, Celia Bauset, Jose Remohi, Fernando Bonilla-Musoles, Carlos Simon and Antonio Pellicer. "Reproductive impact of congenital Mullerian anomalies." Human Reproduction 1997. 2277-2281. Accessed 4 Dec 2007.

Reuter, K.L., D.C. Daly and S.M. Cohen, "Septate versus bicornuate uteri: errors in imaging diagnosis." Radiology. 1989. 749-752. Accessed 4 Dec. 2007.

Salim, R., L. Regan, B. Woelfer, M. Backos, and D. Jurkovic. "A comparative study of the morphology of congenital uterine anomalies in women with and without a history of recurrent first trimester miscarriage." Human Reproduction 2003. 162-166. Accessed 4 Dec 2007.

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