Risks of Uterine Septum

Jul 05, 2022 Source: Cainiu Health

Dr. Chong Yiwen

Introduction

The harm caused by a septate uterus includes: due to the presence of this uterine abnormality, women may experience recurrent miscarriages. The septum within the uterus can lead to insufficient blood supply to the placenta, resulting in poor fetal development. There is an increased risk of ectopic pregnancy, particularly tubal pregnancy. When the fertilized egg reaches the uterus, it tends to implant on the protruding areas within the uterine cavity, preventing normal implantation and ultimately leading to infertility associated with a septate uterus.

The uterus is the optimal environment for fetal development. However, in real life, many pregnant women experience preterm birth or miscarriage. Even when they take great care of their health and have not experienced any abdominal trauma, such issues may stem from underlying personal factors—most likely due to a septate uterus. So, what are the risks associated with a septate uterus?

① Recurrent miscarriages

Due to the presence of an abnormally shaped uterus, women may suffer recurrent miscarriages. A septate uterus is one type of uterine malformation and therefore can significantly impact fertility.

② Poor fetal development

Because the endometrium within the septum develops poorly, the placenta in this area may not receive adequate blood supply, impairing normal fetal growth and development. This increases the risk of complications such as fetal demise or intrauterine fetal death.

③ Ectopic pregnancy

The septum tissue can interfere with normal implantation of the fertilized egg, potentially causing sperm or the embryo to travel backward into the fallopian tubes, leading to ectopic pregnancy. Given the complex structure of partial uterine septa, ectopic pregnancies often occur in hard-to-detect locations such as the blocked uterine cornua or cervix.

④ Infertility

Since the septum forms a protrusion inside the uterus, when a fertilized egg reaches the uterine cavity, it may implant on this septal tissue, preventing normal conception and ultimately resulting in infertility caused by a septate uterus.

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Is the chance of pregnancy with a uterine septum very low?

The pregnancy rate associated with a uterine septum is relatively low. Even with successful conception, there is a higher risk of complications such as miscarriage, preterm birth, breech presentation, premature rupture of membranes, placenta previa, postpartum hemorrhage, and intrauterine fetal growth restriction. The pregnancy rate among women with a uterine septum ranges from 17% to 35%. With advances in medical science, the pregnancy rate following surgical correction of a uterine septum has increased to approximately 48%.

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Can a painless abortion be performed for a septate uterus?

Women with a uterine septum can undergo painless abortion. A uterine septum is a cause of female infertility or recurrent miscarriage. If a woman has this condition, she should choose an appropriate abortion procedure after becoming pregnant. The endometrium will sustain some damage after an abortion, so women are advised to abstain from sexual activity during this period.

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What should I do if a uterine septum is detected?

The solutions for uterine septum include cold scissors division under hysteroscopy and laparoscopy, hysteroscopic cold instrumentation, and plasma needle treatment. The cold scissors division technique under hysteroscopy and laparoscopy involves minimal bleeding, causes less trauma, results in a shorter recovery time, and is less likely to cause adhesions. For larger septa, complete correction in a single procedure is not required, and multiple surgeries may be performed.

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What does abnormal fetal position mean?

Abnormal fetal position refers to a situation where the position of the fetus within the uterus does not conform to the normal presentation for delivery. The normal fetal position is cephalic presentation, meaning the fetal head is downward with the occiput near the anterior part of the maternal pelvis. Abnormal fetal positions include breech presentation, transverse lie, oblique lie, and others. Abnormal fetal positioning may occur due to uterine developmental abnormalities, such as uterine malformations or uterine septum, which affect the fetus's normal movement within the uterus.