What are the clinical manifestations of uterine septum?

Uterine septum is commonly caused by impaired fusion of the paired paramesonephric (Müllerian) ducts during embryonic development. Its specific clinical manifestations include:

① Recurrent spontaneous abortion

Recurrent spontaneous abortion is frequently associated with uterine malformations, among which uterine septum is the most common type. The incidence of uterine septum is notably high among women experiencing recurrent pregnancy loss—particularly early pregnancy loss.

② Ectopic pregnancy

Due to the complexity of uterine anomalies, ectopic pregnancies may occur in atypical locations such as an occluded uterine horn, a rudimentary uterine horn, the cervix, or vaginal diverticula. Because these sites are rare, pregnancies occurring in such unusual locations are often difficult to diagnose promptly.

③ Abnormal labor and delivery

The presence of a uterine septum causes uterine cavity deformation, thereby increasing the risk of complications in late pregnancy. Uterine malformations may also lead to obstetric complications including abnormal fetal presentation, dysfunctional uterine contractions, and retained placenta.

④ Menstrual disorders

In patients with a large uterine septum, menstrual flow is significantly increased, menses are prolonged, and irregular vaginal bleeding may occur.