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.

Clinical manifestations include:

① Recurrent pregnancy loss

Recurrent pregnancy loss is frequently associated with uterine malformations, among which uterine septum is the most common. The prevalence of uterine septum is notably high among women experiencing recurrent pregnancy failure—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, rudimentary uterine horn, cervical or vaginal diverticulum. Because these sites are rare, pregnancies occurring in such unusual locations are often difficult to diagnose early.

③ Abnormal labor and delivery

The presence of a uterine septum causes uterine cavity distortion, 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.