SEPTATE UTERUS (Part 1)

A typical uterus is shaped like an upside-down pear and has one hollow cavity. A septate uterus, on the other hand, consists of two smaller cavities rather than one.

A septate uterus is a congenital abnormality where the uterus is divided into two separate cavities by a muscular or fibrous wall called the septum. The septum is a membrane that runs down the middle of the uterus, splitting it into two parts. This membrane can vary in thickness and length. It can start at the top of your uterus and extend to the cervix (bottom of the uterus) and occasionally to the vagina.

A septate uterus is a relatively common uterine anomaly that accounts for between 35% and 90% of all congenital uterine irregularities. Congenital uterine anomalies affect 4% of all women who have uterus and occur when the uterus fails to fully form because the septum does not reabsorb properly. As a result, women with a septate uterus may have a uterine cavity that is divided into two smaller chambers.

Although a septate uterus usually does not interfere with periods, it can occasionally cause pain during the menstrual period. One might not be aware that having that much pain during menstrual period is unusual as this condition has existed since birth.

TYPES OF SEPTATE UTERUS

A septate uterus is a type of uterus that is divided into two or more compartments by septa, which are thin walls of tissue. There are several types of septate uteri, including:

• Double Uterus – In this type of septate uterus, there are two separate uterine cavities, each with its own cervix and fallopian tubes. The septa are usually located in the middle of the uterus and may be incomplete, allowing for the possibility of menstrual flow and pregnancy in both cavities.
• Septate Uterus with Unicornuate Horn – In this type of septate uterus, there is a single uterine cavity with a septum that divides the cavity into two compartments. One compartment is usually much larger than the other and may have a cervix and fallopian tube, while the other compartment may not.
• Bicornuate Uterus – In this type of septate uterus, there are two uterine cavities that are completely separated from each other by a septum. Each cavity has its own cervix and fallopian tubes.

CAUSES OF SEPTATE UTERUS

The precise cause of a septate uterus is still unknown but abnormal embryological development is thought to be the likely cause. Although it can happen at random, there is evidence that suggests it might also have a genetic component. This condition may be more likely to develop if certain risk factors, like a family history of septate uterus or other uterine abnormalities, are present.

In normal embryonic development, there are two ducts called the Mullerian ducts that combine to form a single uterine cavity in a typical uterus. In a septate uterus, the ducts did not fuse together instead a tissue membrane was made to run down the center of the uterus. The septum, which divides the uterus into two parts, is this membrane.

Septate uterus can occur due to a variety of factors, including:

• Congenital abnormalities – Some women may be born with a septate uterus due to genetic or developmental issues during fetal development.
• Infections – Certain infections, such as endometritis or pelvic inflammatory disease, can cause the uterus to become septate.
• Injury or trauma – A severe injury or trauma to the uterus, such as a fall or a car accident, can cause a septate uterus.
• Surgical complications – Complications from surgical procedures, such as a cesarean section or a hysterectomy, can sometimes result in a septate uterus.

SYMPTOMS OF SEPTATE UTERUS

The symptoms of a septate uterus can vary depending on the severity of the condition and the location of the septum. Some common symptoms include:

• Abnormal bleeding – Women with a septate uterus may experience abnormal bleeding, such as heavy menstrual bleeding, irregular periods, or spotting.
• Infertility – The septum can block the fallopian tubes and prevent the sperm from reaching the egg, making it difficult to get pregnant.
• Painful periods – Women with a septate uterus may experience more painful periods due to the abnormal shape of the uterus.
• Difficulty with pregnancy – A septate uterus can increase the risk of miscarriage, preterm labor, and other complications during pregnancy.
• Abdominal pain – Some women with a septate uterus may experience abdominal pain, especially during menstruation.

SEPTATE UTERUS AND FERTILITY

Septate uterus is a rare condition that can affect fertility, as it can reduce the space available for a fertilized egg to implant and develop. It can cause miscarriages due to the following reasons:

• Abnormal placental implantation – A septate uterus can lead to an abnormal implantation of the placenta, which can disrupt the normal development of the fetus and increase the risk of miscarriage.
• Increased risk of infection – The septum in the uterus can provide a site for bacteria to grow and increase the risk of infection, which can lead to pregnancy complications and miscarriage .……………………………………………….………TO BE CONTINUED