Partial septate uterus

Partial septate uterus (also known as subseptate uterus or incomplete septate uterus) is a congenital uterine anomaly classified under Müllerian duct anomalies. It occurs when the fibrous or muscular septum that normally resorbs during embryonic development of the uterus is only partially retained, creating an incomplete partition within the uterine cavity. Unlike a complete septate uterus where the septum extends to the cervix, in a partial septate uterus the septum only partially divides the uterine cavity, typically extending from the fundus partway toward the cervix. The external contour of the uterus typically appears normal, which distinguishes it from a bicornuate uterus. This condition primarily affects the female reproductive system. Many women with a partial septate uterus are asymptomatic and may remain undiagnosed unless they undergo imaging for other reasons. However, the septum can be associated with significant reproductive complications including recurrent pregnancy loss (miscarriage), preterm delivery, malpresentation of the fetus, and infertility. The septum is thought to have a poor blood supply, which may impair embryo implantation and placental development, contributing to adverse pregnancy outcomes. Some women may also experience dysmenorrhea (painful periods) or abnormal uterine bleeding. Diagnosis is typically made through imaging modalities such as three-dimensional transvaginal ultrasound, saline infusion sonohysterography, hysterosalpingography, or magnetic resonance imaging (MRI). Hysteroscopic metroplasty (surgical resection of the septum via hysteroscopy) is the standard treatment for symptomatic patients, particularly those with a history of recurrent pregnancy loss or infertility. This minimally invasive procedure has been associated with improved reproductive outcomes in many cases, though the benefit of prophylactic septum resection in asymptomatic women remains debated. No medical (pharmacological) therapy exists for correcting the anatomical anomaly itself.

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