Septate uterus

A septate uterus is a congenital uterine anomaly in which a fibrous or muscular wall (septum) partially or completely divides the uterine cavity into two sections. It is classified as a Müllerian duct anomaly and results from incomplete resorption of the medial septum during embryonic development, when the two Müllerian (paramesonephric) ducts fuse to form the uterus. The external contour of the uterus typically appears normal, which distinguishes it from a bicornuate uterus. A septate uterus is considered the most common congenital uterine malformation. Many individuals with a septate uterus are asymptomatic and may remain undiagnosed until they experience reproductive difficulties. Key clinical features include recurrent pregnancy loss (particularly in the first and second trimesters), preterm delivery, malpresentation of the fetus, and infertility. The septum has a relatively poor blood supply compared to normal endometrium, which may impair embryo implantation and placental development, contributing to adverse pregnancy outcomes. Some patients may also experience dysmenorrhea (painful menstruation) or abnormal uterine bleeding. Diagnosis is typically made through imaging studies such as three-dimensional transvaginal ultrasound, magnetic resonance imaging (MRI), or saline infusion sonohysterography. Hysteroscopy combined with laparoscopy has historically been used for definitive diagnosis. The primary treatment for symptomatic patients or those with a history of reproductive failure is hysteroscopic metroplasty (surgical resection of the septum), which is a minimally invasive procedure that has been associated with improved pregnancy outcomes in many studies. However, recent evidence has prompted debate regarding the benefit of septum resection in women without prior pregnancy loss, and clinical guidelines continue to evolve on this topic.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Septate uterus