What Effect Will a Partial Uterine Septum Have?

Jane Foley's picture

QUESTION

Dear Ms Ultrasound,
I just had my 7½ week ultrasound today. I was told I have a uterine septum, I think she said a partial one. I don't think the baby has implanted on the septum.

Will the partial septum cause any problems with the rest of the pregnancy or delivery? I have had a blighted ovum and missed abortion in the past.

Thank you in advance for any information you are able to give to me.

ANSWER

Hello, What it sounds like you are describing is a bicornuate uterus. This usually means your uterus has two horns and one cervix. If you sat with a piece of paper and drew hearts, with different degrees of depth to the middle line that separates each side, you would be simulating a bicornuate uterus.There are numerous classifications of a bicornutate uterus, from a slightly heart shaped uterus to two separate uterus, two cervix and two vagina. When this diagnosis is made the sonographer, should always remember to look at both of Mom's kidneys. There is a risk you were born with only one kidney with a bicornuate uterus (you can live fine with only one kidney, so don't worry about that).Problems can sometimes arise when the two horns are quite separate and asymetrical. If the pregnancy decides to implant into the smaller horn this may cause a problem although the statistics do show that problems with pregnancy are rare.

As the pregnancy grows the two horns are difficult to even identify, and the pregnancy usually goes on to full term.

-- Jane, RDMS

Comments

melloyellochelle's picture

While part of the response is completely true, another part is misleading.

But quickly I will say this. There are multiple forms of uterine anomalies. One type is a bicornuate uterus and another is a septate uterus. The difference is in the outer and inner formation of the uterus. A bicornuate uterus is shaped like a heart (which the response described accurately - varying degrees and shapes of the horns). The entire uterus is shaped this way and it does not have a septum (or wall) in the inner part of the uterus. Most BU pregnancies are successful.

On the other hand, a septate uterus has a regular shape on the outside but has a wall (again, of varying degrees) that cuts the inner part of the uterus into sides. The septum does not get adequate blood supply to support a pregnancy if attached on the septum - thus being difficult to carry a baby to full term. The septum can be removed and allow for successful pregnancies thereafter.

From what I understand, these two anomalies can be found together in one uterus, although it is rare.

Again, there are other forms of uterine anomalies that I won't get into here.

Pregnant women who have these anomalies (known as Mullerian Anomalies - NOT Bicornuate Uterus) should be seen by high risk doctors as they are at risk of Incompetent Cervix, Intrauterine growth restriction, preterm labor, and breech presentation.

I hope this helps and I hope more women (and specialists and doctors!!!) will become aware of these major difference as they do make a huge difference for those of us who have such uterine anomalies.

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