Septate uterus is the most common

 congenital uterine anomaly and results from incomplete resorption of the Müllerian ducts during embryological development.

It is characterized by a fibrous or fibromuscular septum partially or completely dividing the endometrial cavity, while the external uterine contour usually remains normal.

Clinically, septate uterus has been associated with:

• recurrent pregnancy loss

• implantation failure

• infertility in selected cases

• preterm birth

• malpresentation

• adverse reproductive outcomes

However, reproductive prognosis varies significantly depending on:

• septum size and extent

• vascularity of the septal tissue

• associated anomalies

• and individual reproductive history

Accurate diagnosis is essential.

2D ultrasound alone may sometimes overdiagnose septate uterus, particularly in:

• early pregnancy

• arcuate uterus

• retroverted uterus

• or asymmetric cavity distortion

3D transvaginal ultrasound remains one of the most reliable noninvasive diagnostic modalities for differentiating septate uterus from other Müllerian anomalies.

Management should always be individualized.

Hysteroscopic septum resection may improve reproductive outcomes in selected patients, particularly those with recurrent pregnancy loss or adverse reproductive history.

A uterine anomaly should be evaluated carefully  not feared automatically.

Dr Rabab Cares 

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