Intrauterine septum
Nowadays, many women suffer from various pathologies of the uterus, which often lead to a violation of reproductive function. One of the most common pathologies, which occurs in 48-55% of cases, is the presence of an intrauterine septum. This anomaly is characterized by the presence of two halves in the uterus, which are separated by a septum. If we talk about the total number of women who suffer from this defect, then this is 2-3% of the entire female population.
The content of the article:
Causes of intrauterine septum development
Symptoms of intrauterine septum
Diagnosis of the intrauterine septum
Treatment of intrauterine septum
Prognosis after removal of the intrauterine septum
Intrauterine septum
The intrauterine septum can have different lengths, and therefore there is a division into a full and incomplete intrauterine septum. It is worth noting that the complete intrauterine septum reaches the cervical canal, in some cases the septum reaches the vagina. But this species is very rare. The second type occupies only part of the cavity, the length of such a partition varies from 1 to 4 cm. However, even an incomplete intrauterine septum can provoke infertility.
The intrauterine septum is quite dangerous, because it can provoke the development of many diseases, and most importantly, deprive a woman of the opportunity to carry and give birth to a child. If you have been diagnosed with an intrauterine septum, it is necessary to start treatment immediately, the development of pathology is very dangerous.
Causes of intrauterine septum development
How does an intrauterine septum arise? The uterus is formed by the Muller ducts. As a result of the natural process, which is characteristic of the 19th-20th week of gestation, the median septum resolves, a single uterine cavity is formed. If this does not happen, the median partition is preserved.
Also, an intrauterine septum may occur for the following reasons:
infectious diseases of the mother (rubella, measles, toxoplasmosis, etc.);
heredity;
medical effects;
severe toxicosis during pregnancy;
severe endocrine diseases of the mother (diabetes mellitus, etc.);
onizing radiation;
poor nutrition;
bad habits.
Quite often, the intrauterine septum may not manifest itself for a long time. That is why women often learn about this pathology through random diagnosis.
Symptoms of intrauterine septum
The intrauterine septum is accompanied by nonspecific symptoms, which are manifested individually in each case. First of all, it is worth highlighting menstrual cycle disorders by the type of pathological uterine bleeding.
Also, the deviation may manifest itself with the help of other symptoms:
primary amenorrhea;
infertility;
dysmenorrhea;
premature birth;
spontaneous miscarriages.
A woman who has been found to have an intrauterine septum risks not carrying a child, even if she has already managed to get pregnant. In the first trimester of pregnancy, the risk of miscarriage is 30-60%, in the second it decreases by only 5%. In addition, the intrauterine septum during pregnancy often leads to premature birth.
It is also possible to distinguish a violation of the contractile abilities of the uterus and the incorrect position of the fetus. Along with this, the physiological process of pregnancy will change.
Thus, the intrauterine septum has a negative effect on the body during pregnancy, due to the following factors:
isthmic-cervical insufficiency;
embryo implantation on the septum;
insufficient volume of the uterine cavity (the fetus cannot develop freely).
Incomplete intrauterine septum during pregnancy is not so dangerous. But this anomaly can provoke bleeding, algodismenorrhea, inability to conceive or carry a child.
In any case, doctors assure that even an intrauterine septum will not prevent a woman from carrying and giving birth to a completely healthy child. However, pregnancy will be more complicated, which every patient should understand.
Diagnosis of the intrauterine septum
It should be understood that the diagnosis will reveal the features, stage and complexity of the course of the disease. Modern medicine offers various research methods that make it possible to diagnose such pathology as the intrauterine septum. Let’s take a closer look at this process.
Hysterosalpingography. In relation to this method, the opinions of experts differ somewhat. Hysterosalpingography will allow you to examine only the internal contours of the uterine cavity. External contours are not taken into account. The patient can be recognized as healthy, although this does not guarantee that she does not have any varieties of uterine defects. Therefore, hysterosalpingography is not always able to detect such an anomaly as an intrauterine septum.
Ultrasound examination. In most cases, ultrasound coincides with the period of pregnancy, so women learn about the presence of such a disease as an intrauterine septum during pregnancy. But ultrasound does not always help to identify the septa in the uterus. On the echogram, the septum is defined as a thin-walled structure having an anterior-posterior direction. The best result is given by hydrosonography, with the help of which it is possible to understand whether a woman has an intrauterine septum. Currently, ultrasonic devices have begun to be used, which allow you to display an image in three-dimensional form. This method allows you to identify the partition with a 95% probability. If fears have been confirmed that the patient has an intrauterine septum, then doctors prescribe another examination of the kidneys and liver.
Endoscopic research methods. A more accurate result can be obtained with a combination of hysteroscopy and laparoscopy. The fact is that the results of hysteroscopy give an identical picture both with a septum in the uterus and with a two-horned uterus. In turn, laparoscopy will allow you to more accurately determine the nature of the uterine defect. In addition, when the septum is excised, laparoscopy allows you to control the course of hysteroscopy.
Magnetic resonance imaging and X-ray computed spiral tomography are also practiced. These methods make it possible to make a more accurate diagnosis if an intrauterine septum was initially detected.
Treatment of intrauterine septum
According to many experts, the intrauterine septum should be surgically removed immediately after the detection of violations of the functions of childbirth. According to other experts, the patient should plan the excision of the septum in advance so that complications do not arise.
Modern medicine suggests fighting the intrauterine septum using a transcervical dissection under the control of a hysteroscope. A thin septum is dissected with endoscopic scissors, a wide, thick, vascularized one is dissected with a hysteroresectoscope. A laser is also used, with which it is easy to dissect the intrauterine septum.
Prognosis after removal of the intrauterine septum
As practice shows, the intrauterine septum is best removed using the excision method, which is the most gentle and low-traumatic among all operations, after it scars do not form and the possibility (by 70-85%) of a natural outcome of childbirth increases. But in some cases, complications may occur that cause infertility. In any case, only a specialist can prescribe the most appropriate method of treatment.
