Saddle uterus
A saddle—shaped uterus is a pathologically formed uterus, which is a variation of a two-horned uterus. With this defect, the bottom of the uterus is literally formed in the form of a saddle. There are various degrees of splitting of the uterus body into two horns, but in almost all cases, the shape of the uterus when cut visually resembles a saddle. The saddle-shaped uterus may not have any external manifestations, but it often makes itself felt during pregnancy in the form of complications such as discoordination and weakness of labor, premature birth, the threat of not bearing a fetus and postpartum bleeding. Often, the saddle-shaped uterus is combined with other developmental pathologies. The detection of the saddle uterus often occurs accidentally during routine ultrasound examination, NMRI, as well as hysteroscopy. With the threat of pregnancy failure, surgical correction of the uterus is recommended.
The content of the article:
Saddle uterus and conception
Saddle uterus and pregnancy
Causes of saddle uterus
Symptoms of the saddle uterus
Saddle – shaped uterus
The saddle-shaped uterus is considered not a very complex pathology of uterine development, and pregnancy prognoses are more often favorable. In a healthy woman, the uterus develops in the form of a pear, narrowed from below, and expanded from above.
The saddle—shaped uterus is a particular manifestation of a two-horned uterus. Bicorn and saddle-shaped uterus are very rare pathologies of uterine development, which occur in about 0.1% of women. The formation of a saddle-shaped uterus occurs approximately at 10-14 weeks of fetal development.
Saddle uterus and conception
The saddle-shaped uterus and conception do not always manifest themselves together in the best way. If there are problems with conception due to the development of the saddle uterus and if pregnancy is not carried, surgical treatment is indicated. Most often, there is no need to carry out radical interventions and the reconstruction of the uterus occurs without incisions, through natural pathways during hysteroscopy. After a successful operation, the chances of getting pregnant and giving birth to a healthy child increase significantly. Plastic surgery of the uterine cavity is the most optimal solution to the problem, so it is important for a woman with a saddle uterus to be psychologically prepared in advance.
Saddle uterus and pregnancy
Saddle-shaped uterus and pregnancy: if a woman managed to safely carry a child and normally produce offspring, then in the future there are no threats to the development of the fetus and the health of the mother, the main thing is to pass scheduled medical examinations and observations on time.
Pregnant women with a saddle-shaped uterus must be under medical supervision, regardless of the duration of pregnancy and should be hospitalized at the slightest suspicion.
If pregnancy complications occur, a patient with a saddle uterus should adhere to bed rest. From drug therapy, antispasmodic drugs, sedatives of plant origin, progestogens (dufaston, utrozhestan), essense forte, actovegin are prescribed.
The form of labor management in patients with saddle uterus should be discussed and determined in advance, it is worth conducting psychological training of the patient and explaining possible difficulties and options for completion.
Causes of saddle uterus
During the period of embryogenesis, the mesonephral ducts merge, which is the reason for the formation of the saddle uterus. During embryonic development, the uterine cavity is initially divided into two parts by the sagittal septum. This septum resolves by the time the fetus is born, so the two-horned uterus initially acquires a saddle-shaped shape, and then a normal, single-striped, pear-shaped shape. If by the time of the girl’s birth the process of uterine formation has not had time to complete, a malformation occurs, which is called a “saddle uterus”. Also characteristic of the saddle-shaped uterus is its expansion in diameter.
The causes of the development of the saddle uterus can serve as a variety of disruptive and damaging factors during pregnancy: endocrinopathy (diabetes mellitus, thyrotoxicosis), stress, vitamin deficiency, heart defects, maternal intoxication (chemical, medicinal, narcotic, alcoholic, nicotine), radiation.
Infectious diseases are considered particularly dangerous for the fetus — rubella, measles, syphilis, influenza, toxoplasmosis and others. Also, pregnant women suffering from prolonged toxicosis, which can cause chronic fetal hypoxia, fall into the risk factor of carrying a fetus with this pathology.
Many women, after hearing this diagnosis, decide that this is a verdict, but do not panic, first you need to understand the very essence and definition of the diagnosis. The severity depends on the amount of deformation of the uterus body.
Symptoms of the saddle uterus
A woman may not even suspect the presence of a saddle uterus until she becomes pregnant. If the deformity of the uterus is not significant, complications during pregnancy and childbirth may not occur.
With pronounced changes in the uterus, there is a risk of developing placental pathology (premature detachment accompanied by bleeding, low or lateral placenta placement, placenta previa), pelvic or transverse fetal presentation, premature birth.
During childbirth, the saddle-shaped uterus often causes abnormal labor activity: discoordination and weakness. Often, in the presence of a saddle—shaped uterus during childbirth, it is necessary to resort to radical methods of delivery – cesarean section.
If a pregnant woman is not monitored at the proper level, the risk of perinatal mortality may increase. If the uterus is very badly deformed, women may be diagnosed with primary infertility.
The main methods of diagnosis of the saddle uterus are instrumental studies: ultrasound diagnostics, hysteroscopy, magnetic resonance imaging, hysterosalpingography, ultrasound examination. The use of a standard gynaecological examination with a saddle uterus will not be effective.
It is not always possible to identify a saddle-shaped uterus during pelvic echography. If the deformation of the uterus is significant, at the time of transverse scanning, it is possible to determine the thickening of the muscular layer of the uterine fundus to 10-14 mm, its protrusion into the uterine cavity, as well as an increase in the width of the uterine fundus to 68 mm. It is better to determine the saddle uterus by ultrasound in the second phase of the pregnancy cycle, using a vaginal sensor.
Hysterosalpingography is the most reliable method of diagnosing the saddle uterus: in the pictures in the area of the uterine fundus, a depression that flows into the uterine cavity, similar to a saddle, is clearly visible, and two mouths are visible in the fallopian tubes. The same signs are observed during magnetic resonance imaging.
During pregnancy, women with a saddle uterus undergo dopplerography of uteroplacental blood flow, phonocardiography and fetal cardiography.
Even without a medical education, after seeing pictures from various diagnostic methods, you can see a drawing in the shape of a saddle.
