Laura Miller MD

The Common Vein Copyright 2010

Definition

Septate uterus is a congenital anomaly of the uterus caused by incomplete regression of the uterine septum after fusion of the mullerian ducts in embryonic development.

The result is a normal sized uterine cavity divided by a septum.

The structural change is characterized by a septum, composed primarily of fibrous tissue, extending from the uterine fundus and dividing the uterine cavity. These septa vary in length and thickness.

The functional change varies depending on the degree of septation. Significant fibrous septa usually lack an adequate blood supply to support placental development early in pregnancy.

As a result, women present clinically with infertility or repeated loss of pregnancy in the first trimester. Imaging modalities used to evaluate uterine abnormalities include sonohysterography, hysterosalpingography, and MRI. MRI is useful as it allows for differentiation of septate and bicornuate uterus, as wells as concurrent evaluation of the urinary tract.

Diagnosis is made with these imaging studies, combined with laparoscopy if necessary.

Treatment is recommended for women with recurrent pregnancy loss and consists of hysteroscopic resection of the septum.

 

Septate Angle of divergence <75 degrees incomplete

 

Reference  Web

Images of Arcuate  bicornuate  DES septate didelphys from Zurich Foundation