WHAT IS A UTERINE SEPTUM?
A uterine septum is a form of a congenital malformation where the uterine cavity is partitioned by a longitudinal septum; the outside of the uterus has a normal typical shape. The wedge-like partition may involve only the superior part of the cavity resulting in an incomplete septum or a subseptate uterus, or less frequently the total length of the cavity (complete septum) and the cervix resulting in a double cervix. The septation may also continue caudally into the vagina resulting in a double vagina.
WHAT COULD BE THE SYMPTOMS?
The condition may/maynot result in infertility,thus normal pregnancies may occur.[2] However, it is associated with a higher risk for miscarriage , premature birth and malpresentation.
The condition is also associated with abnormalities of the renal system. Further, skeletal abnormalities have been linked to the condition
HOW IS IT DIAGNOSED?
A pelvic examination may reveal a double vagina or double cervix that should be further investigated and may lead to the discovery of a uterine septum. In most patients, however, the pelvic examination is normal. Investigations are usually prompted on the basis of reproductive problems.
Helpful techniques to investigate a septum are transvaginal ultrasonography and sonohysterography, MRI, and hysteroscopy. LAPAROSCOPY AIDS TO THE DIAGNOSIS More recently 3-D ultrasonography has been advocated as an excellent non-invasive method to delineate the condition.[4] Prior to modern imaging hysterosalpingography was used to help diagnose the uterine septum, HOWEVER hysteroscopy remains the gold standard.
WHY IS hysteroscopy PERFORMED?
Common reasons for undergoing a hysteroscopy include the assessment of heavy periods, abnormal vaginal bleeding, post-menopausal bleeding, fibroids, polyps, or as part of the assessment of fertility. ombined with a curettage, which samples the lining of the uterus,OR TO diagnose or treat a uterine septum
Why is hysteroscopic septal resection done?
Hysteroscopic septum resection is accompanied by a significant improvement in the reproductive performance of the patients. There is no adverse effect in the achievement of pregnancy in women with a history of recurrent abortions. Septate uterus does not seem to be an infertility factor, although it may contribute to the delayed natural conception of patients with secondary infertility. Patients with septate uterus and infertility should be treated mainly for the improvement of their reproductive performance.
HOW IS IT TREATED?
Hysteroscopic removal of a uterine septum is generally the preferred method, as the intervention is relatively minor and safe in experienced hands.
What should I expect after the procedure?
You will stay in the recovery room within the operation theatre after the operation while you wake up from your anaesthetic.
You will then be transferred in your bed to the Day Procedure Unit.
You will be given pain relief as needed.
You should be eating and drinking normally, and be mobilising.
What are the after care tips?
You should be able to return to work the following day, but may require more time off work depending on the procedure performed.
You may continue to have spotting lightly for 3-4 days after the procedure.
It is important for you to shower rather than bath.
It is important for you to use sanitary pads and not tampons.
What to avoid ?
Intercourse, taking a bath, using tampons and swimming for two weeks.
When to contact the doctor?
HOW COMMON IS SEPTUM?
in about 15% of patients with recurrent pregnancy loss anatomical problems are thought to be causative with the septate uterus as the most common finding.
HOW DOES IT CAUSE PROBLEM ?
One often undetected cause of female infertility and recurrent miscarriage is a uterine septum. This uterine abnormality, present from birth, essentially divides the uterus in half, hindering a woman's chances for successful implantation of an embryo and carrying a baby to term.
HOW FAR IS IT SUCCESSFUL IN ACHIEVING PREGNANCY?
One often undetected cause of female infertility and recurrent miscarriage is a uterine septum. This uterine abnormality, present from birth, essentially divides the uterus in half, hindering a woman's chances for successful implantation of an embryo and carrying a baby to term.
What can I expect after the procedure?-spotting/abdominal cramps?Will I have to stay in the hospital overnight?
There is a high success rate for improving pregnancy chances after uterine septum surgery 75-80%.
Hysteroscopic surgery is relatively painless and recovery time is short.
Successful uterine septum surgery WIDENS UPTO top of the uterus to restore a normal shape and function.
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