Septate Uterus

A septate uterus is when your uterus is divided into two parts by a membrane called a septum. A typical uterus is one hollow or open space. With a septate uterus, your uterus has two smaller spaces instead of one. The septum acts as a wall or barrier. This condition is sometimes called a uterine septum.

You may not know you have this type of uterus until you’re pregnant or trying to get pregnant. If you have a septate uterus, it’s still possible to have a healthy pregnancy and delivery.

A septate uterus is rare, but it’s one of the more common uterine abnormalities. Uterine septum affects about 1.5 in 100 women.

Symptoms of a septate uterus

You usually don’t have symptoms of a septate uterus. Your healthcare provider sometimes finds it while they’re investigating the cause of repeat miscarriage or infertility.

Septate uterus causes

A septate uterus is congenital (something you’re born with). It happens during fetal development. Instead of forming one open uterus, a tissue wall (called a septum) stays in the middle, dividing the uterus into two parts. A septum can vary in size and length.

There’s nothing you can do to prevent having a septate uterus. And there isn’t any evidence that a septate uterus is genetic.

How does it affect periods?

A septate uterus shouldn’t affect your period.

Complications of uterine septum

A septate uterus usually doesn’t cause health problems. During pregnancy, it may lead to certain risks, like:

• Miscarriage (especially in the first or second trimester)
• Preterm birth
• Low birth weight
• Preterm labor
• Baby being breech
• Needing a C-section delivery

You may also be at a higher risk for endometriosis.

How doctors diagnose septate uterus

A healthcare provider will usually start with a pelvic exam. But unless the septum extends into your vagina, it won’t give them enough information. Instead, your provider will use imaging tests to clearly see the septum — its size, thickness and location.

Your healthcare provider may use any of the following:

• Ultrasound
• MRI
• Hysteroscopy

After that, they may classify your septate uterus as:

• Complete septate uterus: This is when the septum runs the entire length of your uterus and includes your cervix. In some cases, it can also extend down into your vagina.
• Partial septate uterus: This is when the septum doesn’t reach your cervix. This type is less severe than a complete septate uterus.

How is it treated?

Uterine septum doesn’t always need treatment. It depends on your symptoms, pregnancy history and plans for pregnancy.

Surgery is the only way to fix a septate uterus. The surgery involves removing the septum. Once this happens, your uterus is one open space (like a typical uterus).

A procedure called hysteroscopic metroplasty is the most common treatment. It’s an outpatient procedure that takes about an hour. You’re asleep for surgery under anesthesia. The steps are:

1. Your surgeon inserts a thin, lighted tube called a hysteroscope through your vagina and cervix. This allows them to see the inside of your uterus.
2. They use a saline solution to expand your uterus.
3. They place surgical tools through the hysteroscope. They make cuts in the septum to remove it.
4. You’re taken to a recovery room where your healthcare provider monitors you until you’re able to go home.

What are the complications of treatment?

The risks associated with removing the septum include:

• Abnormal vaginal bleeding
• Infection
• A hole in your uterus
• Damage to your cervix

Can you get pregnant after your septate uterus is fixed?

Yes, you can get pregnant after. One study found that 47% of women got pregnant within one year of surgery. Most healthcare providers will recommend at least two months to recover from surgery before trying to conceive.

Can a septate uterus grow back?

No, a septate uterus can’t grow back.

When should I see my healthcare provider?

If you’re pregnant and have a septate uterus, it’s important to contact your healthcare provider if you experience any of the following:

• Contractions
• Your water breaks
• Vaginal bleeding

If you’re not pregnant, the chances of having health complications are rare. Talk to your healthcare provider about any signs or symptoms you should watch for.

What questions should I ask my doctor?

If you have a septate uterus, it’s normal to have questions. Some questions you might ask your provider are:

• Am I still able to have a healthy pregnancy?
• What are my chances of miscarriage?
• Should I have surgery to correct my septate uterus?
• What are my chances of having a successful pregnancy after treatment?

How hard is it to get pregnant?

Having a septate uterus may not affect your fertility or pregnancy. It depends on the size of the septum and how far it extends. Talk to your healthcare provider about the risks of becoming pregnant and if they recommend surgery to fix the septum.

If you have a septate uterus, your provider will want to monitor the fetus’s growth closely throughout your pregnancy.

Do babies survive a septate uterus?

Yes. You’re at higher risk for pregnancy complications, but most likely, your baby will be born healthy. Your pregnancy care provider will monitor your pregnancy and watch for any signs of problems.

How does it affect my delivery?

Your baby is more likely to be in a breech position. This is because the fetus has less room to rotate into a head-down position. You’ll need a C-section if your baby is breech.