Recurrent pregnancy loss (RPL) is a distressing condition where a woman experiences multiple miscarriages, often without a clear cause. One of the significant contributing factors is a structural abnormality of the uterus, with the septate uterus being the most common uterine anomaly linked to RPL.
What is a Septate Uterus?
A septate uterus is a congenital condition where a fibrous or muscular wall (septum) divides the uterine cavity partially or completely into two sections. This malformation disrupts the normal shape and size of the uterus.
How Does It Affect Pregnancy?
The septum is often poorly vascularized and may impede proper implantation and growth of the embryo, leading to increased risks of:
- Early miscarriage, especially in the first trimester
- Recurrent pregnancy loss, with rates significantly higher than in women without uterine abnormalities
- Other obstetric complications like preterm birth and fetal growth restriction
Prevalence and Impact
Studies suggest septate uterus occurs more commonly in women with recurrent miscarriages—up to 18% after two or more pregnancy losses—compared to 2–3% in the general population. Surgical correction by hysteroscopic metroplasty has shown to improve reproductive outcomes, significantly increasing live birth rates and decreasing miscarriage rates in many women.
Treatment and Management
Hysteroscopic surgery to remove or resect the septum (septoplasty) is the standard treatment option. This minimally invasive procedure helps restore the uterine cavity’s normal shape, improving the chances of successful implantation and maintaining pregnancy.
Conclusion
A septate uterus is the most common uterine abnormality linked to recurrent pregnancy loss. Proper diagnosis using imaging techniques such as ultrasound or hysteroscopy, followed by surgical management, can substantially enhance fertility outcomes for affected women. If recurrent miscarriages are experienced, consulting a fertility specialist to evaluate for structural anomalies like the septate uterus is essential for effective treatment and hopeful pregnancy outcomes.