Uterine septate is the condition where there is a presence of a convex ridge deformity growing from the uterine roof towards the uterine cavity. It is identified to be the excessive or remaining connective tissue’s structure leftover during the process of infusion of the uterine auxiliary mesonephric canal during the differentiation of the female genital tracts during the developmental stage of the embryo.
Uterine Septae is the most common form or commonly occurring type of congenital uterine malformation. It is the primary cause for recurrent early miscarriage (REM), recurrent late miscarriage (RLM), ectopic pregnancies and infertility, all of which varies according to the severity of the septate. This condition expresses itself in the form of an abnormal shape and/or size of the uterine cavity, and the decrease in uterine volume. It can be further classified according to the size of the growing septate, namely: small septate, a medium septate and a large/complete septate. According to its related and observed complications, uterine septate is commonly associated and also accompanied with conditions such as multiple cysts complicated with uterine septate, uterine septate complicated with vaginal mediastinum, uterine septate complicated with cervical insufficiency, uterine septate complicated with naive uterus, uterine septate complicated with ectopic kidney, etc.
Pathophysiology: The uterine septate is primarily composed of connective tissues, where there are very little blood vessels, which leads to uterine blood flow insufficiency. As compared to a heathy uterus, it is primarily consisting of muscles tissues, which is rich and abundant with blood vessels, delivering optimal amounts of nutrients and oxygen within the uterine cavity.
Fetal Hypoxia can arise if embryonic implantation occurs on the septate, also known as a blood-insufficiency miscarriage. If it happens multiple times it will develop into a recurrent early miscarriage. A medium size or large size septate functions very similar to an IUD (intrauterine device), disrupting the process of conception. Furthermore, septates can cause obstruction to healthy implantation or even embryonic migration towards the adjacent fallopian tube, leading to an ectopic pregnancy.
Diagnosis requires the use of panoramic 4D Ultrasound, dynamic digital hysterography, Diagnostic Hysteroscopy, and also relies on patient’s medical history (Does she have a history of abortions, miscarriages, infertility, or ectopic pregnancies). The rate of clinical misdiagnosis of uterine septate, most especially the milder/smaller forms of septate, is highly significant due to common misreading’s or improper readings of the ultrasound and x-ray images of the uterus, this is further amplified by the lack of experience of some doctors with application of hysteroscopy.
Treatment includes the use of hysteroscopic cold knife separation, pear-shaped intrauterine stent and also a bio-adhesion barrier to prevent formations of unwanted adhesions. The administration of wrong treatment is also common, where open abdominal surgery is conducted unnecessarily, leading to complications such as pelvic and uterine adhesions, sometimes even complicating a simple miscarriage cause into a complex one, potentially leading to infertility. The complete removal of the septate tissue is a medical error, because the septate itself is not considered to be excess tissue, simply tissue that did not finish differentiating completely. If surgically removed, it will cause the loss of crucial fundus tissue, at will lead to the cohesion of the two adjacent uterine horns. Many treatments also do not include using intrauterine stents and bio-adhesion barriers. The former aids in the restoration of healthy shape and size of a uterus, while the former prevents adhesions to form as part of the healing process post-surgery. Finally, when uterine septate is accompanied with aforementioned complications, they are most often un-diagnosed or under-looked, leading to ineffective treatment outcome.
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Antai Hospital’s Commitment
Antai Hospital’s full refund policy for the miscarriage prevention treatments we provide should already be the best guarantee for a healthy pregnancy. Patients should rest assured, can and should go about their everyday life, focusing their diet on vegetables, beans, celery, and other fiber-rich foods. Besides that, an active lifestyle of yoga and swimming should also be incorporated to help relieve stress and increase blood circulation, which is beneficial for the fetus’s development and the mother’s health. With our assurance, a healthy lifestyle, and peace of mind, you can go through a healthy pregnancy with no complications.
Recurrent miscarriages are no doubt a heavy blow to the patient’s physical and mental health. All we can do is to help ease the burden and decrease your trauma, to slowly help you overcome the anxiety with the love and care that we provide at Antai Hospital.
Trust in Antai Hospital and trust in yourself, your pregnancy is our priority.