What are the clinical manifestations of uterine septation? How to check uterine septation?

The uterus septate is formed in varying degrees when the bilateral paramesonephric ducts fuse and a certain process of septum absorption is blocked, with an incidence of 0.009% to 12%. The incidence in the population is unknown, accounting for about 75% of uterine malformations, and is a common uterine malformation.

Two types of septate uterus

1. A completely septate uterus is one that extends from the fundus of the uterus to the internal or external os of the cervix.

2. If the septum ends at any part above the internal os of the cervix, it is an incomplete septate uterus.

What are the clinical manifestations of uterine septate

1. Excessive menstrual flow and dysmenorrhea are common. This is caused by poor uterine contraction and poor menstrual blood discharge; 2. The incidence of infertility increases; 3. It is easy to leak during abortion, resulting in continued pregnancy;

4. Recurrent spontaneous abortion. The incidence of pregnancy failure increases;

5. The incidence of premature birth and abnormal fetal position increases;

6. Prolonged labor and increased incidence of postpartum hemorrhage;

7. It is easy to cause placenta retention after delivery.

How to check the septate uterus

1. Ultrasound examination

Cross-section: The transverse diameter of the uterus is relatively wide, and attenuated mediastinal echoes can be seen in the center of the uterine body. Two uterine bodies can also be seen.

Longitudinal section: When the probe is slowly moved from one side of the uterus to the other side, the uterine body disappears first and then a whole echo appears.

2. Iodine oil radiography

It is commonly used and can often confirm the diagnosis through contrast examination. However, iodized oil contrast examination cannot distinguish between a bicornuate uterus and an incomplete septate uterus, nor can it distinguish between a double uterus and a complete septate uterus. However, it is still a good method for diagnosing uterine malformations.

3. Hysteroscopy

It has been commonly used in recent years. It can not only observe the morphology of the uterine cavity, determine whether there is a septum and the type of septum, but also remove the septum under the microscope to achieve the purpose of treatment.

4. Laparotomy

Although hysteroscopy can be used to diagnose most cases, laparotomy combined with lipiodol contrast is still an effective method. Laparotomy can clearly distinguish between a bicornuate uterus and an incomplete septate uterus, and between a didelphys and a complete septate uterus.