Septate Uterus: Congenital Anomaly, Reproductive Impact, and Management

A septate uterus is a Müllerian duct anomaly where a fibrous/muscular septum divides the uterine cavity into two compartments. Prevalence ~1–2% of women.

Reproductive Sequelae

• Recurrent first-trimester miscarriage (most common)
• Preterm labor, malpresentation
• Infertility or subfertility
• Abnormal uterine bleeding

Diagnosis

• 3D transvaginal ultrasound (gold standard non-invasive)
• Hysterosalpingography (HSG)
• MRI (complex cases)
• Hysteroscopy (definitive, therapeutic)

Treatment

Hysteroscopic metroplasty (septal resection) is outpatient, minimally invasive, and significantly improves live birth rates. Indicated for recurrent loss or infertility with septate uterus.