Septate Uterus

Medically Reviewed by Dan Brennan, MD on May 02, 2023
3 min read

A septate uterus is when a thin tissue membrane, called the septum, runs down the middle of the uterus (i.e., the womb) and divides it into two separate parts. This condition occurs when the baby is developing in the womb, making it the most common abnormality related to the uterus in women.

Women with a septate uterus have higher chances of pregnancy loss or miscarriage, preterm birth, and fetal malpresentation (i.e., the condition when the baby is not facing head down while it forms in the womb).

Septate uteruses are divided into three types: 

  • Partial septate uterus. When the septum tissue doesn’t include the cervix. 
  • Complete septate uterus. When the septum also includes the cervix, which is the opening of the womb.
  • Septate uterus and vagina. When the septum extends into the vagina.

The septum is important for the development of the uterus and fallopian tubes. The septate uterus happens when the septum doesn’t get absorbed by the body after the fallopian tubes and uterus are formed. The septate uterus is a genetic abnormality and has no known cause.

A septate uterus can go undiagnosed for a long time because there are no symptoms until a girl reaches puberty. A septate uterus can cause a more painful period but often doesn’t get diagnosed until the woman has multiple pregnancy losses.

A normal uterus has a triangular shape on the inside. A septate uterus, although it looks normal from the outside, is heart-shaped on the inside. But a partial septum can be relatively more difficult to diagnose because the heart shape will be less defined.

It is unknown why women with a septate uterus have a higher chance of miscarriage. Not all women with a septate uterus experience a miscarriage, but some women will go into premature labor. It is possible for you to have a healthy pregnancy even with a septate uterus.

The septum is usually a very thin line of tissue and can be difficult to see visually. So, doctors prefer to use various imaging methods to diagnose septate uterus. These include:

An ultrasound can be done by using an ultrasound probe on the outside of the abdomen or by inserting an ultrasound probe into the vagina. For diagnosing a septate uterus, 3D ultrasound is better than 2D ultrasound because it gives a detailed picture of the uterus. 

MRI, or magnetic resonance imaging, is often used to determine if the condition is a septate uterus or bicornuate uterus. A bicornuate uterus is when the uterus is divided into two horns and may, or may not, have a septum. 

Hysteroscopic surgery can be used to cut or shave off the septum. By cutting the septum, the uterus is no longer divided into two parts.‌

The procedure is regarded as a minor outpatient surgery. That is, the doctor will allow you to go home the same day as the surgery.‌

If your case is more complicated, the doctor may advise you to stay overnight in the hospital for observation. But in most cases, the procedure is simple and has a good outcome.‌

‌During the surgery, the surgeon uses a small scope, placed on a tube, to go through your vagina to the uterus and then cuts the septum. The surgeon also uses ultrasound during the surgery to make sure the septum is removed fully.

Hysteroscopic surgery rarely involves major risks, but they can include:‌

The most common side effects from the surgery are period-type pains and some bleeding for one to two days.

Using tampons after the surgery can increase the risk of infection, so your doctor may recommend using sanitary napkins instead. Make sure to consult your doctor if you have a lot of bleeding, pain, or concerns after your surgery.