Patient History: A 23 yo female sent from her vertility clinic for complete pelvic exam and salpingogram. Pt having difficulty with pregnancy attempts. Your thoughts?
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7 comments:
Hi, Nancy
I think these are typical images of septate uterus. The outer fundal contour of the uterus is almost flat, which means it is not a biconuate but a septate uterus.
The septum is fibrous tissue without much of a blood supply. So pregnancies that implant on the septum are thought to be at higher risk of miscarrying because the placenta cannot develop properly and access nutrients. Women with septate uteri who do not miscarry may be at increased risk for preterm labor and having a premature baby.
Hye said
Great comment, Hye! Thanks
I don't see an indentation at the top of the uterus so I also agree with Hye that it's a septated uterus.
Women with a septate uterus have a band of tissue called a septum running down the middle of their uteri. Septate uterus is a type of congenital uterine malformation that results from a problem in the formation of the woman's uterus during her own prenatal development.
A uterine septum increases the risk of miscarriages and can be a factor in recurrent miscarriages.
septate uterus is the most common mullerian anomaly.
Do you think there may be a possibility that this patient has a bicornuate uterus? In the coronal view, I don’t see the septation go down very far. With a septate uterus, the septation extends down into the body of the uterus. The uterine lining looks more heart shaped to me. Pregnancies in patients who have a bicornuate uterus are considered high risk because these patients may miscarry more frequently then a person who has no uterine malformation. They are also more likely to have preterm labor with a malpresentation such as a breech or transverse presentation. I would like to see a HSG. So glad you had a coronal view to look at.
Image 4 look heart-shaped. I think it is bicournuate uterus. It is a type of uterine malformation. Upper part of uterus has two horns.
Learning the natural female Whole Woman posture, and exercising to make it comfortable to hold while you sit, stand, walk, run, lift and carry, will bring about improvement in your symptoms. For younger women this will happen quickly. Older women will take longer. Women often write into the forum that the posture feels strange at first, but once it becomes a habit, it feels completely natural and anything else feels strange. Uterine-Prolapse.net comprehensive and informative site for mothers who want to learn about Uterine Prolapse and find ways to deal with pain and stress of this condition.
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