A septate uterus is a congenital condition where a fibrous and muscular wall, known as a septum, divides the uterus into two parts. While a typical uterus is a single, hollow, pear-shaped cavity, the septum creates two smaller cavities. This condition is present from birth, forming during fetal development when two structures that usually fuse completely to form one uterus do not do so. Understanding the potential effects of a septate uterus on the baby is important for managing pregnancy.
Impacts on Fetal Growth and Positioning
The presence of a septum within the uterus can directly influence the space available for a developing baby. This physical constraint may sometimes lead to restricted fetal growth, where the baby does not grow as large as expected. This limited space can hinder optimal growth, potentially resulting in a smaller-than-expected baby, a condition known as intrauterine growth restriction (IUGR).
The septum can also prevent the baby from moving freely and settling into the ideal head-down position for birth. This increases the likelihood of abnormal fetal presentations, such as a breech position, where the baby’s feet or bottom are positioned to exit first. Alternatively, the baby might present in a transverse lie, lying sideways across the uterus.
Risks of Early Arrival
Pregnancies involving a septate uterus carry an increased likelihood of preterm labor and premature birth, occurring before 37 weeks of gestation. This can happen because the septum may irritate the uterus, or the uterus might be unable to stretch effectively due to its divided structure. Premature birth can have implications for the baby, as their organs, including the lungs, brain, and digestive system, may not be fully developed.
Babies born prematurely may face challenges such as breathing difficulties, feeding issues, and problems with regulating their body temperature. Depending on the gestational age at birth, these babies might require specialized medical attention in a neonatal intensive care unit (NICU). While a septate uterus increases the risk of early arrival, many individuals with this condition still have full-term pregnancies.
Considerations for Birth
A septate uterus can significantly influence the method of delivery, primarily due to concerns for the baby’s safety. Cesarean section (C-section) rates are higher in pregnancies with a septate uterus. This is often recommended because the septum can obstruct the birth canal, making a vaginal delivery difficult or risky.
The baby’s position, if it remains breech or transverse due to the septum, also frequently necessitates a C-section to prevent complications during birth.
Care and Monitoring During Pregnancy
Throughout pregnancy with a septate uterus, healthcare providers employ specific medical strategies and monitoring. Frequent ultrasounds are a standard part of care, allowing providers to closely monitor the baby’s growth, detect any signs of IUGR, and track the baby’s position and the amount of amniotic fluid.
Cervical length monitoring is also performed to check for any shortening of the cervix, which can indicate an increased risk of preterm labor. If signs of preterm labor emerge, interventions such as medications to halt contractions may be considered. Additionally, corticosteroids might be administered to help mature the baby’s lungs in anticipation of an early delivery. A collaborative approach between the pregnant individual and their healthcare team is central to managing the pregnancy and achieving the best possible outcomes for the baby.