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What is a Septate Uterus?

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Septate uterus is the most common congenital uterine malformation, affecting 1 percent of all women, which happens during fetal development before birth. A membrane called the septum divides the inner portion of the uterus, at its middle. This dividing septum is a fibrous and muscular band of tissue that can be thick or thin. 

It’s possible for a septate uterus to be misdiagnosed as a bicornuate uterus. A bicornuate uterus is one that is heart-shaped. In this condition, the top portion of the uterus, or fundus, dips in towards the midline of the uterus. This dip can range from shallow to deep. A bicornuate uterus does not typically affect a woman’s chances of successful pregnancies unless the dip is extreme. There are also rare cases of a bicornuate uterus and a septate uterus occurring together. 

How does a Septate Uterus affect pregnancy?

Women with a septate uterus can have a normal reproductive life, but it may add complications to pregnancy. The rate of miscarriage in the general population is around 10 to 20 percent in women who know they are pregnant. The estimated rate of miscarriage in women with septate uteri is thought to be between 20 to 25 percent. Some research shows it may be as high as forty percent.

A septate uterus is believed to be the most common type of abnormal uterine development. It’s estimated that over half of developmental problems of the uterus involve a septum.

Women with a septate uterus have an increased risk of both miscarriage and recurrent miscarriage. Pregnancies that occur within a uterus with any type of abnormal development increase the risk for:

  • Premature labor
  • Breech Positions 
  • C-Section Delivery 
  • Bleeding complications after delivery

What are the symptoms of septate uterus?

  • unusual pain before or during a menstrual period.
  • a tampon may not prevent menstrual blood from leaking out.

What causes septate uterus?

  • A septate uterus forms during embryological development when the tubes that eventually become one uterus don’t fuse together properly.
  • Septate uterus is a genetic abnormality.

Will a septate uterus affect sexual and reproductive life?

  • Having a septate uterus doesn’t affect a woman’s sexual pleasure or fertility.
  • Women with a septate uterus can have a normal reproductive life, but it may add complications to pregnancy. 

How is it diagnosed?

A septate uterus often remains undiagnosed until a woman experiences repeated miscarriage. At other times, the doctor may stumble upon it during a routine physical exam. This is because a septate uterus is often accompanied by similar malformations of the cervix and vagina. Typically referred to as a “double cervix” and “double vagina,” these are often the first clues of a similar abnormality in the uterus.

 A septate uterus may be seen on a standard 2-D pelvic ultrasound. An MRI can be a more accurate way to identify problems of the uterus. A definitive diagnosis may be required on a hysterosalpingogram (an X-ray procedure highlighting the uterus) and/or hysteroscopy (a visual examination using a lighted scope). Even with these examinations, a septate uterus can sometimes be misdiagnosed as a bicornuate uterus, also known as a “heart-shaped uterus.” While the malformation is by no means considered normal, it does not typically increase the risk of miscarriage.

Treatment

A septate uterus is treated with surgery, most commonly by removing the septum during a hysteroscopy. This is a fairly minor procedure usually performed on an outpatient basis. The surgery, called metroplasty, is minimally invasive and involves the insertion of a medical device through the cervix and into the uterus to cut away excess tissue. This can usually be performed in between 30 and 60 minutes. Antibiotics and estrogen may be prescribed afterward to prevent infection and aid in healing. Hysteroscopic metroplasty can improve chances of a successful pregnancy in women with recurrent pregnancy by 53.5 percent, according to a comprehensive analysis of 29 studies conducted from 1986 to 2011.

It is unnecessary for women with septate uteri who have no intention of getting pregnant. On its own, a septate uterus poses no risk for cancer.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

https://www.webmd.com/baby/septate-uterus

https://www.childrenshospital.org/conditions/septate-uterus#:~:text=A%20woman%20with%20a%20septate,there%20is%20recurrent%20pregnancy%20loss.

https://www.healthline.com/health/septate-uterus#septate-uterus-and-pregnancy

FALSE PREGNANCY (Pseudocyesis)

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What is a False Pregnancy?

In this, women experience more pronounced symptoms of pregnancy including missed periods, a growing abdomen, and even baby kicks. False pregnancy is not only common in women, but men also experience it at times. They develop similar pregnancy symptoms like their partner, including weight gain, nausea, and backache, which is referred to as couvade or sympathetic pregnancy. But this isn’t related to a miscarriage. In a false pregnancy, there was no conception and there is no baby. Despite this, symptoms can last long enough to make a woman, and even those around her, believe she’s expecting.

In simple terms, pseudocyesis or false pregnancy is believing that you are pregnant when in reality you are not carrying a child. Pseudocyesis is the medical term for a false pregnancy or what some people refer to as a phantom pregnancy. People with pseudocyesis have many, if not all, symptoms of pregnancy, with the exception of an actual fetus. 

A woman’s intuition is a funny thing. Most women know they are pregnant before they are even far enough along to take a test.

How Common Is Pseudocyesis?

In the general population, pseudocyesis occurs in about 1-6 out of every 22,000 births.  Most instances of pseudocyesis occur in women of childbearing ages, between the ages of 20-44 years. Rarely, pseudocyesis occurs in men and this is called “sympathetic pregnancy”. You can experience pseudocyesis more than once in your life.

What Causes False Pregnancy?

Pseudocyesis is extremely rare in both men and women and just recently doctors have begun to understand the psychological and physical root of pseudocyesis. Although the exact causes still aren’t known, doctors suspect the cause comes from trauma, either a physical or mental trauma, while others believe it is a chemical imbalance. In some cases, there are other medical conditions that may cause pregnancy symptoms to be experienced.

Here are some of the reasons a person might experience symptoms of pseudocyesis:

  • An intense desire to get pregnant after miscarriage or impending menopause and hormonal imbalance which causes pregnancy symptoms to appear.
  • Abdominal distention from other physical factors such as weight gain, gas, or tumors, in combination with psychological delusions of pregnancy, may cause a woman to believe she is pregnant
  • Other physical and hormonal factors such as pituitary tumors or ovarian/uterine cysts or growths along with a desire to become pregnant.
  • The woman’s brain then misinterprets those signals as pregnancy, and triggers the release of hormones (such as estrogen and prolactin) that lead to actual pregnancy symptoms.

Symptoms

  • Enlarged and tender breasts, changes in the nipples, and possibly milk production
  • Interruption of the menstrual period
  • Weight gain
  • Morning sickness and vomiting
  • Reduced appetite

Tests for False Pregnancy

Ultimately, the only way to know for sure if someone is experiencing pseudocyesis is to administer a pregnancy test or ultrasound. The most definitive test to check for pregnancy would be an ultrasound that checks for the presence or absence of a developing fetus. In a case of false pregnancy, no baby will be seen on the ultrasound, and there won’t be any heartbeat. 

If the absence of pregnancy is confirmed, but concerning physical symptoms linger, another testing might be administered to rule out other medical issues, such as hormonal imbalances or tumor growth. Certain medical conditions can mimic the symptoms of pregnancy, including ectopic pregnancy, morbid obesity, and cancer. These conditions may need to be ruled out with tests.

Treating False Pregnancy

Pregnancy, whether true or false, is an exciting time for an expectant mother. When women believe they are pregnant, especially for a period of several months, it can be very upsetting for them to learn that they are not. The grief that comes next may be intense.  In this case, they may need to be under the care of a psychiatrist or psychologist. In some cases, psychotropic drugs, in combination with psychotherapy, may be helpful.

Bottom line

It’s important to understand that pseudocyesis is a very complex issue. If you are caring for a loved one who has experienced pseudocyesis, it’s important to be gentle. Very often, pseudocyesis stems from the trauma of having lost a pregnancy or having experienced infertility. 

Pseudocyesis is treatable and can be resolved, but it may be painful for the person who is experiencing it as well as their loved ones. So be kind and also encourage your loved one to seek professional help when the situation warrants it. Most of all, remember that you are not alone, and with proper care, you will feel like yourself again before you know it.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.webmd.com/baby/false-pregnancy-pseudocyesis#1 https://americanpregnancy.org/getting-pregnant/false-pregnancy/ 

https://www.healthline.com/health/pregnancy/phantom-pregnancy