Incomplete septum
The septum of category 1 is short (up to 1/3–1/2 the length of the cavity) and thin, without a pronounced vascular and muscular component: the surgeon dissects it along the midline from the free edge to the bottom until a single cavity appears with symmetrical orifices of the tubes, bleeding is minimal, and the septal tissue does not require removal - it contracts and is retracted into the wall. Depth control is carried out using ultrasound or bottom thickness; the risk of perforation is low. After the operation, estrogens are prescribed for 3–4 weeks for epithelization and control hysteroscopy after 1–2 months; Natural childbirth after such an operation is possible.
Indications
- intrauterine septum (complete or incomplete) with recurrent miscarriage, infertility, unsuccessful IVF;
- septum identified during pregnancy planning and examination (by doctor’s decision);
- bicornuate uterus, T-shaped uterus, complex anomalies with miscarriage (metroplasty);
- combination of septum with polyps, synechiae, fibroids.
Uterine abnormalities and pregnancy
The intrauterine septum is the most common anomaly of the uterus: it is poorly supplied with blood, and implantation on it leads to miscarriages in 60–80% of cases, premature birth and abnormal position of the fetus. Hysteroscopic incision of the septum eliminates the problem without incisions, and the miscarriage rate is reduced from 80 to 10-15%. A bicornuate uterus (two horns with a common or separate body) in case of repeated pregnancy losses is corrected by metroplasty - open union of the horns into a single cavity. The diagnosis is clarified by 3D ultrasound or MRI and hysteroscopy with laparoscopy to distinguish the septum from a bicornuate uterus.
