Decreased Foetal Movements Secondary to Uterine Septum: A Case Report and Proposed Algorithm of Management

Abstract

Congenital uterine anomaly has been well established as cause of infertility and recurrent pregnancy loss. However, only few studies have reported the association of mullerian anomalies and adverse pregnancy outcome in third trimester. We are hereby reporting a case of 25-year- old female second gravida who presented at 36 weeks six days pregnancy with complaint of decreased foetal movements for the past two weeks. The female had previous history of multiple admissions on account of decreased foetal movements in the third trimester. Ultrasonography for biophysical profile and cardiotocography were done on each admission which revealed normal findings. Decision to terminate the pregnancy was taken because of persistent decreased foetal movements. She was induced with dinoprostone gel 0.5 mg intracervically; however she underwent lower segment caesarean section on account of non reassuring cardiotocography. Peroperative findings confirmed the presence of partial uterine septum.

Keywords: Mullerian anomaly; Non reassuring cardiotocography; Reduced foetal movements.

[Table/Fig-1]:

Algorithm for the mother presenting with reduced perception of foetal movements. NST: Non Stress Test, BPP: Biophysical Profile.