Obstetrical prognosis of the septate uterus: a plea for treatment of the septum

Abstract

Objective: To evaluate the obstetrical and perinatal implications of the septate uterus and assess the improvements of the prognosis after treatment of the septum.

Investigation: This retrospective investigation was carried out in a single centre on 78 patients with septate uterus who had previously been correctly classified. A total of 203 pregnancies were observed. All complications occurring during the first, second and third trimesters and the neonatal outcome were logged. Furthermore, 25 patients in this sample underwent surgery which enabled reassessment of the obstetric and neonatal outcome.

Results: Prior to surgery, during the 203 pregnancies, the fetal loss rate during the first two trimesters was 47%, prematurity 17% and 89 children were alive, i.e. an overall perinatal mortality rate of 16.8% when pregnancy exceeded 24 weeks. After surgical treatment of the septum, the proportion of pregnancies proceeding subsequent to 24 weeks and infant survival changed, respectively, from 13.3% to 90% and from 4.4% to 87.5%.

Conclusion: The obstetric and neonatal prognosis of septate uteruses is extremely unfavourable. This is radically transformed by treating the septum.