#fertilityawareness-
Uterine Septum and it’s effects on reproductive outcomes
Uterine septa is the presence of fibrous bands extending from the upper part of Uterus (Fundus) into the Uterine cavity.
Accordingly it can be a partial or complete Uterine septum.
Implications : Evidence suggest that intrauterine septum is associated with recurrent pregnancy loss, miscarriage, inability to conceive, preterm pain and bad obstetrics outcome.However the grade of evidences are low (grade C).
Diagnosis : Various modalities with different sensitivity and specificity are used to diagnose uterine septum.
• HSG(Hystrosalpingography)
• 2D Ultrasound
• 3D/4D Ultrasound
• MRI
• Hysteroscopy
Differential Diagnosis: uterine SEPTUM is often confused with ARCUATE( normal varient) or BICORNUATE uterus.
Classification
ASRM Classification: seems to under diagnose cases of uterine septum. These are Arcuate, Septate & Bicornuate
a)ARCUATE :Depth>1 cm,Angle more than 90 degrees.
b)SEPTATE :Depth >1.5cm,angle<90degrees
c)BICORNUATE :serosal depth indentation >1 cm.
ESHRE Classification: seems to over diagnose uterine septum as it define septa if ratio of indentation to myometrial thickness >50%.
No concept of arcuate uterus .
CUME classification: recently developed by experts incorporating both ACRM and ESHRE guidelines.Septate uterus is when:
• Ratio of indentations to myometrial thickness is >110%.
• angle of indentation
Treatment :
• HYSTEROSCOPIC SEPTAL RESECTIONS/ METROPLASTY is the treatment of choice for patients of uterine septum done both for diagnosis as well as treatment of septum.
• It is a minimally invasive day care procedure to visualize the inside of the uterine cavity on a moniter by inserting special instruments (hystroscope) through the vagina and cervical opening.
• Hystroscopic septal resection is done for patients of repeated abortions, Preterm pain or Bad obstetrics history after proper counselling regarding treatment success and consequences associated with the procedure.
To know more
Visit @ www.drnehasingh.com
www.facebook.com/drnehafertility
Call 9369904942 for best fertility treatment plans
#BestIVF
#Best #fertility #doctor #gorakhpur
