Uterine Curtains (Uterine Septum)
What are uterine curtains, i.e. uterine septum?
The pieces of fibrous tissue that cover the inner layer of the uterus from end to length or to a certain extent, occupy its volume, and have relatively little vascularization are called uterine curtains. It is a congenital anomaly. In female babies, this extra tissue, which should dissolve spontaneously while in the mother’s womb, does not melt and divides the uterus like a curtain. Thus, the inner layer of the uterus cannot form wide enough.
How many types of uterine curtains are there?
The uterine curtains, that is, the septum, can be very broad-based and long, or they can be very small and limited. The curtains are sometimes very wide and occupy from beginning to end, that is, from the whole to the uterus. Sometimes they also cover a very small part of it. And sometimes they can be not only in the uterus, but also in the vagina.
How is the diagnosis of uterine curtains made?
It is necessary to suspect the curtains of the uterus during routine ultrasound. Especially using three-dimensional ultrasound, uterine curtains can be identified very easily. Uterine x-ray, or HSG, is also very useful for identifying uterine curtains, but additional imaging may be needed. Sometimes MRI imaging may be required.
What are the clinical consequences of uterine curtains?
Wide curtains can make it difficult to conceive, they can cause recurrent early pregnancy losses, they can also cause recurrent advanced week pregnancies or premature births. They may reduce the success of IVF treatment.
How is the treatment of uterine curtains performed?
The size, shape and place of the uterine curtains revealed by ultrasound or uterine film are evaluated very well. The most effective form of treatment of the curtains, that is, the uterine septum, is the cutting of the curtains by the closed method, that is, hysteroscopically.
With the optical camera system entered into the uterus, the curtain is seen and can be cut. Large uterine curtains are treated with larger systems called operative hysteroscopy. These treatments are by cutting the uterine curtain with the help of electro-cautery. Smaller uterine curtains can be cut using office hysteroscopy, that is, smaller diameter instruments, using scissors or electricity.