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Saturday, 22 February 2014

Uterine malformations: Does it matter?

Like all our body parts the way our reproductive organs form while still in the mother's womb can sometimes go a little awry. The reason why this happens is usually impossible to decipher though. But the big question is what can go wrong and does it matter?

What all can go wrong is too complicated for this forum but the range is complete lack of development of vagina and/or uterus to very mild changes in the shape.  For obvious reasons severe malformations preclude fertility and will require the assistance of fertility specialists. For example, if there is a block or curtain (called septum by doctors) in vagina but the upper structures are normal, then the surgical removal of the septum would suffice but if the uterus is absent or too underdeveloped then surrogacy is the only option.

It is important to keep in mind that a girl who has entered puberty and is having abdominal pain some days of the month but not having periods may have a problem like hymen without perforation or a vaginal septum. This required immediate treatment through a gynaecologist.  

The presence of uterine malformations has been linked with infertility, miscarriage, preterm labour and pregnancy complications such as placental abruption, growth problems in the baby, prematurity and death of the baby. The correlation between uterine malformations and these complications is hard to prove and surgical correction of all malformations may not be beneficial. The decision has to be individualized by the treating doctor. In patients with infertility or with recurrent miscarriages, removal of uterine septum is generally recommended. Other more complicated surgeries to unite two uterine cavities into one are generally not recommended nowadays.

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