The saddle uterus is an anomaly in the structure of the uterus, which is a type of bicornuate pathology. According to statistics, it occupies 25% among the varieties of bicornuate pathology. Diagnosed by chance, because it does not have severe symptoms. Pregnancy with her will not be easy, because there is a risk of miscarriage.
How is it different from normal?
Normally, the outer surface of the fundus of the uterus has a flat plane, and with a saddle uterus, the fundus is split, in the form of a saddle, while a concave depression forms on the outer surface. The degree of splitting is different, but in all cases it will resemble a saddle.
Pathology in everyday life may not manifest itself, but if pregnancy occurs, non-carrying of the fetus becomes a high risk. In the presence of pathology, further infertility is observed, and the anatomical and functional inferiority of the uterus provokes postpartum hemorrhage. The saddle uterus is combined with other anomalies in the development of the female reproductive and urinary system.
Pathology is detected more often by chance during a routine examination during an ultrasound scan. Surgical treatment is prescribed only if there are clear risks of miscarriage.
Reasons for formation
The cause of the development of the saddle uterus is the fusion of the mesonephric ducts during embryogenesis, which give the uterus a characteristic saddle shape, as well as a genetic predisposition. However, such deformities can be caused by bad habits (most often smoking and drinking alcohol), taking drugs or substances of chemical origin, abnormalities in the functioning of the circulatory and endocrine systems, toxicosis or exposure to infections, hypoplasia or impaired development of the uterus, as well as congenital pathologies and changes. in its structure.
Hormonal imbalance, lack of the right amount of vitamins. Endometriosis of the uterus and the aggravating influence of the environment also often lead to the development of this pathology.
Symptoms of pathology
Symptoms:
- Before pregnancy, the presence of this deviation does not have characteristic symptoms, especially if the changes in the structure are minor, so it is not possible to determine it yourself. But a more pronounced deformation of the uterus causes a number of disorders in the genitourinary system and the appearance of severe discomfort during intercourse.
- During gestation, not only the development of various pathologies can occur, but also complete detachment of the placenta, characterized by profuse bleeding, the cause of which can also be a violation of the structure of the uterus. Characteristic is a violation of the position of the fetus, as well as the development of weakness of labor activity.
These deformations in some caseslead to preterm birth, fetal death, miscarriage, and numerous birth and postpartum complications.
It is worth noting that serious changes in the structure of the uterus very often lead to primary infertility.
Views
The saddle uterus, a photo of which can be obtained on hysterosalpingography, is called a bicornuate uterus. It comes from her appearance. The pathological divergence of the bicornuate uterus is divided into:
- saddle bicornuate uterus;
- uterus with septum;
- not complete duplication of the uterus;
- complete doubling of the uterus.
All these pathologies are detected during pregnancy, that is, they are obtained during embryonic development.
With a saddle uterus, there is a slight concavity on the outer part of the fundus of the uterus. It resembles the shape of a saddle.
With a uterus with a septum, the concavity of the outer surface of the septum reaches a larger size than with a saddle. It begins to dangle towards the opposite side.
Incomplete duplication of the uterus looks like an incomplete splitting of the upper bottom into parts.
With complete duplication of the uterus, two isolated cavities are observed, each of which contains a separate neck.
Among all, the latter type is the most difficult option, as there is little room for the fetus to develop.
Diagnosis
It should be understood that a visual standard gynecological examination does notinformation about the shape of the uterus, therefore, instrumental diagnostic methods are used for clarification.
The following instrumental methods are used to diagnose the saddle uterus:
- ultrasound hysterosalpingoscopy;
- ultrasound;
- hysteroscopy;
- hysterosalpingography;
- magnetic resonance imaging.
When performing ultrasound, it is not always possible to determine the deviation, since the thickness of the uterine membrane does not allow this method to fully see the structure. The result can only be obtained using the vaginal probe.
A good result in the diagnosis can be achieved using hysterosalpingography. The pictures clearly show the shape of the uterine fundus.
Shows no worse results when using magnetic resonance imaging. Hysteroscopy is an instrumental visual examination of the uterus.
Treatment
Currently, modern laparoscopic surgery methods are used to treat congenital uterine anomalies, which can overcome infertility.
The operation is performed using a special tool equipped with a light, an operating tool and a video camera, which allows, looking only at the monitor screen, to successfully carry out the operation.
The method has the following advantages:
- no major incision;
- detailed preoperative examination;
- informativeness of actions during the operation;
- high detail of the examined organs;
- quick recovery;
- no big scars;
- good aesthetic appearance after restoration.
Also in the past used the method of cavitary abdominal surgery. The method involves a complete tissue incision, which will allow manipulation of the organ.
During the operation, through the incisions made, the fundus of the uterus is excised, and then it is sutured.
Pregnancy
A slight change in the shape of a saddle uterus does not affect the success of conception and pregnancy. But if the deformation has a distinct form, then pregnancy will become more complicated for both the mother and the child. The position with a saddle uterus for having sex for the purpose of conception must be selected carefully. For example, the bottom can sag to such a size that it becomes an obstacle to the passage of the fetal egg. Also, the problem arises when the placenta of the embryo is attached to the uterus, because the useful volume is reduced and it can attach incorrectly. For a successful pregnancy, such patients must be constantly monitored by a gynecologist. The problem is that the wrong shape prevents the implantation of the ovum to the uterus.
If the embryo is successfully fixed on the wall, then during such a pregnancy the child practically does not suffer, but if complications arise, this creates a risk of fetal loss. And if the embryo is initially fixed on the septum, then it cannot fully develop.
Results
Worth itto summarize that pregnancy with a saddle uterus is possible and is not a contraindication, but may be:
- difficulty attaching an egg to the uterus;
- attachment of the egg to the side, resulting in an ectopic pregnancy;
- muscles in pathology are not able to fully contract, therefore, more often during childbirth, it is necessary to perform a caesarean section, as this complicates labor activity;
- pregnancy success depends on the degree of uterine deformity;
- if the concavity of the uterus is significant, then most often they talk about infertility;
- at the last stages of fetal development, due to an increase in size, placental rupture and hemorrhage are possible;
- this pathology leads to an incorrect position of the fetus before childbirth, as it does not allow the head to turn down, a caesarean section is necessary;
- with a slight concavity, a woman can give birth to a child without knowing about the pathology.
Women who have a saddle uterus, reviews are very different. Most of them argue that if you turn to a gynecologist in a timely manner and he will observe the entire pregnancy, then it is quite possible to endure and give birth to a baby.
