Saddle uterus during pregnancy: causes and treatment. Features of pregnancy with a saddle uterus

The inability to get pregnant and pathologies during the development of the fetus can be due to a number of reasons, one of which may be malformations of the uterus. The most common defect is a bicornuate uterus, which is detected in 1% of women. With this disorder, a single organ cavity is split into two horns, which merge again in the lower section. A variation of this defect is the saddle uterus. In this case, the woman’s uterine fundus splits, and the organ in the section takes the shape of a saddle. Every fifth woman who is observed in connection with uterine defects is diagnosed with this deviation.

During the formation of the embryonic organs, the development of the uterus takes place in three stages: first, a bicornuate uterus is formed, then it transforms into a saddle-shaped one, and by the time the child is born, it takes on a normal single-cavity pear-shaped shape. If at any stage there is an adverse effect on the fetus, then the development of the organ may stop. This process is affected by:

• maternal smoking;
• drug use;
• alcohol consumption;
• taking medications without the consent of a gynecologist;
• stress and neuroses;
• lack of vitamins;
• maternal heart defects;
• problems with the endocrine system;
• infectious diseases during pregnancy;
• severe toxicosis;
• and etc.

For some, this disease is due to hereditary reasons and has nothing to do with the mother’s lifestyle during pregnancy.

Diagnostics

Important: in the vast majority of cases, patients with this deviation do not even realize its presence, because the saddle uterus does not cause them any inconvenience, it does not provoke pain or abnormal bleeding.

Typically, women learn about this defect at the stage of planning pregnancy or in the process of bearing a child. This pathology cannot be detected during a visual examination by a gynecologist; the doctor can only guess about it based on indirect signs. To accurately determine the presence of a defect, the following studies are carried out:

• hysteroscopy, a study in which images of the organ are taken using special equipment and displayed on a monitor;
• magnetic resonance imaging of the organ, during this study a 3D model of the uterus will be displayed on the screen, which allows you to most accurately determine the nature and degree of the defect.

In a small percentage of women, this defect is pronounced and manifests itself, which allows it to be diagnosed earlier. Reasons for contacting a gynecologist may include:

• pain during sexual intercourse;
• bleeding outside of menstrual periods;
• miscarriage;
• difficulties conceiving a child.

Video - what is important to know about the bicornuate uterus

The likelihood of conception with this defect greatly depends on how severe the disorder is. It happens that a woman becomes pregnant without any problems and carries the child normally, without even realizing that the organ is defective. But it also happens differently.

After the egg is fertilized, the fertilized egg must attach to the uterine wall. If the organ is deformed to a slight degree, then this attachment occurs normally, and the fetus develops as in a normal uterus. However, if the situation is the opposite, the fundus of the uterus is greatly changed compared to the norm, then difficulties will arise with implantation.

Progress of pregnancy

Important: the main thing that a woman diagnosed with a saddle uterus should know is that the entire process of bearing a child must take place under the constant supervision of a gynecologist! Miscarriage is not uncommon with this disorder.

The defect can cause placenta previa. With this pathology, the placenta forms in the lower part of the uterus and is located on the way to the birth of the child. This can lead to placental abruption before the required period and provoke bleeding.

Sometimes the fertilized egg is attached not to the wall of the uterus, but to the septum inside it. This septum is characteristic of a saddle-shaped uterus. Since the septum is not designed for such a load and cannot perform the functions of the uterus, the development of the fetus will be disrupted and the embryo will not grow.

The main complication during pregnancy in women with this defect is fetal malposition. The fact is that there is less space inside the saddle uterus than in a normal one, so the baby is not located in it with the head down, but across the uterus or diagonally. The doctor will be able to determine this based on the results of the ultrasound and make a decision about the nature of the birth.

If there is any change in the body, a pregnant woman with this diagnosis should immediately notify the doctor who is observing her. If she starts bleeding, then you need to immediately call an ambulance and, when calling, report your diagnosis.

Childbirth

The process of childbirth is again influenced by the degree of deformation of the organ; some give birth on their own without any problems, while others will need additional help.

As mentioned above, one of the complications of a saddle uterus is the unnatural position of the embryo. When the baby is placed transversely or obliquely, the doctor often prescribes a planned cesarean section.

Even if the doctor determines that the patient can give birth naturally, the decision may change during labor. The fact is that this defect can interfere with normal uterine contractions, which means that the labor process will not be intense enough for successful resolution. In this case, the obstetric team performs an emergency caesarean section.

Most often, surgical intervention is used for premature birth of women with a saddle uterus.

During the postpartum period, heavy bleeding is possible due to insufficient uterine contractions. In this case, stimulating drug therapy is prescribed.

Child development

If conception has occurred and the embryo develops, the saddle uterus does not lead to the development of any pathologies in the child. Of course, if complications arise during pregnancy or childbirth, this can harm the baby. But with normal delivery (natural or surgical), children are born without any physical or mental problems. Gestation in the uterus with such a defect does not affect the health of the baby.

Treatment

Important: today there are no medications or physiotherapeutic methods for curing the saddle uterus.

If a woman is unable to conceive or bear a child, which is a consequence of severe deformation of the organ, surgical intervention is indicated to correct the uterus. The operation is performed through natural pathways during a hysteroscopic examination. This avoids incisions and exposure to anesthesia.

A saddle uterus is not a contraindication for conceiving and bearing a child, but it complicates these processes. If this defect is diagnosed, then all attempts to conceive should be carried out together with a specialist who will determine what the likelihood of a successful pregnancy is and what actions need to be taken for a positive outcome. If a successful pregnancy has not occurred within 3 years, then there are all indications for an operation to correct the defect. Such a diagnosis does not in any way affect the child’s health.

Sometimes, during the first ultrasound after pregnancy, the doctor makes a strange diagnosis: a saddle uterus. And even less often, a diagnosis may be made: a bicornuate uterus. A woman is usually scared: what could this mean? Will this harm the pregnancy? Let's figure out together what a saddle-shaped and bicornuate uterus is, and whether it is dangerous for pregnancy and childbirth.

Saddle and bicornuate uteruses are rare, and approximately 0.1% of women are born with such uterine malformations, and many of them do not even suspect that their uterus is irregularly shaped. The saddle uterus is considered a type of bicornuate uterus, but is very different in shape. The saddle-shaped and bicornuate uterus are formed between the 10th and 14th weeks of intrauterine development of the fetus; doctors consider the saddle-shaped uterus to be a pathology of the development of the woman’s genital organs.

What does a bicornuate uterus look like?

First, let's figure out what a normal human uterus looks like and how it differs from the uterus of some representatives of the animal world.

The human uterus is shaped like an inverted pear. The part of the uterus that is located above is called the fundus, and below is the exit from the uterus: the cervix and vagina. It is so laid down by nature that there should be one child in the human uterus; its shape is intended specifically for bearing one fetus. Of course, multiple pregnancies do happen, and twin pregnancies are not uncommon, but such pregnancies are always the most difficult for the woman and her babies, since the uterus has to stretch more to accommodate two or even more children.

The uterus of many animals is structured completely differently. For example, the uterus of a cat or dog, which is destined by nature to bear several babies at once, is precisely bicornuate in shape. Instead of being pear-shaped like the human uterus, animal uteruses are divided in two, forming two “horns” on the right and left sides. During pregnancy, a cat's uterus can be felt from the sides, and the kittens are located in it, like peas in a pea pod, one after another. During pregnancy, the human uterus protrudes forward and is located in the middle of the abdomen. The same arrangement of the uterus can be found in apes, which also usually bear one young.

It is not difficult to guess that if there are abnormalities in the development of the uterus in humans, we will get a uterus similar in shape to the uterus of animals. This pathology of uterine development, such as a bicornuate uterus, occurs as a result of disturbances in the fusion of the Müllerian ducts during the period of intrauterine formation of the fetus. A double uterus is formed, having one outlet through the cervix and vagina, but fused with two cavities below.

Is it possible to get pregnant and carry a child to term normally with a bicornuate uterus?

It is possible, and often, pregnancy in women with a bicornuate uterus proceeds normally and without complications. However, we should not forget that pregnancy itself in a bicornuate uterus can begin unfavorably. For example, the fertilized egg will attach too low and placenta previa will occur.

The risk of placenta previa or its low location is very high with a bicornuate uterus. Sometimes it happens that a woman fails to get pregnant due to pathology of the uterus. It is also important to know that since one uterus is divided into two, each of these uteruses is smaller in size than a normal uterus, and accordingly, during pregnancy it can be stretched more, putting stress on the muscles and ligaments. All this is fraught with premature birth, premature rupture of amniotic fluid, as well as various anomalies of labor, for example, weakness of labor due to overstretching and fatigue of the uterine muscles. Also, doctors often have to resort to caesarean section, because there is a high risk of trauma to the uterus and fetus during childbirth.

If two eggs have been fertilized, and each of them has implanted in the horns of the uterus, then the pregnant woman must be under close medical supervision throughout the entire pregnancy.

It is easy to diagnose a bicornuate uterus using ultrasound. The only problem is that it is not always possible to identify this before pregnancy for the simple reason that not all women examine the internal genital organs before planning a pregnancy. Often, a bicornuate uterus can be discovered after a so-called habitual miscarriage - when a woman’s pregnancy has repeatedly ended in early miscarriage. In such severe cases as the inability to implant the fertilized egg, or early miscarriages, the doctor may prescribe surgery to restore the uterine cavity. This surgical operation to sew together the uterine horns and restore the normal shape of the uterus is called laparotomy. After laparotomy, a woman can have children and has a chance of a normal pregnancy.

What is a saddle uterus?

The saddle uterus is a peculiar type of bicornuate uterus, and it is also classified as a pathology of uterine development. The difference between the saddle-shaped and bicornuate uterus is that the saddle-shaped uterus is like an intermediate stage between the normal and bicornuate uterus. In the process of formation, the uterus initially looks like a bicornuate uterus, then the stage of its development turns into a saddle-shaped uterus, and only then the saddle-shaped uterus finally fuses and takes on the appearance of a normal pear-shaped uterus. If this process is disrupted, the uterus remains at one of these stages. Therefore, the saddle uterus is one uterus, but often has the shape of a saddle (a deflection in the fundus of the uterus), or a heart (not completely fused septa).

What are the features of pregnancy with a saddle uterus?

Pregnancies with a saddle uterus are known to have a number of complications, often due to abnormal positioning of the fetus. There is not as much space in a saddle-shaped uterus as in a normal-shaped uterus, which is why the baby sometimes chooses not a head-down position, but an oblique or transverse position, in which natural childbirth is dangerous or impossible. Very often, the saddle uterus has poor contractility in the postpartum period, which often results in hypotension or atony of the uterus, and uterine bleeding during or after childbirth.

The uterus with a septum should also be mentioned. Often, a septum is located inside the saddle uterus; this can lead to infertility or early miscarriage. Sometimes a saddle uterus with a septum is combined with isthmic-cervical insufficiency, which can cause a miscarriage, while the frequency of miscarriages in the early stages (in the first trimester of pregnancy) is 20-60%, and in the second trimester - already about 5%. Sometimes it happens that implantation of the embryo occurs not on the muscular body of the uterus, but on the septum, which cannot fully perform the function of the uterus, and the embryo cannot develop.

The septum in the uterus should be surgically removed in case of obvious signs of miscarriage and recurrent miscarriages. The septum is removed using hysteroscopic scissors or a laser. After removal of the septum, a woman has a chance for normal development and course of pregnancy.

– a type of bicornuate uterus; a malformation in which the fundus of the uterus becomes split in the shape of a saddle. The degree of splitting of the uterine fundus into two horns varies, but in all cases the shape of the uterus in cross-section resembles a saddle. The presence of a saddle uterus may not be manifested by any disturbances or may be accompanied by an increased risk of miscarriage, premature birth, weakness and incoordination of labor, and postpartum hemorrhage. The saddle uterus is often combined with other developmental defects. The saddle uterus is usually detected by chance - during ultrasound, hysteroscopy, and nuclear MRI. Surgical correction of the saddle uterus is indicated in case of miscarriage.

Reasons for the formation of a saddle uterus

The saddle-shaped deformation of the uterus is formed between the 10-14th weeks of embryogenesis during the fusion of the mesonephric ducts. At the stage of embryonic development, the uterine cavity is initially represented by two uterovaginal cavities, separated by a median sagittal septum. By the time the female fetus is born, the septum gradually resolves, i.e., the initially bicornuate uterus first takes on a saddle-shaped shape, and then a normal, pear-shaped, single-cavity uterus. In cases where the formation of the uterus is not complete by the time the girl is born, a concavity in the fundus remains, which leads to a congenital defect - a saddle-shaped uterus. In addition to the splitting of the fundus with a saddle-shaped uterus, there is always its expansion in diameter.

The causes of disembryogenesis and the formation of a saddle-shaped uterus can be various damaging factors that disrupt the correct formation of organs during pregnancy: maternal intoxication (alcohol, nicotine, narcotic, medicinal, chemical), vitamin deficiency, stress, endocrinopathies (thyrotoxicosis, diabetes mellitus), heart defects. Infectious diseases of a pregnant woman - measles, influenza, rubella, syphilis, toxoplasmosis, etc. - have an extremely adverse effect on organogenesis. Pregnancy under conditions of toxicosis and chronic fetal hypoxia can contribute to the formation of a saddle-shaped uterus.

Symptoms of a saddle uterus

Outside of pregnancy, a woman may not be aware of the presence of a saddle uterus. A slight saddle-shaped deformation of the uterine fundus does not prevent pregnancy and does not complicate pregnancy and childbirth. With more pronounced changes, there may be a threat of spontaneous abortion, pathology of the placenta (lateral or low location, placenta previa, premature detachment), transverse position of the fetus, breech presentation of the fetus, premature birth.

During childbirth, the saddle uterus can be a factor in the development of abnormal labor - weakness or incoordination. Often, with a saddle uterus in obstetrics, it is necessary to resort to a caesarean section. Anatomical and functional inferiority of the uterus can provoke postpartum hemorrhage. In the absence of proper monitoring of a woman during pregnancy, the risk of perinatal mortality increases. In cases of severe deformation of the uterine fundus, primary infertility may occur.

Diagnostics

In the diagnosis of the saddle uterus, a decisive role is given to instrumental studies - ultrasound, ultrasonography, hysteroscopy, hysterosalpingography, magnetic resonance imaging. A standard gynecological examination for a saddle uterus is not informative.

During pelvic echography (ultrasound), the saddle uterus is not always detected. With significant deformation, transverse scanning reveals an increase in the width of the uterine fundus to 68 mm, thickening of the myometrium of the fundus wall to 10-14 mm and its bulging into the organ cavity. To detect a saddle uterus, it is preferable to perform ultrasound with a vaginal sensor in the second phase of the cycle when the thickness of the endometrium is sufficiently pronounced.

The most reliably characteristic signs of a saddle-shaped uterus are detected during hysterosalpingography: on radiographs, 2 orifices of the fallopian tubes are identified, in the fundus, a small depression in the form of a saddle is clearly visible, protruding into the uterine cavity. Similar signs are detected during nuclear MRI. Hysteroscopy is used to directly visualize the uterine cavity. During pregnancy in patients with a saddle uterus, Doppler ultrasound of the uteroplacental blood flow is monitored, cardiotocography, and fetal phonocardiography are performed.

Treatment of saddle uterus

Surgical tactics for a saddle uterus are used only if conception is impossible (in the absence of other reasons) or habitual miscarriage. Reconstruction of the uterine cavity is often performed during hysteroscopy through natural pathways, without incisions. After correction of the defect, the chances of a normal pregnancy increase tenfold.

Patients with a saddle uterus should be closely monitored by an obstetrician-gynecologist from the early stages of pregnancy, strictly follow all recommendations, and if the slightest disturbance occurs, be hospitalized in a maternity care facility. In case of complicated pregnancy in patients with a saddle uterus, bed rest, antispasmodics, herbal sedatives, gestagens, deproteinized hemoderivative of calf blood, and essential phospholipids are prescribed. Tactics regarding the upcoming birth in pregnant women with a saddle-shaped uterus are decided in advance.

Considering that medicine has come a long way, today people are being diagnosed with more and more pathologies and congenital malformations. The field of medicine such as gynecology does not stand aside; in our time, anomalies in the development of organs of the reproductive and reproductive system are increasingly being identified.

For example, an irregularly shaped uterus, as well as various malformations of its development, are present in 0.1-0.5% of women who have reached childbearing age, while a bicornuate uterus is present in 62% of these women, while a saddle uterus is found in 23 % of cases.

Shapes of the uterus: where is the norm and where is the pathology

The shape of the uterus resembles a pear, which is turned with its extended side up. The upper part is called the fundus of the uterus, and the lower part (isthmus) ends with the cervix, which communicates with the vagina through the cervical canal (which is why sperm, along with pathogenic microflora, penetrate into the uterine cavity).

The length of the uterus reaches 7-8 centimeters, and the width - 4-5 centimeters and weighs about 50-60 grams. At the top, the fallopian tubes extend to the sides from the corners of the uterus, which at the ends resemble brushes and are made of fimbriae. Thanks to the ciliating abilities of the fimbriae, the egg that leaves the ovary enters the fallopian tube, where it implants and develops (during fertilization).

Anomalies in the development of this female organ are numerous and can be either an independent pathology or one of the signs of a defect of the cervix or vagina. Thus, it is customary to distinguish one-horned, double, two-horned and other types of uterus. The saddle-shaped uterus is one of the variants of the bicornuate uterus. In this case, according to Adamyan, the bicornuate uterus is divided into three types:

complete - the division of the uterus into two horns begins at the level of the sacrouterine folds, in which case both horns diverge in different directions at an angle;

incomplete - there is a division of the uterus into two horns, but only in its upper third the shapes and sizes of the horns are identical;

saddle-shaped - the uterus is expanded in cross section, while in the fundus there is a small depression that looks like a saddle; The splitting into two separate horns is practically not expressed, that is, there is a fusion of the horns that does not involve the bottom.

It is characteristic that the pear-shaped uterus is inherent in humans by nature and is intended for bearing only one fetus (the exception is multiple pregnancies). In animals, for example, a dog or a cat, the uterus is normally bicornuate (this can be easily felt on the sides of the pregnant pet’s abdomen, and the fetuses are located like a pea pod).

Causes and mechanisms of development of the saddle-shaped uterus

The cause of the saddle-shaped uterus has not been precisely established to this day. Doctors can only speak with confidence about the mechanism of development of this pathology. It is known that the organ begins to form at 10-14 weeks of intrauterine development of the child. This occurs by fusion of the paramesonephric ducts. As a result, two vaginal-uterine cavities are formed, which are separated by a sagittal septum, in other words, the uterus has a left and a right cavity. During further intrauterine development, this septum gradually resolves, and by the time of birth the girl has a pear-shaped uterus. However, if during the process of embryogenesis harmful factors begin to influence the fetus, incomplete fusion of the paramesonephric ducts occurs, which leads to the formation of various variants of anomalies of the vagina and uterus. Among such unfavorable factors are:

chronic fetal hypoxia due to the presence of various obstetric pathologies;

infectious diseases (influenza, herpes, cytomegalovirus, toxoplasmosis, rubella);

heart defects (heart failure causes chronic intrauterine hypoxia of the child);

endocrine pathologies (diabetes mellitus, thyroid diseases);

• lack of vitamins during pregnancy;

  intoxication of the expectant mother during gestation (use of certain medications, alcohol, drugs, occupational hazards and smoking).

What are the signs of a saddle uterus?

If there are any clinical manifestations of such a pathology of the uterus, then it will take a significant amount of time to find them, or the detection of pathology will be confined to pregnancy or attempts to become pregnant. In other words, the saddle uterus does not have specific signs that would indicate its presence.

It can be present in an absolutely healthy woman who does not even suspect that she has such an anomaly. Another important point is that it is impossible to palpate this feature of the organ during a routine gynecological examination, because the doctor’s hands do not have x-ray properties. Even during an ultrasound examination, it is not always possible to determine the presence of such a deviation, the only exception being ultrasound during pregnancy.

Saddle uterus and pregnancy

It is during pregnancy that the saddle uterus makes itself felt.

Firstly, small changes in the shape of the uterine fundus can provoke a threat, and often a real one, for termination of pregnancy.

Incorrect implantation of the placenta (previa or low location) also occurs with greater frequency. Since the uterus has an uncharacteristic shape, the threat of miscarriage and incorrect placentation are due to the fact that the egg is attached in a place unusual for it. As the gestational age increases, a transverse position or malpresentation of the fetus may appear. Also, due to improper attachment of the baby's place, there is a risk of placental abruption and subsequent uterine bleeding.

The likelihood of developing premature birth in women who have a saddle-shaped uterus is significantly higher than in women with a normal form of the organ cavity.

During childbirth, there is a disturbance in the transmission of nerve impulses during contractions, against the background of which an anomaly of labor forces develops (either incoordination or weakness of labor). Therefore, in most cases, such births end through cesarean section.

In the postpartum and subsequent period, there is a high risk of bleeding due to impaired contractile activity of the uterus.

However, the described complications may not always be present; about half of the pregnancies of women with a saddle-shaped uterus end and proceed safely.

Problems with conception

Many women ask the question: “Since I have a saddle uterus, does that mean I won’t be able to get pregnant normally?” It is worth answering right away that such a malformation of the uterus is not always the cause of female infertility. Difficulties with conception can arise only when there is a pronounced saddle shape and the attachment of the fertilized egg occurs in the wrong place. If there is an intrauterine septum, even if pregnancy occurs, in 90% of cases it ends in spontaneous abortion.

If a woman has slightly pronounced saddleback, but cannot get pregnant safely, then the reason for the lack of pregnancy should be looked for elsewhere (tubal obstruction, hormonal imbalances). It is also worth noting that such an anomaly in the development of the uterus is quite often combined with other congenital defects of the reproductive and urinary systems. In addition, not everyone has a normal hormonal balance in the body, and not everyone can boast of the absence of chronic extragenital pathologies.

Poses for conception if you have an irregularly shaped uterus

If we talk about the most optimal positions for successful conception in the presence of a saddle uterus, one thing can be said that there are no positions that are inappropriate or suitable in order to get pregnant. Today, many online forums discuss positions during sexual intercourse that are better than others for a particular gynecological pathology. Don't delude yourself.

Sexual intercourse and receiving pleasure during it are aimed at making the woman pregnant as a result, therefore, no matter what position it occurs in, in the absence of pathologies, pregnancy will occur, since this is how nature intended. A man’s sperm have pronounced motility and activity, and do not lose their viability for a long time, so the chances of successfully conceiving a child in a woman with normal health are much higher than the chances that “it might pass.”

If you cannot conceive even if you follow the recommended sexual position, you should start looking for a problem in your own health (this may not necessarily be a pathology that the woman herself is guilty of) and in the health of her sexual partner (perhaps the percentage of live and active sperm in the ejaculate is small).

The saddle-shaped uterus plays absolutely no role in the ability of sperm to penetrate the uterine cavity and move through the fallopian tubes to fertilize the finished egg. The question is: can an already fertilized egg be safely implanted in the right place in the uterine cavity? Therefore, position during intercourse plays absolutely no role.

Diagnostics

To diagnose a saddle-shaped uterus, the following examination methods are the most suitable and effective:

Ultrasound of the appendages and uterus.

Ultrasound examination does not always reveal such an anomaly. In the presence of significantly pronounced deformation, during a transverse scan, an increase in the width of the uterine fundus is determined to 68 mm, the myometrium is also thickened to 10-14 mm and bulges into the uterine cavity. The optimal option for ultrasound examination for diagnosing such a pathology is ultrasound with a vaginal sensor, and it is better to perform it in the 2nd half of the cycle, if there is a significant thickness of the endometrium.

Hysterography and hysterosalpingography.

This is a type of X-ray examination in which a contrast agent is injected into the uterus, and then a series of images of the organ are taken. A sign of the presence of a saddle-shaped uterus is a saddle-shaped depression that protrudes into the uterine cavity.

Magnetic resonance imaging.

The method consists of taking a series of photographs at different levels of the internal genital organs.

Hysteroscopy.

An optical device is inserted into the uterine cavity, with the help of which a visual examination of the organ cavity is performed and developmental pathologies, if any, are detected.

Treatment of pathology, including therapy during pregnancy

Treatment of such a malformation of the female fetal sac is carried out only in the absence of the ability to become pregnant or if recurrent miscarriage develops. Plastic reconstructive surgery is performed through hysteroscopy, in other words, without a visible incision or prolonged anesthesia. After surgery, the chances of pregnancy and pregnancy increase tenfold or more.

During pregnancy, if a woman has a saddle uterus, if obstetric complications are detected (intrauterine hypoxia of the fetus, threat of miscarriage), appropriate treatment is prescribed: hormonal drugs (Utrozhestan, Duphaston), tocolytics and antispasmodics, bed rest. To improve blood flow in the uterus-placenta system, it is recommended to use drugs that normalize blood clotting and metabolic processes (Troxevasin, Essentiale-Forte, Curantil, Actovegin).

It is a type of bicornuate uterus. The cause of this anomaly is considered to be a defect in the intrauterine development of the fetus. It appears as a result of maternal alcohol and drug addiction, smoking, taking medications during pregnancy, vitamin deficiency, diabetes mellitus, heart disease, and thyrotoxicosis. The appearance of a saddle uterus can be provoked by infectious diseases suffered by the mother: influenza, scarlet fever, rubella, measles, syphilis, toxoplasmosis.

Sometimes the cause of the development of pathology is fetal hypoxia - a chronic lack of oxygen.

The saddle uterus does not show any symptoms. In most cases, it does not affect the possibility in any way; conceiving will not be difficult. In order for all the sperm to successfully reach the cervix, the most suitable position is the classic position - lying on your back. If the deformation of the organ is mild, the attachment of the egg occurs in the same way as in the usual form. We can talk about it when the saddle-shaped shape of the uterus interferes with the attachment of the fertilized egg to its wall.

If with this pathology it is not a problem to get pregnant, in this case the difficulty becomes preserving the fetus. A deformed organ can provoke premature birth, low-lying fetus, early placental abruption, placental abruption, low placentation. In these cases, the risk is high. During childbirth, a saddle uterus can cause incoordination (impaired labor), so a caesarean section is recommended. During the postpartum period, there is a high risk of serious bleeding, which can be fatal.

Treatment of saddle uterus

Correction of a defect in the structure of the uterus is only possible through surgery. The operation is prescribed if the saddle of the uterus causes infertility or miscarriage. The intervention in most cases is carried out using hysteroscopy through natural pathways, and no incisions are made on the body. As a result of such an operation, the likelihood of conception and normal pregnancy increases tenfold.

A slight change in the shape of the uterus does not affect the course of pregnancy.

If it was possible to conceive a child with a saddle uterus without resorting to surgical correction of the organ, the woman should follow the necessary recommendations, starting from early pregnancy. It is believed that a small deformed organ does not affect the course of pregnancy. However, with the slightest deterioration of the condition, hospitalization in a hospital is required. If complications are identified with a saddle uterus, antispasmodics, gestogens, and sedative herbal remedies are prescribed, which will maintain the woman’s good condition during pregnancy.

Most women perceive the diagnosis of a “saddle uterus” as a terrible death sentence and classify themselves in the “infertile” group. In order to understand whether this is really true or not, you need to find out what kind of disease this is, what effect it has and whether it is possible to get pregnant with a saddle uterus.

Instructions

The saddle uterus is a peculiar anomaly of the woman’s reproductive system, which consists in a change in the structure of the uterus. It has a slightly different shape, the features of which are a flattened bottom and widening across. If you look at such a uterus in cross-section, its shape resembles a saddle. The causes of this disease are still not reliably known. With confidence, our medicine can only state the fact that this pathology begins to appear as early as the 14th week of intrauterine development of the fetus.

It should be immediately noted that pregnancy and saddle uterus are completely compatible concepts, since the presence of this disease does not pose a health threat to either the mother or the child. If the uterus has minor changes in shape, then this has virtually no effect on the conception of a child and does not cause difficulties either during fertilization or during pregnancy. During the period of gestation, all processes proceed in the same way as in a healthy woman.

You can speak only when the saddle of the uterus is clearly pronounced. In most cases, with this degree of disease, the fertilized egg cannot implant normally due to the shape of the uterus. With this diagnosis, the placenta is not attached correctly. This is due to the fact that placentation with this form of the uterus may be low or lateral due to the lack of the necessary platform on the fundus of the uterus. Also, with a saddle uterus, the fertilized egg may be attached, but incorrectly, which leads to miscarriage and premature birth. In some cases, partial placental abruption is observed, which is accompanied by heavy bleeding. In addition, this diagnosis is accompanied by pain in the bladder. The formation of the pelvis in women with this anomaly is accompanied by poor development, which leads to incorrect placement of the fetus in the event of pregnancy.