Saddle womb: causes, conception andpregnancy, symptoms and diagnosis

Update: October 2018

Due to the fact that medicine has leaped forward, to the present
time people are being diagnosed with more and more diseases and congenital
malformations. Is not an exception and the field of gynecology,
when malformations of genital organs began to be detected more often
system.

For example, an irregular shape of the uterus and various defects
development has 0.1 – 0.5% of women of childbearing age, and
two-horned uterus is observed in 62% of the specified number of women, and
saddle takes 23%.

The shape of the uterus: the norm and pathology

The uterus looks like a pear, with the expanded side turned upwards.
The upper part of the uterus is called the bottom, and the lower part or the isthmus
ends with the cervix, through the channel of which the cavity of the uterus
communicates with the vagina (this is the way spermatozoa like
however, the whole pathogenic microflora, and penetrate into the uterus).

The length of the main female organ is 7–8 cm, width 4–5 cm, and
weighs uterus about 50 – 60 grams. From the corners of the uterus (top) to
lateral sides of the pipe go away (fallopian), which have the form
tassels on the ends (fimbriae). Thanks to the flickering fimbria
the ovule released from the ovary enters the fallopian tube, where
fertilization occurs.

Anomalies of development of the uterus are numerous and can be as
self-pathology, and combined with developmental defects
cervix and / or vagina. So, allocate two-horned uterus,
horned uterus, double and others. Saddle uterus
treats numerous options of a two-horned uterus. In his
queue, two-horned uterus (Adamyan) is divided into 3
view:

  • saddle (there is an expansion of the uterus in cross section, and in
    bottom area there is a slight depression that resembles a saddle;
    the splitting of the uterus into 2 horns is practically not expressed, that is, it has
    the place of fusion of the uterine horns, not capturing the bottom);
  • incomplete (there is a division of the uterus into 2 horns only in her
    upper third, but the size and shape of the horns are identical);
  • complete (separation of the uterus into 2 horns begins immediately, on
    level of the sacro-uterine folds, in this case both horns
    branch in opposite directions at an angle).

Characteristically, the pear-shaped uterus in man laid
nature and is intended for carrying (except, of course,
multiple pregnancy) only one child. But the structure
the uterus, for example, a cat or dog has a two-horned shape that can
palpate during pregnancy the animal from the sides of the abdomen (fruits
arranged as in a pea pod).

Causes and mechanism of development of the saddle uterus

What contributes to the formation of the saddle uterus, that is, the causes
the development of this defect is still not precisely established. WITH
With confidence, doctors only state the development mechanism
abnormalities of the uterus. It is known that at the 10-14 week of embryogenesis
the formation of the described organ begins. This is due to
fusions of paramesonophral ducts. What is formed
two utero-vaginal cavities, the separation of which is due to
a sagittal septum (i.e., there is a right and left
cavity).

During prenatal development, or rather, to its end,
this partition is absorbed, and the formed uterus becomes
single-cavity. That is, the initially formed two-horned uterus with
obstructed inside by the end of intrauterine development acquires
saddle shape, and by the time the girl is born
pear-shaped. But if in the process of embryogenesis harmful
factors, then there is an incomplete fusion of the parameson
ducts, which causes different variants of uterine defects
and / or vagina. Such adverse factors include:

  • intoxication of women during pregnancy (use
    drugs, alcohol, smoking, certain drugs or
    occupational hazards);
  • lack of vitamins during pregnancy;
  • stress;
  • endocrine pathology (diseases of the thyroid gland, sugar
    diabetes);
  • heart defects (associated heart failure
    leads to chronic fetal hypoxia);
  • infectious diseases (rubella, toxoplasmosis,
    cytomegalovirus, herpes, flu and others);
  • chronic hypoxia in the mind of various obstetric
    pathologies.

How to suspect the presence of a saddle uterus?

If you look for some clinical manifestations of this anomaly
uterus, the search for them will take considerable time, at least until
as long as the woman does not think about pregnancy or not
will get pregnant. Why? All simple, specific signs
saddle uterus does not exist.

It can take place at quite healthy in all respects.
a woman who does not even suspect the presence of such a defect in her.
All the more so to probe the saddle uterus during
gynecological examination is simply impossible (the hands of doctors are not
have radiological abilities). Yes, and with the passage
Ultrasound of the pelvic organs this defect is not always detected (for
exception, perhaps, only ultrasound examination
pregnant patient).

Pregnancy and saddle uterus

BUT here’s a saddle uterus during pregnancy will usually give about
know yourself.

  • First, the slightly modified shape of the fruit tree can
    provoke a threat, and often permanent, interruptions.
  • Also, abnormal placentation (low
    location of the placenta or its presentation). Since the uterus has
    uncharacteristic form, then the threat of miscarriage, and the wrong
    placentation is due to the attachment of a fertilized egg in
    not very convenient place for it. As the gestation period increases
    wrong position and presentation of the fetus may occur
    (transverse or pelvic presentation). Again as a result
    improper attachment of the placenta increases the risk of it
    premature detachment, and therefore bleeding.
  • The probability of preterm labor in women with a saddle
    the uterus is also higher than in pregnant women with normal form
    fruit shrubs.
  • At birth, the process of transmission of nerve impulses during the
    contractions, which leads to various anomalies of labor forces (or
    weakness of labor activity, or discoordination). Therefore, more often
    such deliveries end in abdominal delivery, that is,
    cesarean section.
  • Both in the postnatal and postpartum periods there is a high risk of
    bleeding due to impaired contractile activity
    uterus.

But the described complications are not always the place to be, in half
cases of pregnancy in women with a saddle uterus proceeds
safely.

Problems with conception?

Many women are interested in the question: “If I have a saddle-shaped uterus,
so I can not conceive a child and how to get pregnant? “. I want to
immediately reply that this malformation does not always lead to
infertility, and many women become pregnant without problems.
Difficulties with conception occur only among women who have
Significantly pronounced uterine saddle due to impairment
attachment of a fertilized egg. In the case of existing
intrauterine septum (except the saddle-shaped uterus) pregnancy,
if it comes, then in 90% of situations ends up spontaneous
abortion

If a woman has a uterus saddle shape slightly, but
she still can not get pregnant, then you should look for others
causes of infertility. WITHледует помнить, что данная аномалия матки часто
сочетается с другими пороками урогенитальной system. Besides,
not everyone has a normal body hormone balance or
there are no chronic extragenital diseases (see
inflammation of the appendages, obstruction of the fallopian tubes, boron uterus
for conception).

Pose for conception with the uterus of irregular shape

As for the optimal posture for conception with a saddle uterus,
as a doctor, I will immediately say that there are no suitable or inappropriate poses for
getting pregnant. Currently the Internet is very
forums where poses are actively discussed during sex,
most favorable for a particular gynecological pathology.
Girls, do not flatter yourself!

Sexual intercourse and the pleasure associated with it are aimed at
so that a woman becomes pregnant, no matter what position he is in (yes
even on the head) – so laid by nature. Male sperm
have a pronounced activity and mobility, for a long time not
lose vitality and therefore the chances of getting pregnant from healthy
women are much higher chance of “carried”.

If a woman cannot conceive a child, even sticking to
recommended posture, you should look for the problem either in yourself (and she
will not necessarily be in the pathology, which she sins herself),
either in a man (it is possible that he has a small percentage of active and living
sperm in the ejaculate, see decoding of semen).

WITHедловидная матка не играет никакой роли в проникновении
�“Zinger” into her cavity and then into the fallopian tubes, where they
meet with the egg to fertilize it. The question is
will the fertilized egg be able to attach itself to the uterine mucosa?
and in the right place? Therefore, I repeat, the pose with coitus is not
plays no role.

Diagnostics

Additional methods help diagnose saddle uterus
surveys:

  • Ultrasound of the uterus and appendages

Ultrasound helps to detect the described
anomaly far away forever. If the deformation is significantly pronounced, then
during the transverse scan revealed an increase
the width of the uterine bottom is up to 68 mm, myometrium is 10 to 14 mm thick and
отмечается, что он выбухает в полость uterus. Optimal for
identify the saddle uterus, is an ultrasound vaginal examination
sensor and preferably in the second half of the cycle, when the endometrium
has a considerable thickness.

  • Hysterosalpingography or hysterography

These are radiological methods of examination, during which time
the uterus is injected with an x-ray contrast agent, and then
take pictures. A sign of saddling is having
углубления в виде седла, которое выдается в полость uterus.

  • Magnetic resonance imaging

The method consists in carrying out a series of snapshots of internal genital
organs at different levels.

  • Hysteroscopy

An optical device is inserted into the uterus, through which
she is examined and identified various intracavitary pathology.
Read more about the effects of hysteroscopy.

Treatment, including during pregnancy

Treatment of this malformation of the uterus is carried out only when
inability of a woman to become pregnant, or in the case of the usual
miscarriage Plastic surgery is performed (reconstruction
uterus) by hysteroscopy, that is, without visible incisions and
prolonged anesthesia. After surgery
the chances of getting pregnant and carrying a child without complications increase in
10 or more times.

During pregnancy in women with a saddle uterus during
obstetric complications (threat of interruption, chronic
intrauterine hypoxia of the fetus) appropriate treatment is prescribed:
bed rest, antispasmodics and tocolytics, hormonal preparations
(dufaston, urozhestan). To improve uteroplacental
blood circulation drugs recommended that normalize exchange
processes and blood clotting (Actovegin, chimes,
Essentiale-Forte, Troksevazin and others).

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