Complete septate uterus with longitudinal vaginal septum

OBJECTIVE: To review clinical implications, reproductive outcome, and long-term consequences in women with complete septate uterus and longitudinal vaginal septum. DESIGN: A retrospective study. SETTING: A university hospital. PATIENT(S): Sixty-seven patients who had a complete septate uterus including the cervix and a longitudinal vaginal septum. INTERVENTION(S): The longitudinal vaginal septum was incised in 36 cases and metroplasty for uterine septum was undertaken in 4 patients. MAIN OUTCOME MEASURE(S): Fertility, outcome of pregnancies, possible late consequences, and presence of other anomalies. RESULT(S): Eight (15.7%) of 51 women attempting pregnancy had primary infertility of nonuterine causes. Forty-nine women not undergoing metroplasty produced 115 pregnancies, abortion rate 27%, preterm delivery 12%, and live birth rate 72%. Only five women with no metroplasty had only miscarriages and 44 women at least one delivery. One of four women undergoing metroplasty delivered preoperatively and three after metroplasty. During the follow-up period endometriosis was observed in two (3%) of 61 cases and two patients had borderline ovarian tumors. Kidney abnormalities were found in 11 (20%) of 55 patients studied, double ureter being the most common. CONCLUSION(S): Complete septate uterus with longitudinal vaginal septum is not associated with primary infertility, and pregnancy may progress successfully without surgical treatment. The results do not support elective hysteroscopic incision of the septum in asymptomatic patients or before first pregnancy.