Grossesse menée à terme sur utérus cloisonné

Pregnant women with septate uterus are at risk of obstetric complications due to reduced uterine cavity, less effective muscles, inability to distend, myometrial and cervical dysfunction, inadequate vascularity and poorly developed endometrium. It is responsible for a higher rate of recurrent miscarriage, preterm deliveries, dystocia, intrauterine growth retardation (IUGR), and cesarean sections. We here report the case of a 23-year-old nulliparous patient (2 spontaneous abortions without curettage), with no significant pathological history. She presented at 8-week of amenorrhea. Clinical examination showed vaginal septum. Ultrasonography objectified progressive intrauterine monofetal pregnancy with suspected septate uterus. Therapeutic approach included: rest, antiplatelet aggregation drug (100mg/day), local progestins, prophylactic cerclage at 12 weeks of amenorrhea (SA) and close follow-up. Patient's outcome was favorable and marked by appropriate gestational age estimated by fetal biometry, premature rupture of the membranes at 28 weeks for which lung maturation was accelerated and the patient received antibiotic therapy, cerclage removal twice-weekly monitoring with C-reactive protein (CRP) test followed by caesarean section at 36 weeks due to breech presenting infant.

Key words: Septate uterus, pregnancy, complications