A Miracle Baby: Grappling with Repeated Miscarriages

Never did she expect that starting a family was such a challenge. She had had 3 miscarriages for the past 4 years. Y, aged  35, came from a neighboring country. For her first pregnancy, she conceived within  6 months of her marriage. She thought that everything would be smooth-sailing. Unfortunately, she had a miscarriage at about 10 weeks of gestation. She felt upset and grieved over her loss  for a while. It took her another year to conceive the second time. The pregnancy progressed smoothly until the fetal heart stopped beating at 12 weeks of gestation. She was  devastated  and suffered a short spell of depression. She had some blood tests done by her local gynecologist, who told her that all the results were normal and the miscarriage was due to “bad luck”.

She moved with her husband to another town due to his work commitments. She was pregnant soon after. Again, mishap happened at around 16 weeks of gestation. This time, she was told that the miscarriage was due to an abnormal wedge of tissue which was found to divide the upper part of her uterine cavity.

“Doc, can you please confirm this anomaly and help me solve the problem?” she asked. Y had a uterine septum which was confirmed by a magnetic resonance imaging (MRI). A uterine septum occurs when a full or partial wall separates the uterus. It is a structural abnormality and is formed during Y’s development as a fetus.

Cause of the septum: During embryonic development, the uterus starts out as two small tubular structures. As the fetus develops, each structure moves downwards and towards the middle of the body where they fuse together to form a single organ. Normally, the wall where the two tubes join in the middle will break down completely resulting in a single triangular shaped uterine cavity (fig 1). If the wall between the two tubes does not disintegrate completely, a septum will form (fig 2).

Figure 1

Figure 2