Our stories are told and retold by people with the idea of spreading hope and happiness. This is perhaps what led Pragathi to us and Dr. Girija. With the baggage of three miscarriages weighing her down incredibly, Pragathi met Dr Girija with a heart full of hope for a medical magic from her. Dr. Girija knew the kind of responsibility this brought to her lap, but also knew that she could bring a world of happiness to Pragathi’s life.
With the motive of helping Pragathi become a mother with minimal discomfort and maximised happiness, Dr. Girija brought her expertise to the table, listening to Pragathi and her physical and emotional struggle over the past few years. Learning about the series of her miscarriages and the effect that it had on her, Dr. Girija, with her softness, first made Pragathi feel comfortable before probing on.
Even though a miscarriage is quite a common thing to happen, especially in the first trimester, yet, having a series of them can be quite daunting mentally and is usually indicative of a defect in the reproductive system of the woman. Considering the fact that Pragathi had presented with not one or two, but three miscarriages in the recent past, it became paramount for Dr Girija to ascertain the causes behind it. The fact that the pregnancies were not lasting had already created a few diagnoses in Dr. Girija’s understanding, but she wanted to be sure and conducted a couple of ultrasounds and an MRI to get a better picture.
Upon doing so, Dr. Girija discovered that Pragathi had two conditions: bicornuate uterus and a septum in the uterus.
Even though the heart shape is most people’s favourite, making its presence felt in everything from pillows to cakes and even balloons, the one thing that’s not supposed to be heart-shaped is the uterus. Bicornuate uterus is exactly that. The uterus is made up of many ducts and when some of them fuse during development, it takes the shape of a heart. Even though it’s not very common, yet many women don’t know that they have this condition till the time an ultrasound is performed for some reason. It’s not known to cause issues with fertility, however, it could cause problems for pregnant women as the dimensions of the uterus become compromised due to its shape.
This is a completely different condition. Occurring even before birth, it happens when a tissue inside the uterus called septem, made of fibrous muscles, divides the uterus almost in half. Understandably, this has the potential to have impacts in terms of pregnancy. Here’s one way of explaining it. Let’s imagine you have a bag that can hold 10 shirts. If you put a divider in between the bag, it will divide it into two portions, right? Each portion will now have only 50% of the capacity. Even though in a bag, you can split the total no of shirts and still be able to carry it, when the same happens in a uterus, one can’t replicate the split in load, because the baby can’t be split into two halves. When a woman conceives, it is the uterus that will carry the baby. When it is divided into two portions, the baby will grow only in one portion. With reduced capacity, the space available for the baby to grow in is compromised, either triggering a miscarriage, or causing birth defects, or leading to a complicated pregnancy.
Many doctors misdiagnose the condition, often using the terms interchangeably. However, they are two distinct conditions, with a bicornuate uterus being a shape defect causing a heart-like appearance, while a septum is a structural defect causing a split in the uterus. One of the reasons why visiting a doctor who has rich experience and incredible knowledge is important is because misdiagnosing a condition like this could lead to very bad clinical outcomes.
That way, Pragathi considers herself lucky to have found Dr Girija because not just was she able to diagnose the conditions accurately, but could also understand that Pragathi had the rare case of having both the conditions. This discovery was important because the treatment plans would change considerably.
Even though a bicornuate uterus can be left untouched, but the septum would need surgical treatment as Dr Girija identified this to be the cause of Pragathi’s previous miscarriages. She assured Pragathi that a surgical intervention to partially correct the septum would be able to help her sustain her pregnancy and lead to successful delivery too. With that in mind, she recommended Pragathi to septal resection, which would partially remove the septum, with the aim of increasing the capacity of the uterus portion by 60%. That would ensure the stability of future pregnancies, giving enough room for the baby to grow in.
Did the surgical process mean that Pragathi’s dream of holding her baby in her arms could finally come true? The next blog will answer that question. Keep reading!