Answers?

With intense relief at having seen our baby’s heart beating, we quickly shared the news (and first pictures of our baby!) with our parents (who had been worried sick and praying relentlessly with us) and decided to tell our siblings as well. Ultimately, we knew that whichever way this all went for us, we would need all of their support no matter what.

Shortly after sharing the good and relieving news of finding our baby’s heartbeat, we received the rest of the less assuring results from the ultrasound. I was told that I had a possible partial septate uterus. (A septate uterus is a uterine deformity that happens during fetal development. The uterus is divided in some degree by a membrane called a septum. Some are separated almost completely, but mine was just partial.) The scan showed that the gestational sac had implanted on the left side of the uterus, and there was a subchorionic hemorrhage (active bleeding) on the right side.

This was a lot of new information to digest and we approached our doctor’s visit two days later hoping for an explanation and some answers. We sort of got those things.

It was all found to be confusing that the septate had not appeared as a result in any previous tests. In October of 2017, I had a hysterosalpingography (HSG) performed, where the doctor was able to check for uterine abnormalities and to see if my Fallopian tubes were clear or not. It’s a common procedure for women who have had difficulties trying to conceive. It was a more invasive and painful experience for me than I had expected, but my doctor had informed me (in a non-creepy way) that my uterus looked beautiful and she was able to clear the bit of blockage in my tubes. She hadn’t noticed anything abnormal in my uterus at that time, or during a laparoscopy to remove endometriosis a few months later. 

It wasn’t until an ultrasound looking for cysts and fibroids in December 2018 that she noticed I had a slight bicornuate (or heart-shaped) uterus. She had said that it shouldn’t make it more difficult to conceive, but that it could potentially cause complications in pregnancy, and would need to be monitored. At the time, I wrote it off, because getting pregnant was the current issue. Complications could come later.

Fast forward to later when complications did in fact come: my new doctor explained that septate uteri can be misdiagnosed as bicornuate, but she definitely saw a small, partial septate that was causing bleeding and could threaten the entire pregnancy. She said that basically the left side of my uterus was growing a baby and the right side was bleeding like I was having a period. We were told that the bleeding would likely stop—either by bleeding out or being reabsorbed into my body. 

For the time being, the bleeding itself was not harming the baby. The real threat was that as the baby continued to grow and the pregnancy progressed, my uterus may not have the strength (because of the septate) to allow the baby to grow as it needed to, which could lead to miscarriage, low birth weight, preterm labor, or bleeding complications after delivery. However, the doctor assured us that as long as the baby grew normally, it could even out the sagging caused by the septate and everything could progress normally from there on out. 

A septate uterus can easily be fixed with a small surgery, but obviously not once I was already pregnant. All we could do at the time was wait and see what happened. My doctor ordered weekly ultrasounds to monitor the baby, the hemorrhage, and the growth of my uterus. She declared me high-risk, referred us to a perinatal specialist, and put me on work restrictions.

We left feeling overwhelmed by the new information, but slightly better for at least having a sense of what was going on. We accepted that day that nothing about our pregnancy journey was likely going to be normal or easy or what we had long expected. We had hope that all would turn out just fine and come September 1ish we would get to me our healthy baby, but we knew that no matter what happened, we would be okay.