Vaginal septum in women: A review of diagnosis, management, and obstetric outcomes

Abstract

 

Congenital anomalies of the female genital tract, such as vaginal septa, arise from disruptions in Müllerian ducts and urogenital sinus development. Vaginal septa, including longitudinal and transverse types, are rare and often remain undiagnosed due to asymptomatic presentation. However, they can lead to significant complications such as dyspareunia, infertility, and obstructed labor. This narrative review aims to provide a detailed overview of the clinical presentation, diagnosis, and management of vaginal septum, with a particular focus on the challenges encountered during pregnancy and labor. A systematic search of PubMed, Web of Science, Scopus, and Embase identified 34 relevant articles, including 16 case reports detailing labor outcomes in women with vaginal septum. The review highlights that timely diagnosis through pelvic examination and imaging, such as magnetic resonance imaging or ultrasound, can prevent labor complications. Management options range from conservative observation in asymptomatic cases to surgical resection, which can be performed intrapartum or before delivery to facilitate vaginal birth. The presence of associated anomalies, including uterine malformations and renal agenesis, underscores the need for thorough evaluation. Postoperative outcomes are generally favorable, though careful surgical planning is essential to avoid complications such as restenosis or infection. Clinicians should remain highly vigilant for women with unexplained infertility, menstrual abnormalities, or labor obstruction. Early identification and individualized management of vaginal septum can optimize obstetric outcomes and preserve reproductive function. Future research should aim to improve early detection methods, refine surgical techniques, and investigate the genetic and embryological basis of these rare anomalies.

 

Keywords: Hysteroscopy, Longitudinal vaginal septum, Obstructed labor, Resection, Ultrasound