Adolescent female referred to ultrasound in view of complaints of dysmenorrhea.

Findings :  Thick hypoechoic septum is seen in Uterine cavity extending from fundus upto distal part of cervical canal.

No obvious fundal indentation noted.

No collection seen in endometrial cavity.

These findings are S/O Complete septate uterus ESHRE CLASS U2b

Differntial diagnoses : Arcuate uterus , Bicoporeal  uterus and thick intrauterine adhesion band.

A septate uterus is the most common type of congenital uterine anomaly, and may lead to an increased rate of pregnancy loss. 

Congenital malformations of the female genital tract are defined as deviations from normal anatomy resulting from embryological maldevelopment of the Mu¨llerian or paramesonephric ducts.

Design of the new and most widely used system is ESHERE/ESGE CLASSIFICATION.

Main concepts of  ESHRE/ESGE classification system has the following general characteristics :

Ultrasound findings of complete septate uterus :

The echogenic endometrial stripe is separated at the fundus by the intermediate echogenicity septum (which is isoechoic to myometrium). In a complete septate uterus, the septum extends to the cervix. The external uterine contour must demonstrate a convex, flat, or mildly concave (ideally <1 cm) configuration and may best be appreciated on coronal images of the uterus.

Now a days 3D and 4D scans on USG are very helpful in dignosing these mullarian anamolies.