In August 2024, Hailey and Justin Bieber welcomed their first child. A happy ending for a journey strewn with uncertainties. Indeed, in the podcast SHE MDthe 29-year-old young woman spoke about the announcement that turned her vision of motherhood upside down: a uterine septum.
“It was a surprise!“, she admitted. Her gynecologist, Dr. Thaïs Aliabadi, had for her part advised her not to conceive before a possible intervention.
What is a septate uterus?
The septate uterus is an anomaly whose origin dates back to embryonic development.
As explained by Dr Samuel Salama, gynecologist at the American Hospital of Neuilly, consulted by True Medical : “It is a congenital anomaly linked to the Müllerian ducts.
During fetal life, these ducts fuse, but a lack of differential growth prevents resorption of the central wall. Instead of leading to a single, spacious cavity, a partition persists.”
This wall can be more or less important. Dr. Salama clarifies the anatomical nuances. “When this fold measures less than ten millimeters, we speak of an arcuate bottom; it is a simple variation of the normal. On the other hand, when a septum descends more pronouncedly and occupies more than a third of the uterus, this becomes problematic because the depth of the cavity is reduced.”
A complex and often ignored diagnosis
Hailey Bieber pointed out that this malformation is often missed during traditional examinations. An observation shared by specialists, for whom precision imaging is essential.
“3D ultrasound is today the reference examination for visualizing the septum and, above all, for differentiating it from a bicornuate uterus.says Dr Salama.
This distinction is vital for treatment. According to the doctor, “the septate uterus has an internal wall that can be resected, while the bicornuate uterus is made up of two distinct structures which have never fused. In this second case, any surgical intervention is prohibited because it would lead to perforation.”
What are the risks for pregnancy?
For Hailey Bieber, the risk of miscarriage was estimated between 25 and 40%, with a probability of premature birth of 10 to 20%.
Dr. Salama confirms that this anatomical configuration “significantly increases the risk of miscarriage, particularly during the second trimester, as well as the risk of premature birth.
Another mechanical complication concerns the position of the fetus.
“We observe a higher prevalence of breech presentations, because the child has less space to rotate naturally,” adds the gynecologist. This lack of space therefore leads to more frequent recourse to cesarean section.
Should you operate before conceiving?
Faced with this diagnosis, the question of surgical resection sometimes divides the medical profession. If Dr. Aliabadi was cautious with Hailey Bieber, Dr. Salama advocates a case-by-case approach.
“A woman should never be prevented from conceiving. However, when faced with a large septum, or in a context of infertility and a history of miscarriages, intervention is strongly recommended.”
The operation, carried out under general anesthesia, consists of cutting the septum using natural means. “The goal is to restore a functional uterine cavity“, explains the doctor.
Although the systematic surgical benefit is still debated in the scientific literature, recent studies suggest a clear improvement in pregnancy outcomes after the procedure. For Hailey Bieber, destiny finally defied the statistics: despite a septum that widened over the months, her son was born full term and in perfect health.