The position of the uterus is not the same in all women since despite being attached to the other structures by the ligaments it has some mobility. It can be located anteversion, which is the most frequent position.
When the uterus is anteverted it means that the cervix is at the bottom of the vagina , but from there the uterus is oriented forward, towards the bladder of urine and the pubic bone. When the uterus is retroverted from the cervix, the uterine body is oriented posteriorly, that is, towards the rectum.
The positions of the uterus
The different positions of the uterus within the abdominal cavity are variants of the normality, but they do not have repercussions in the pregnancies, deliveries … simply the anteversion position is more frequent than the retroversion.
The fact that the retroverted position is less frequent is a variant of normality. However, in some cases, the retroverted uterus is associated with endometriosis . This pathology produces adhesions between different tissues and it is frequent that it causes the uterus to adhere to the rectum, that is to say, towards its posterior face and that it loses mobility.
When it is interesting to know the position of the uterus
Sometimes the gynecologist is interested in knowing the position of the uterus, especially when he must insert an instrument into the uterine cavity since he must know in which direction the material should be directed. The procedures in which it is very important to know the uterine position are:
- The hysteroscopy , a surgical procedure in which a camera is inserted into the endometrial cavity.
- In the placement of an intrauterine device ( IUD ).
- Uterine curettage , both for an abortion and for the study of irregular bleeding.
- In embryo transfer in in vitro fertilization procedures or in artificial insemination.
In order to determine the uterine position, the gynecologist can perform a vaginal examination with a bimanual examination, that is, holding the cervix with one hand from the vaginal side and with the other hand palpating the upper uterine face through the abdominal wall. Another way to determine the uterine position is with an ultrasound , both abdominally and transvaginally.
The cervix or cervix
It is the lowest part of the uterus, it has a cylindrical shape, with a canal in the center, the endocervial canal, and communicates the vagina with the uterine body.
The uterine body
It is the uppermost part of the uterus, in the shape of an inverted pear and has a virtual cavity inside that is where the fetus, placenta and amniotic fluid are housed in a pregnancy. The wall of the uterine body is made up of three layers :
- The layer outermost , which is in contact with the inside of the abdomen, called serosa and is a very thin layer, like a paper film that covers the entire body.
- The middle layer is the thickest and is made up of muscle, called the myometrium and is responsible for contractions in labor.
- The innermost part is the endometrium, the mucosa that comes off every month with the rule if there has been no pregnancy and where the pregnancy nests if it occurs.
The uterus on its lower face contacts the vagina and has several ligaments to hold itself in place :
- The round ligaments , one on each side, that laterally join the upper part of the uterus with the groin.
- The uterosacral ligaments connect the posterior aspect of the uterus with the sacrum, the bone at the end of the spinal column.
Organs related anatomically to the uterus
- On the front side , the uterus is related to the urine bladder since it is the structure that is located just in front of the uterus, and on the back side it is related to the rectum.
- The uterus in its lower part is continuous with the vagina and in the upper part it is in contact with the intestines.
- In the upper and lateral angles of the uterus, the fallopian tubes originate that will end up contacting the ovaries, generally on both sides of the uterus, but sometimes the ovaries are located on the posterior uterine face.
What you should know…
- In some cases, the retroverted uterus is associated with endometriosis. This pathology produces adhesions between different tissues and it is frequent that it causes the uterus to adhere to the rectum, that is to say, towards its posterior face and to lose mobility.
- Sometimes the gynecologist is interested in knowing the position of the uterus, especially when he must insert an instrument into the uterine cavity since he must know in which direction the material should be directed.