What is a female uterus. The female uterus - how is the organ structured, what are its sizes and functions at different periods of life? Normal size of a nulliparous woman's uterus

The date: 04.03.2020

The length of the uterus in an adult woman is on average 7-8 cm, width - 4 cm, thickness - 2-3 cm.The mass of the uterus in nulliparous women ranges from 40 to 50 g, and in those who have given birth it reaches 80-90 g. The volume of the uterine cavity is 4-6 cm.

The uterus as an organ is largely mobile and, depending on the state of neighboring organs, can take a different position. Normally, the longitudinal axis of the uterus is oriented along the axis of the pelvis. Most of the surface of the uterus is covered by the peritoneum, with the exception of the vaginal part of the cervix. The uterus is pear-shaped, flattened in the anteroposterior direction.

Anatomy

Parts of the uterus

The uterus consists of the following parts:

Fundus of the uterus - This is the upper convex part of the uterus, protruding above the line of confluence of the fallopian tubes into the uterus.
Body of the uterus - The middle (most) part of the organ has a conical shape.
Cervix - The lower, narrowed, rounded part of the uterus.

Functions

The uterus is the organ in which the embryo develops and carries the fetus. Due to the high elasticity of the walls, the uterus can increase in volume several times during pregnancy. Being an organ with developed muscles, the uterus is actively involved in the expulsion of the fetus during childbirth.

Pathology

Developmental anomalies

Aplasia (agenesis) of the uterus - extremely rarely, the uterus may be completely absent. There may be a small, infantile uterus, usually with a pronounced anterior bend.
Doubling of the body of the uterus - a developmental defect of the uterus, which is characterized by a doubling of the uterus or its body, which occurs due to the incomplete fusion of the two Müllerian ducts at the stage of early embryonic development. As a result, a woman with a double uterus may have one or two cervix and one vagina. With the complete non-confluence of these ducts, two uterus with two necks and two sheaths develop.
Intrauterine septum - incomplete fusion of the embryonic rudiments of the uterus in various variants can lead to the presence of a septum in the uterus - a "two-horned" uterus with a clearly visible sagittal depression at the bottom or a "saddle" uterus without a septum in the cavity, but with a notch at the bottom. With a two-horned uterus, one of the horns can be very small, rudimentary, and sometimes detached.

Diseases

Prolapse and prolapse of the uterus - The prolapse of the uterus or a change in its position in the pelvic cavity and its displacement down the inguinal canal is called complete or partial prolapse of the uterus. In rare cases, the uterus slides right into the vagina. In mild cases of uterine prolapse, the cervix protrudes forward at the bottom of the genital slit. In some cases, the cervix falls into the genital slit, and in especially severe cases, the entire uterus falls out. Prolapse of the uterus is described depending on which part of the uterus protrudes forward. Patients often complain of the sensation of a foreign body in the genital cleft. Treatment can be both conservative and surgical, depending on the specific case.
Myoma of the uterus - A benign tumor that develops in the muscular membrane of the uterus. It consists mainly of elements of muscle tissue, and partly of connective tissue, also called fibroids.

Polyps of the uterus - Pathological proliferation of the glandular epithelium, endometrium or endocervix against the background of a chronic inflammatory process. In the genesis of polyps, especially uterine polyps, hormonal disorders play a role.

Uterine cancer - Malignant neoplasms in the uterus.
- Cancer of the body of the uterus - Cancer of the body of the uterus means cancer of the endometrium (the lining of the uterus) that spreads to the walls of the uterus.
- Cervical cancer - a malignant tumor, localized in the cervical region.

Endometritis - Inflammation of the lining of the uterus. In this case, the disease affects the functional and basal layers of the uterine mucosa. When inflammation of the muscular layer of the uterus joins it, they speak of endomyometritis.

Cervical erosion - This is a defect in the epithelial lining of the vaginal part of the cervix. Distinguish between true and false erosion of the cervix:
- True erosion - refers to acute inflammatory diseases of the female genital organs and is a frequent companion of cervicitis and vaginitis. It occurs, as a rule, against the background of general inflammation in the cervix, caused by genital infections or conditionally pathogenic flora of the vagina, under the influence of mechanical factors, malnutrition of the cervical tissue, menstrual irregularities, hormonal levels.
- Ectopia (pseudo-erosion) - there is a common misconception that ectopia is the body's response to the appearance of erosion, since the body is trying to replace the defect in the mucous membrane of the vaginal (outer) part of the cervix with a cylindrical epithelium lining the uterine (inner) part of the cervical canal. Often, this confusion arises from the outdated point of view of some doctors. In fact, ectopia is an independent disease that has little to do with true erosion. The following types of pseudo-erosion are shared:
  - Congenital ectopia - in which the columnar epithelium can be located outward from the external os of the cervix in newborns or move there during puberty.
  - Acquired ectopia - ruptures of the cervix during abortions lead to deformation of the cervical canal, as a result of which post-traumatic ectopia of the columnar epithelium (ectopion) occurs. It is often (but not always) accompanied by an inflammatory process.

Diagnostics

Operations

Abortion (not to be confused with the term "spontaneous abortion", meaning "miscarriage") - an operation aimed at terminating a pregnancy, performed in its first 12 weeks in a hospital at the request of a woman. It is a mechanical destruction of the embryo with further curettage of the uterine cavity. Distinguish between clinical (in a hospital) and criminal abortion. Any abortion can lead to serious complications. A criminal abortion can be the cause of a woman's death.
Vacuum aspiration or the so-called "mini-abortion" - an intervention aimed at terminating pregnancy at a very early period - from twenty to twenty-five days without the expected menstruation. Refers to minimally invasive operations, can be performed on an outpatient basis.
Cesarean section (lat. caesarea "royal" and sectio "incision") - carrying out childbirth using abdominal surgery, in which the newborn is removed not by natural birth canal, but through an incision in the abdominal wall of the uterus. Previously, a cesarean section was performed only for medical reasons, but now more and more often the operation is performed at the request of the woman in labor.
Hysterectomy - (Greek hystera uterus + Greek ectome ectomy, removal; possibly writing hysterectomy; another common name is extirpation of the uterus) - a gynecological operation in which the woman's uterus is removed.

Links

BSE.sci-lib.com. - The meaning of the word "Uterus" in the Great Soviet Encyclopedia. Retrieved September 2, 2008.

The womb of a woman is an organ provided by evolution for carrying and giving birth to a child. What does a woman's uterus look like? It is similar in shape to a pear or has the appearance of a cone truncated from top to bottom, hollow inside, it is an organ of the reproductive system. The place where the uterus is located is the central part of the female pelvic cavity, reliably protected by the pelvic skeleton, muscles, adipose tissue for complete and reliable protection during pregnancy. The structure of a woman's uterus is so well thought out that it is difficult to find a more protected organ.

Topography

Where is the woman's uterus? It is located inside the pelvic cavity behind the bladder and in front of the rectum. In the place where the woman's uterus is located, its front wall is covered with the sheets of the peritoneum up to the neck, and from behind including the neck, which contributes to the division of space into separate anatomical zones. Along the edges, two peritoneal sheets, joining together, participate in the formation of ligaments. Topographically highlighted:

The anterior surface is the part of the organ located in front of the bladder. In front of it there is a cystic cellular space filled with fatty tissue, in which the lymph nodes and lymphatic ducts are located.
The posterior surface is located anterior to the rectum. Between it and the intestine, a retardial space is formed, filled with fiber with lymphatic collectors.
Right and left ribs of the uterus.

The adipose tissue surrounding from all sides - parametric fiber - is the place where the supplying arterial vessels, veins pass, lymph nodes and ducts can be located.

The volume of the female uterus is about 4.5 cubic centimeters, the average size is 7x4x3.5 cm. How a woman's uterus may look, its shape, size, volume depends on how many births a woman has. The parameters of the organ of women who have given birth and who have not given birth are different. The uterus of a woman who has given birth weighs almost twice as much as that of a woman who has not given birth. On average, the weight is from 50 to 70 g. In order to show how the main physiological function of this small organ is carried out, we will consider the main structural features.

Anatomical structure

The anatomy of the uterus is due to the main physiological function of the organ. Different parts of the organ are supplied with blood in different ways, the outflow of lymph occurs in different collectors, which is important to take into account during surgical interventions on the organ. This plays a key role in determining the tactics of treating pathological processes. Three areas are anatomically distinguished:

The body of the uterus is the largest part in volume, it forms the uterine cavity. The cut is a triangular truncated shape.
The bottom is the anatomical part of the organ, which forms an elevation above the place where the fallopian tubes open.
The cervix is \u200b\u200ba cylindrical hollow tube up to three centimeters long that connects the body to the vagina.

Body

The body of the uterus is the most voluminous anatomical part of the organ, it owns about two-thirds of the total volume. This is where the implantation of a fertilized egg takes place, the formation of the placenta, the growth and development of the child. It has the shape of a truncated cone, with its base facing upwards, forming a physiological bend.

In the upper part of the body, on the right and left along the edges, the fallopian tubes flow into its lumen, through which the ovum from the ovary enters the organ cavity.

Bottom

The uppermost part of the organ. If you mentally connect the points where the fallopian tubes open with a straight line passing through the body of the uterus, then the domed overhang of a part of the body forms the bottom. It is by the height of the bottom that the gestation period is determined.

Neck

Topographically, the place where the cervix is \u200b\u200blocated in front and behind is surrounded by cellular spaces: in the front - by the cystic, in the back - by the rectal. The neck is covered with a sheet of peritoneum only along its posterior surface. The structure of the cervix is \u200b\u200bdue to the physiological functions performed. It is a hollow tube that connects the uterine cavity to the vagina. It accounts for a third of the length of the entire organ. In the neck, parts that are different in structure are distinguished:

Isthmus. This is a small area of \u200b\u200bphysiological narrowing in the lower part of the uterus, the place of transition to the cervical part.
The vaginal portion of the cervical part is directly facing the inside of the vagina and communicates with it with an opening - the external pharynx. The vaginal part is clearly visible during a gynecological examination.
The supravaginal area is the part of the cervix facing the uterine cavity.
The cervical canal connects the vagina through the uterine pharynx to the uterine cavity.

The selection of various anatomical regions in a small part of the organ, which is the cervical part, is due to the peculiarities of its structure.

The structure of the walls of the organ

The structure of the uterine wall has three distinct layers:

External serous - it is formed by a sheet of the peritoneum, the outside lining of the organ is the perimetry.
The middle muscle, representing several layers of muscle tissue - the myometrium.
The internal lining organ from the inside, which is a mucous membrane - the endometrium.

The layers of the uterus have some differences depending on the functional purpose of its individual parts.

Perimeter sheath

Covers the outside of the body, is a sheet of the peritoneum that lines all the organs of the abdominal cavity. Perimetry - continuation of the serous membrane of the bladder, continuing and covering the uterine surface.

Muscular membrane

The middle shell, represented by muscle fibers, has a rather complex structure. Its thickness in different parts of the organ is different. In the area of \u200b\u200bthe bottom, the muscular membrane of the uterus has the greatest thickness. This is due to the need for the muscle to contract and expel the fetus during labor. The severity of the muscular layer of the fundus area is also different in the pregnant and non-pregnant uterus, reaching a thickness of four centimeters by the time of delivery.

The fibers of muscle tissue have a three-dimensional direction, tightly intertwined with each other, forming a fairly reliable framework, between the components of which are elastin and connective tissue fibers.

The sizes and volumes of the uterus change over time, due to changes in the thickness and size of the fibers of the muscle layer. This process is influenced by many factors, but the changing level of sex hormones in different periods of a woman's life is of primary importance. Increasing significantly during pregnancy and childbirth, the uterus contracts again, acquiring the same size, 6-8 weeks after the birth of the baby.

Only thanks to such a complex structure of the myometrium is it possible to maintain pregnancy, gestation and childbirth.

Inner lining of the uterus

The endometrium is represented by a columnar epithelium with a large number of glands, it is two-layer:

Superficially located functional layer.
Basal layer located under the functional.

The surface layer of the endometrium is represented by a glandular cylindrical epithelium containing a large number of glands; receptors for sex hormones are located on the surface of its cells. It is able to change in thickness at different periods of a woman's reproductive cycle under the influence of changing hormonal levels. It is this layer of the epithelial cover that is rejected during menstrual bleeding, and the fertilized egg is implanted into it.

The basal layer is a thin layer of connective tissue, tightly connected with the muscle layer, participating in the formation of a single, functionally well-coordinated mechanism.

Features of the internal structure of the neck

The internal structure of this small part of the uterus has its own differences, due to the functional loads performed:

The cervix is \u200b\u200bcovered with an external serous membrane only from behind.
Has a thin, not very pronounced layer of smooth muscle fibers, a sufficient amount of collagen. This structure contributes to a change in the size of the canal during childbirth. The opening of the cervix during labor reaches 12 cm.
A large number of mucous glands produce a secret that closes the lumen of the canal, which contributes to the performance of a barrier and protective function.
The inner epithelial layer of the canal is represented by a columnar epithelium, the area of \u200b\u200bthe external os is covered with stratified squamous epithelium. There is a so-called transition zone between these parts of the neck. Pathological changes in the structure of the epithelial cover of this area often occur, leading to the occurrence of dysplasia, oncological diseases. Absolutely indicated is the special close attention to this area during the examination by the gynecologist.

Functions

It is difficult to overestimate the functions of the uterus in a woman's body. As a barrier to infection, it is involved in the direct regulation of the hormonal state. The key purpose is the implementation of reproductive function. Without it, the process of implantation, bearing and childbirth is impossible. The birth of a new person, an increase in the population, ensuring the transfer of genetic material are possible only thanks to a woman, the well-coordinated work of the organs of her reproductive system.

That is why the problems of maintaining women's health in all countries of the world have not only purely medical but also social significance.

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The uterus is the most important organ of the female structure. Thanks to her, childbearing becomes possible. It is in the uterus that the fertilized egg continues to develop, and at the end of the gestation period, the formed child is in it.

Location of the uterus

We are talking about a hollow, pear-shaped organ. Its natural location is in the pelvic area. This organ is adjacent to the bladder and rectum. The uterus is slightly tilted forward. It is securely fixed in its position, but at the same time it has sufficient mobility.

This is facilitated by special ligaments. They allow the organ to respond safely to environmental changes while maintaining a comfortable position. For example, when fluid accumulates in the bladder, the uterus shifts slightly backward, and as the rectum fills, it rises.

The ligaments have a complex fastening. His character explains why pregnant women should not raise their arms often. In this position, the tension of the ligaments occurs, the uterus tenses and shifts. As a result, the fetus may take the wrong position, which is undesirable in the late gestation period.

The weight of the uterus can vary. After giving birth, it becomes heavier on its own. During pregnancy, the uterus, having elastic walls, increases many times over. She is able to withstand a five-kilogram fruit. At the end of the childbearing period, the uterus decreases, its tissues atrophy, and sclerotic changes occur in the blood vessels.

Organ structure

The uterus is formed by several sections.

Neck

This part is the transition between the vagina and the uterine cavity. It is a kind of muscle tube that makes up about a third of the organ. Inside is the cervical canal. At the bottom, the neck ends in a pharynx. This opening is the entrance for the sperm to enter the egg. Menstrual blood also flows out through the pharynx.

The cervical canal is filled with a thick substance that the mucous membrane produces. One of the functions of such a "plug" is to kill harmful microorganisms that can infect the uterus and its tubes. The latter open into the peritoneum. Therefore, mucus protects from infection not only the uterus itself, but also indirectly the internal organs.

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During ovulation, the substance in the canal becomes less dense. The environment of the cervix during this period is favorable for male cells and promotes their mobility. The same thing happens with mucus during menstruation. Such changes are needed so that blood can flow out unhindered. In both situations considered, the female body becomes more vulnerable to infection. By the way, infection can also occur through sperm cells, so intimacy with a stranger is undesirable.

The shape of this part of the uterus is not always the same. Before delivery, the neck is round in section and resembles a truncated cone. In women who have given birth, changes are taking place in this area. The neck expands and takes a cylindrical shape. The same thing happens after an abortion. During the examination, the gynecologist sees these changes well, so it is impossible to deceive him.

Isthmus

This short section connects the cervix to its main body. The isthmus during childbirth helps the pathways expand so that the fetus is successfully released. This is a vulnerable spot where ruptures can occur.

Body of the uterus

The internal structural element of this main part of the organ is the endometrium. In the mucous layer, as it is also called, there are many vessels. The endometrium is very sensitive to the action of hormones. During the menstrual cycle, he prepares himself for pregnancy. If fertilization does not occur until a certain point, the endometrium partially exfoliates. Menstrual bleeding is observed these days. After the release of a part of the endometrium, the growth of this uterine layer begins again to a certain limit.

At conception, the endometrium becomes a "nest" for the embryo. During this period, he is not rejected, obeying the changed action of hormones. Therefore, women who are carrying a child do not normally have bleeding. If discharge appears, this should be alarming.

The middle layer in the body of the uterus is formed by muscles. By themselves, they are very strong, so much so that they are able to push out the grown fetus during childbirth. At this point, the muscles are even more strengthened and reach their maximum development. This dense layer of the uterus also plays a major role in protecting the fetus from shock.

The muscles of the organ are always in good shape. Their constant contraction and relaxation is observed. Muscle movements are especially intense in connection with intercourse. Thanks to this, the sperm cells safely move to their destination. In addition, the uterus contracts more strongly during menstruation. This promotes successful endometrial rejection.

The body of the uterus also has an outer layer - the perimetry. The fabric of which it consists is connective. The perimetry covers most of the organ. The exception is some areas in the area above the vagina.

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Uterine abnormalities

The organ may be in the wrong position. There are also cases when the proportions of the uterus are disturbed or its size deviates greatly from the norm. Typically, such defects arise even in the prenatal period. This is caused by viral infections, taking certain medications, alcoholism and other factors. Examples of encountered anomalies:

One-horned uterus. This pathology appears due to the abnormal growth of the so-called Müllerian ducts. They are paired channels that form after about two months of embryo development. A one-horned uterus forms when one of the ducts stops growing. Often, simultaneously with such an anomaly, defects of the urinary system are observed.
Bicornuate uterus. In this state, the organ has two cavities. In addition, an incomplete two-horned uterus is sometimes found. In its outlines, it resembles a heart - there is a common cavity, and the bottom - in the uterus, this is the upper part - as if divided into two parts. The reason for the described conditions is the incomplete fusion of the same Müllerian ducts in their middle part.
Saddle uterus. With such a pathology, a woman may not be bothered by any symptoms. But with ultrasound and other applied research methods, a saddle-shaped notch is found in the bottom area. With such an anomaly of the uterus, there is a chance to carry a baby normally and give birth to it. Along with this, there are frequent cases of premature birth. Various pathologies of the placenta may occur or an incorrect position of the fetus is observed.
Uterine hypoplasia. This condition is characterized by the development of the organ in a reduced form. At the same time, the girl as a whole lags behind in development. She is too short, has a narrow pelvis and a greatly reduced breast. The gynecologist, already upon examination, can reveal the named pathology. To confirm the diagnosis, an ultrasound scan is performed and the level of hormones is determined.

You can always check the condition of your female organs in our medical center "Euromedprestige". We can carry out a full diagnosis, and if problems are identified, enlist the support of experienced doctors.

The uterus (uterus) is a hollow unpaired smooth muscle organ, about 7-9 cm long in a nulliparous woman and 9-11 cm in a woman who has given birth; the width of the uterus at the level of the fallopian tubes is approximately 4-5 cm; the thickness of the uterus (from the front surface to the back) does not exceed 2-3 cm; the thickness of the walls of the uterus is 1-2 cm; its average weight ranges from 50 g in nulliparous women to 100 g in women who have multiparous. The position of the uterus in the small pelvis is not constant. It can vary depending on a number of physiological and pathological factors.

In the uterus, the front, or vesical (facies vesicalis), and the back, or intestinal, surfaces (facies intestinalis), as well as the right and left lateral edges (margo uteri dexter et sinister) are distinguished.

The uterus is divided into a body and a cervix, gradually merging into each other; often the organ is divided by a constriction, about 10 mm wide, which is called the isthmus (isthmus uteri). Usually there is an angle between the body and the cervix, corresponding to an average of 70-100 °, open anteriorly (anteflexio); the entire uterus, in addition, is tilted anteriorly (anteversio). This position of the uterus in the small pelvis is considered normal.

The body of the uterus (corpus uteri) is the most voluminous proximal part of a triangular organ with a truncated angle at the border with the isthmus. The upper part of the body of the uterus, which rises in the form of a wide vault above the level of the fallopian tubes, is called the fundus uteri.

The cervix (cervix uteri) is the lowest section and has an average length of about 3 cm; the shape of the neck in childhood and in girls is conical, in adult women, especially those who have given birth, it is cylindrical.

In the cervix, there are supravaginal (upper 2/3) and vaginal (lower 1/3) parts (portio supravaginal et vaginalis). In addition, the middle part of the cervix is \u200b\u200bisolated, which corresponds to the area between the attachment of the anterior and posterior fornix of the vagina.

The uterine cavity has the shape of a triangular slit flattened from front to back; the base of this triangle is located at the top, in the region of the fundus of the uterus, and the apex is at the bottom, in the region of the cervix. The length of the cavity from the external opening to the fundus of the uterus (along the probe) in nulliparous corresponds to about 7 cm, and in those who have given birth 8 cm.

The cervical canal (canalis cervicis uteri) has a fusiform shape, as it is slightly expanded in the middle part. The length of the canal corresponds to the length of the cervix (about 2.5-3 cm), its average diameter does not exceed 2 mm. At the bottom, the canal opens into the vaginal cavity through the external opening of the uterus (ostium uteri).

The wall of the uterus over a greater extent consists of three layers: serous, or peritoneal (tunica serosa s. Perimetrium), muscle and mucous membranes.

The appendages of the uterus include two fallopian tubes and both ovaries. The fallopian tubes extend from the fundus of the uterus in the area of \u200b\u200bits upper corner to the right and left, the direction of which is initially horizontal. As they approach the lower poles of the ovary, they are somewhat displaced anteriorly so that, bending around its upper edge, they completely cover the ovaries with themselves and with their mesentery. The length of the pipe is on average 10-12 cm. There are four main sections. The uterine, or interstitial, part of the tube is intramural, the narrowest; its length usually does not exceed 2 cm. The neck is a short segment formed after the tube leaves the wall of the uterus. The pipe wall at this point is thicker than the rest of its length.

The ampullar section - the largest part (about 8 cm long) is a gradually expanding section of the tube, reaching 1 cm in diameter.The fimbrial part is the widest end section of the tube with many outgrowths (fimbrium) bordering the abdominal opening of the tube. The wall of the fallopian tube is divided into four layers: the serous membrane, the unstable sub-serous - loose connective tissue, muscular, consisting of the external, internal longitudinal bundles and the middle circular, and the mucous membrane, which forms longitudinally located folds in the lumen of the tube.

The ovary, like the fallopian tube, is a paired organ. It is located in the deepening of the parietal peritoneum, called the ovarian fossa. The shape of the ovary is ovoid, it is as if flattened from front to back. The side of the ovary that faces the pelvic cavity is called the inner surface, the opposite is the outer. Its dimensions are normally about 3x2x1.5 cm. By means of their own ligaments, which are dense fibrous-smooth muscle-cervical strands passing between the leaves of the wide uterine ligament, the ovaries are attached to the corner of the uterus. With the help of suspension ligaments, they are fixed to the side walls of the pelvis. These ligaments are folds of the peritoneum stretched between the lateral walls of the pelvis, the lumbar fascia, and the upper (tubal) end of the ovary.

The ovary is covered with embryonic epithelium, and only a small part of it is located between the leaves of the wide uterine ligament. Duplication of the peritoneum, extending from the posterior leaf of the broad ligament, forms a short ovarian mesentery. This part of the ovary is called its gate; the main vessels and nerves pass through it. Above the ovary, between the leaves of the broad ligaments, there is a network of tubules - the supra-ovarian appendage.

The physiological position of the uterus, tubes and ovaries is provided by hanging, fixing and supporting devices that unite the peritoneum, ligaments and pelvic tissue (Fig. 1.2.2.2). The suspension apparatus includes the own ligaments of the ovaries and the wide ligaments of the uterus, which suspend the ligaments of the ovaries. The wide uterine ligaments are a frontally located duplication of the peritoneum, connecting with the anterior and posterior surfaces of the uterus and heading to the lateral walls of the pelvis, where it passes into the parietal peritoneum. Part of the wide uterine ligament is the mesentery of the fallopian tube. Between the leaves of the broad ligament, a layer of loose tissue is laid, divided by the fascial plate into two sections: the upper one, practically devoid of vascular bundles, and the lower one with a developed arterial and venous network, as well as with the ureter passing here. This part of the broad ligament, or rather, the accumulation of intertwined fascial smooth muscle fibers, fiber with blood vessels and nerves is called the main, or cardinal.

Under the anterior leaf of the broad ligament, from the anterior surface of the uterus towards the inner opening of the inguinal canal, there is a round uterine ligament, which is a paired strand. It consists of connective tissue and smooth muscle fibers, which are essentially a continuation of the muscular layer of the uterus. Its length is on average 10-15 cm, thickness 3-5 cm. The round ligaments pass through the internal openings of the inguinal canals, gradually become thinner and, leaving the inguinal canal, completely branch out in the subcutaneous fatty tissue. In the round ligaments passes the artery of the round ligament of the uterus, extending from the lower epigastric artery. The proper ligament of the ovary is a short paired, but rather dense fibro-smooth muscle cord connecting the lower (uterine) end of the ovary with the uterus.

The hanging ligament of the ovary is also a paired formation, starting from the lateral part of the wide uterine ligament in the region of the tubal end of the ovary and the tube and passing into the peritoneum of the lateral wall of the pelvis in the region of the sacrospinal joint, through which the ovarian artery and vein pass.

The fixing apparatus includes the cardinal, sacro-uterine, vesicouterine and vesicopubic ligaments. They represent "zones of compaction", which are an accumulation of intertwined dense fascial and smooth muscle fibers. These clusters form the basis of the ligaments and are in close contact with the parietal and visceral fascia of the pelvis. Of particular importance are the cardinal and sacro-uterine ligaments. The cardinal ligaments constitute the middle part of the "zone of compaction", which is the most powerful in the system of the fixing apparatus. They consist of powerful connective tissue, elastic and smooth muscle fibers with a large number of arterial and especially venous vessels running at their base.

The sacro-uterine ligaments are formed predominantly by smooth muscle and fibrous fibers and constitute the posterior part of the "zone of compaction". From the posterior surface of the cervix, arcuately covering the rectum from the sides, they are directed to the parietal leaf of the pelvic fascia on the anterior surface of the sacrum. The upper part of the ligaments raises the peritoneum covering them, forming rectal-uterine folds.

The internal genital organs are supplied with blood by the vessels extending from the internal iliac artery and the ovarian artery (Fig. 1.2.2.3). The ovarian artery branches off directly from the aorta, just below the origin of the renal artery, goes down and outward, crossing the abdominal ureter. Then it enters the suspension ligament of the ovary, located outside of the ureter, and approaches the ovarian gate, giving two branches - the ovarian and tubal.

The uterine artery most often departs from the internal iliac artery. Located laterally from the ureter, it reaches the base of the parametrium and here it intersects with it, and then goes medially to the lateral surface of the pelvis at the level of the internal os. At the intersection with the ureter, the uterine artery almost always gives the ureter an arterial branch. Further, several small branches extend from this artery to the bladder, where they anastomose with the cystic arteries.

The uterine artery runs along the lateral edge of the uterus, giving off smaller horizontal branches to the uterus. The thickness of the uterine artery and the degree of its tortuosity are in direct proportion to the physiological state of the uterus and the woman's age. At the level of the tubal angle, the artery gives off a branch supplying the bottom, the tubal and ovarian branches, which anastomose with the branches of the ovarian artery.

Anastomoses are located, as a rule, on the border of the upper and middle third of the body of the uterus. The fusion of the vessels is carried out without a visible change in their lumen, which does not allow us to accurately determine the site of the anastomosis. The vaginal artery departs from the uterine artery. Heading down, it branches in the anterior and posterior surfaces of the cervix and in the upper vagina.

The uterine veins form a narrow-looped thin-walled plexus located along the uterine arteries.

The innervation of the internal genital organs comes from the upper hypogastric plexus (pi. Hypogastricus superior sn presacralis), both lower hypogastric plexuses (pi. Hypogastricus inferior dexter et sinister, s. Pi. Pelvinus) and secondary plexuses - uterine and utero-vaginal (pi. Uterinus et uterovaginalis) located in the peri-uterine tissue. The body of the uterus has predominantly sympathetic innervation, and the cervix is \u200b\u200bparasympathetic.

The place where the fetus normally grows and develops after conception is the female uterus. This organ, in addition to its reproductive function, plays an important role in the regulation of the menstrual cycle. The structure of the uterus allows it to grow and change with the fetus until it is expelled during childbirth. Oddly enough, many women do not know what the uterus looks like and how its size changes during pregnancy. Consider these issues and what happens to her during and during pregnancy.

The uterus is a receptacle for the developing fetus.

What is this organ

The uterus is an unpaired, hollow muscular organ located between the bladder in front and the woman's rectum in the back. The diagram shows its location relative to other organs.

The uterus has physiological mobility.

The normal uterus has physiological mobility and is easily displaced relative to other organs. So, when the bladder is filled, it goes posteriorly, and when the rectum is overflowing, it moves anteriorly. During pregnancy, it grows and shifts upward, but after giving birth, it takes its original position.

Anatomical structure

In shape, a normal uterus resembles a pear, which is slightly flattened from front to back. Structurally, it is customary to distinguish:

Bottom. This upper part protrudes beyond the line of entry of the fallopian tubes into it.
Body. The shape resembles a triangle, which gradually narrows towards the neck.
Neck. It is an extension of the body, but it is narrower and more round. The outer part of the cervix protrudes into the vagina and is called the vaginal part. The area adjacent to the body is called the supravaginal part. If the average size of the uterus is 6-7 cm, then the length of its neck is about 2.5-3 cm.

The diagram shows its constituent parts.

The size and position of the organ

On average, her dimensions in a woman of childbearing age are as follows: length 5-8 cm, width 3-4 cm, thickness within 2-3 cm.In a nulliparous woman, the body weight is about 50 grams, while after giving birth it weighs 70-80 gr. Such changes are associated with muscle hypertrophy during pregnancy.

Its cavity is only 5-6 cm. This is relatively small in relation to its size. Such a small cavity is due to the powerful thick walls of the organ itself.

A normal uterus is positioned in such a way that its longitudinal axis runs parallel to the axis of the pelvic bones. Possessing physiological mobility, it can easily move relative to nearby structures, forming temporary bends. So, with an empty bladder, its bottom will stand forward, and when the bladder is stretched, on the contrary, it deviates back.

Important! A sharp and constant bending of the uterus is not the norm, but a pathological phenomenon.

What is the wall of the uterus and the structure of its cervix

The organ wall is represented by three layers:

serous membrane;
the muscular membrane is the main component of the wall, which is represented by unlined fibers intertwining with each other in different directions;
the mucous membrane lining the organ cavity. It is represented by the ciliated epithelium, which contains various types of glands.

The cervix is \u200b\u200bthe narrowest part of it. The length of her neck is within 2-3 cm. Her canal opens into the vaginal cavity with the uterine opening, which forms the internal pharynx. In women who have not given birth, it is round or transverse, and in those who have given birth, it is in the form of a transverse slit with tears along the edges. During a visual examination, a specialist always assesses the condition of the cervix and its internal pharynx. These data can tell him about problems with the woman's reproductive system.

How does this organ change during ovulation?

The fact that the size of the uterus grows during pregnancy is clear to everyone, but what happens to it during. Normally, before ovulation, her neck is dense and dry. During ovulation, under the influence of hormones, it becomes loose, preparing for conception. The mucus that covers the inner pharynx becomes viscous and allows sperm to pass through more easily than on other days. The position of the cervix these days is lower than usual. All these changes are aimed at preparing the woman's body for conception.

If conception did not occur during ovulation, then the woman begins menstruation. The internal pharynx expands to expel clots and parts of the endometrium from it. This position of the cervix contributes to the addition of infection during this period, if the woman does not observe personal hygiene, swims in open water bodies or pools.

After the cessation of menstruation, the internal pharynx narrows again and a new layer of functional endometrium begins to recover in the uterus. It completely regenerates for the next ovulation and prepares for the implantation of the embryo.

Many women's forums talk about how you can determine the onset of ovulation by touch. They suggest taking into account the length of the neck, its consistency, position and other parameters. Nevertheless, we advise you to refrain from this manipulation. Incorrect and inept palpation of the cervix, at best, will not lead to anything, and at worst, after it, you will introduce an infection or damage the delicate mucosa. If you want to know about the onset of ovulation, then take a test or visit a gynecologist who is proficient in correct palpation.

What happens to the uterus during pregnancy by week

During pregnancy, the size of the organ changes rapidly. After the 8th month, it becomes oval-round, about 20 cm long. Individual muscle fibers increase not only qualitatively, but also quantitatively.

The growth of the uterus occurs throughout pregnancy. In the first weeks, it retains its pear-shaped shape and does not change, since the size of the fruit is very small.

In the second month, it becomes rounded and its size increases several times. Its mass is also growing, by the end of pregnancy the norm is almost a kilogram.

At a gynecologist's appointment, at each scheduled examination, the doctor measures the height of the uterine fundus. This helps to predict the gestational age and to notice when she is starting to sink in preparation for childbirth. The table below shows the normal fundus height by week.

Questions to a specialist

Question: I learned that by the height of the uterine fundus, you can find out the gestational age. How does the height of the fundus of the uterus change by week?

Answer: The estimated height of the fundus of the uterus in centimeters is equal to the duration of your pregnancy by weeks. So, if it is 23 cm, then you are 23 weeks pregnant.

Question: What is the normal length of the cervix and how does it change during childbirth?

Answer: The length of the cervix is \u200b\u200b2.4-3 cm. During pregnancy, it lengthens by several centimeters. If the length of the cervix is \u200b\u200bbelow certain values, then this can cause premature birth. On the eve of childbirth, the length of the cervix becomes one centimeter less and the internal pharynx begins to open. These signs indicate that labor is about to begin.

Question: If the length of the cervix is \u200b\u200brapidly decreasing, and it is still far from the due date, what to do?

Answer: In different situations, the doctor may offer different treatment: medicines, as well as the imposition of a pessary or sutures on the internal pharynx. The length of the cervix is \u200b\u200bof great importance, it is especially important to monitor it in pregnant women after previous abortions.

The female reproductive system is a well-coordinated mechanism. Each organ in it is responsible for its own functions. The normal shape and size of the uterus enable the fetus to reliably strengthen and continue its growth and development until the very birth.