Uterus - position, fixation, syntopy, birth defects

The uterus, known commonly as the womb, is a hollow organ in the females pelvis, where the fetus develops.

Position:

The uterus is located in the pelvis. Its exact position varies according to the fullness of the bladder.

The body is located intraperitoneally and the cervix sub peritoneally.

Its curved forward towards the vagina (anteversion) and bent backwards towards the cervix (anteflexed).

Fixation:

The uterus is "fixed" in its position by a number of ligaments listed as follows:

1. Round ligament: its the remnant of the gubernaculum, extends from the uterine horns to the labia majora through the inguinal canal, it holds the uterus in its anteverted position.
2. Cardinal ligament: also called the parametrium, connects the cervix to the lateral pelvic wall
3. Broad ligament: folds of peritoneum that cover the body of the uterus, the fallopian tubes and the ovaries
4. Pubocervical ligament: connects the cervix ventrally with the pubic bone

Syntopy:

Anteriorly is the vesicouterine pouch and the bladder

Posteriorly is the Douglas pouch and the rectum

Birth Defects

1. Bicornuate uterus: when there's a septum dividing the uterus internally, but only the superior part of the body
2. Bicornuate uterus with rudimentary horn: develops when one of the paramesonephric duct is retarded and doesn't fuse with the other one
3. Unicornuate uterus: when one of the paramesonephric ducts doesn't develop, so the uterus develops with only one uterine tube
4. Double uterus (uterus didelphys): failure of fusion of the inferior part of the paramesonephric ducts, could occur with a double or single vagina