MY TOPIC IS TODAY..NORMAL UTERUS
The uterus (womb) is a pear-shaped
organ, tucked away in your pelvis. It is 7.5cm long, 5cm wide and 2.5cm
deep. Inside, it is hollow with thick, muscular walls. The lower third
of the uterus dips down into the vagina and is called the cervix. The
upper portion is called the fundus and this is where the fertilised egg
grows into a baby. Two fallopian tubes, each connected to an egg-filled
ovary, enter your uterus on either side at the top.
What is a normal uterus?
The uterus
leans forwards over the top of the bladder. Doctors call this position
anteverted or anteflexed. Some women have a tilted uterus or retroverted
uterus. This means it leans away from the bladder rather than over it.
It's not strictly speaking an abnormality, because it affects the
position, rather than the structure, of the uterus.
About one in
six women have a tilted uterus. If you're told you have one, it won't
affect your chances of getting pregnant. The ability of the sperm to get
to your fallopian tubes via your uterus has nothing to do with its
position.
ABNORMAL UTERUS
What is an abnormal uterus?
A
small number of women have a uterus that differs from the norm in
structure, rather than position. This is called an abnormality of the
uterus, or uterine abnormality. It is a bit of a catch-all phrase, and
the numbers reflect this. In the general population, it's thought that
somewhere between one woman in 100 and one woman in 20 has a uterine
abnormality.
It's also hard to pin down numbers because only some
women will have their abnormality identified. In women who seek help
for infertility, the rates of uterine abnormalities are estimated to be
up to one in 13 women. While in women with a history of late
miscarriage, the rates are higher still at up to one in three women.
HOW YOU WILL GET PREGNANT IF YOU HAVE ABNORMAL UTERUS?
It depends on the abnormality. But, generally speaking, uterine
abnormalities do not affect your ability to become pregnant. You may not
even realise you have an abnormality.
Once you're pregnant, it
will be seen on an ultrasound scan. Depending on the abnormality, it may
make it more difficult for you to carry your baby for the full nine
months of pregnancy. Doctors put uterine abnormalities into these
categories:
Agenesis
This is extremely rare. It's thought
to affect between one woman in 4,000 and one woman in 10,000. It happens
when the vagina does not form properly, or is very short. There may be a
very small uterus or none at all. This is usually picked up when a girl
doesn't start her periods.
When the time comes, it can also make
sex very uncomfortable. The condition can be treated with surgery, and
if you have agenesis of the uterus, you should be offered counselling,
too. The only way for a woman with agenesis to have a baby is by
surrogacy.
Uterus didelphysUterus
didelphys This is when the uterus has two inner cavities. Each cavity
may lead to its own cervix and vagina, so there are two cervixes and two
vaginas. It is uncommon, affecting about one in 350 women. It is
possible to conceive if you have this type of abnormality, and have a
straight forward pregnancy.
Unicornuate uterusUnicornuate uterus
A unicornuate uterus is half the size of a normal uterus and there is
only one fallopian tube. Because of its shape, it is described as a
uterus with one horn. It is a rare abnormality, affecting about one in
1,000 women in the general population. It develops in the earliest
stages of life, when the tissue that forms the uterus does not grow
properly. If you have a unicornuate uterus, you probably have two
ovaries. Only one will be connected to your uterus, though. As long as
there is one, healthy, developed horn, it is perfectly possible to
conceive. However, it does put you at greater risk of miscarriage.
Bicornuate uterusBicornuate uterus
Instead of being pear-shaped, this type of uterus is shaped like a
heart, with a deep indentation at the top. It is called a uterus with
two horns, because of its shape. It's thought that fewer than one in two
hundred women in the general population have a bicornuate uterus. It
shouldn't affect your fertility, but you have a higher risk of
miscarriage if you do conceive.
Septate uterusSeptate uterus
This is where the inside of the uterus is divided by a muscular or
fibrous wall, called the septum. About one in 45 women in the general
population have a septate uterus. The septum may extend only part way
into the uterus (partial septate uterus) or it may reach as far as the
cervix (complete septate uterus). Partial septates are more common than
complete septates. A septate uterus may make it more difficult for you
to conceive and may increase your risk of miscarriage.
Arcuate uterus
This looks more like a normal uterus, except it has a dip, or slight
indentation at the top. It is a common abnormality, affecting about one
in 25 women in the general population. It.doesn't usually make
conceiving difficult.
HOW YOU WILL KNOW,IF YOU HAVE AN ABNORMAL UTERUS?
If you are having fertility problems, your doctor will refer you to a
specialist to see if it has anything to do with your uterus or fallopian
tubes. There are various investigations that can be carried out:
An 3D ultrasound scan of your uterus may identify an abnormality.
A magnetic resonance imaging (MRI) scan may be used. This is
considered to be the best way of scanning for abnormalities. MRI scans
use strong magnetic fields and radio waves to produce a detailed image
of the inside of your body. This type of examination will only be used
if you and your doctor are sure you are not already pregnant.
A special X-ray using dye, called a hysterosalpingography,
may be carried out. Liquid containing the dye is flowed into your
uterus and fallopian tubes via a fine tube (catheter). This will give
your doctor a picture of how well your uterus and fallopian tubes are
working.
A minor operation called a laparoscopy may be advised.
This allows your doctor to have a look at your uterus and fallopian
tubes. Your doctor will perform a small cut in your belly button. He
will then pass a tube with a camera (endoscope) through the cut to
examine you internally.
HOW UTERINE ABNORMALITIES TREATED?
Not all abnormalities need treatment. Some can be treated, but the
treatment itself can carry risks. For example, if you have a septate
uterus, one of your options is surgery to have the septum removed. If
you have surgery to open your uterus, the lining of your uterus may be
damaged. This can reduce your fertility.
It is possible to remove
a septum using an instrument called a hysteroscope. A hysteroscope is a
thin, telescope-like device that is placed into your uterus via your
vagina and cervix. It does far less damage to your uterus than open
surgery but it has not been shown to increase the rate of pregnancy in
women with infertility.
