The Uterus

The uterus is a hollow muscular reproductive organ sat inverted in the pelvis area between the bladder and rectum. The upper area is connected to the fallopian tubes laterally. The lower part of it connects to the cervix and the vagina. Its muscular pear shape can adapt and change in size during pregnancy. The uterus provides a thick layer of support, nourishment and protection throughout pregnancy and provides the muscles to push the baby out during childbirth. Should the egg not become fertilised by the time it reaches the uterus the blood vessels of the uterine lining begin to shed. This is called menstruating or a period.

There are three layers within the uterus, the perimetrium is the outermost layer that forms the external skin. It is a membrane that cover the abdominal cavity of which the organs lay. It protects the uterus from friction and secretes a watery substance to lubricate it surface. Deep to the perimetrium layer, the myometrium forms the middle layer which consists of visceral muscle tissue. This provides expansion of the uterus throughout the pregnancy and contracts after childbirth. Inside the myometrium is the endometrium layer that borders the hollow lumen. This section is the support to the embryo or foetus during development with its vascular connective tissue’s and special glands.

The endometrium layer or lining houses the embryo and as the embryo becomes a foetus it triggers changes for the placenta to form which provides oxygen and vital nutrients from mother to developing baby through blood. It also disposes of the baby’s carbon dioxide and metabolic waste too sending it back into the mother’s blood stream to be excreted out.

Hormones trigger the uterus to begin contractions in child birth. The muscles of the uterus begin contracting and slowly increase with frequency and strength in waves. The smooth muscles in the cervix begin work by thinning and dilating to allow the baby to pass. A wave of contractions generally last about a minute. At around 10 centimetres the cervix is fully dilated, and the uterus contractions dramatically increase and continue till the baby has birthed through the vagina and out of the mother’s body.

During a Caesarean section or C-section an abdominal incision is made and then an incision into the uterus itself. Once the baby is safely delivered the uterine wall can be repaired or stitched and then the external abdomen is closed. A C-section carries more risk than a natural birth during and after delivery. Some C-sections are planned due to having a heart shaped womb (bicornuate womb), abdominal/ bladder/ rectal surgeries, family history and even mental health reasons. This shouldn’t be taken light heartedly as it is major surgery and can lead to complications for mother and baby.

A uterus prolapse is when the organ drops from its place and bulges into the vagina or rectum. Its where the muscles and ligaments supporting the uterus weakens causing the prolapse to occur with discomfort and pain. It is not life threatening as such and this can happen to any organ not necessarily just the uterus. It can be caused by pregnancy, age, obesity, menopause and excessive lifting. Keeping your pelvic floor muscles in good shape will help against a prolapse. Sometimes the symptoms may only be persistent during sex or going to the toilet, some have only picked up on a prolapse uterus during a smear test or examination. This can be rectified, and should you have any concerns with your own health then please seek medical advice.

Written by Justine Gibbs

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