Will Having a Tilted Uterus Increase Your Risk of Miscarriage?

One in five women have a titled, or retroverted, uterus

Speculum
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Many women wonder whether having a retroverted or tilted uterus can be a factor in pregnancy loss. Typically, the answer is no. No medical studies have ever tied having a retroverted uterus to any risk of miscarriage.

What Is a Retroverted Uterus?

About one in five women (20 percent) have a uterus that tips toward the back rather than forward. Usually the uterus sits horizontally over the bladder. In the case of a tipped uterus, the uterus is rotated back towards the spine and rectum.

This tipping is called a retroverted uterus or a tipped or tilted uterus. Generally, doctors consider this a normal variation. A tipped uterus should cause no problems and rarely requires treatment. Some women who have retroverted uteri may experience pain during intercourse.

What Happens to a Retroverted Uterus During Pregnancy?

In most cases, a retroverted uterus will assume the normal position at some point during pregnancy. During the first trimester, you may experience some back pain or difficulty urinating. However, these can also be symptoms of pregnancy, not just a retroverted uterus. If you have a tipped uterus, your doctor may have a hard time finding your uterus on an ultrasound during the first trimester. As your uterus grows, it will no longer be difficult to locate.

In rare cases, a tilted uterus does not correct during pregnancy and may become trapped in the pelvis causing a condition known as incarcerated uterus.

An incarcerated uterus can cause second-trimester miscarriage or other pregnancy complications. Having an incarcerated uterus is extremely uncommon, occuring in about 1 in 3,000 pregnancies, and is not a factor in unexplained first-trimester miscarriages. An incarcerated uterus can be diagnosed via ultrasound during the 13 to 17 week of pregnancy.

If you have an incarcerated uterus, you may experience difficulty peeing, abdominal pain, constipation, or discomfort in your rectal area.

Other Factors Which May Cause a Retroverted Uterus

Sometimes a uterus is tipped because of scar tissue or pelvic adhesions. These adhesions may be caused by:

  • Endometriosis: A reproductive condition where tissue similar to the lining of the uterus grows outside of the uterine cavity. This tissue is usually found on the outside of the uterus, the ovaries, the pelvic cavity, and the bladder.
  • Pelvic inflammatory disease (PID): PID is caused by bacteria and is usually sexually transmitted. Bacteria can be introduced through medical procedures, like having an intrauterine device (IUD) inserted, although this is much less common than sexually transmitted PID.
  • Pelvic surgery: Previous pelvic surgery, like a laparoscopy for endometriosis, can cause adhesions to grow in places that were manipulated during the procedure.

While these conditions may not cause miscarriages, endometriosis and pelvic inflammatory disease can both cause infertility.

Pelvic inflammatory disease can also cause ectopic pregnancy. Pelvic adhesions, pelvic inflammatory disease, endometriosis, uterine fibroids, and congenital uterine malformations (uterus didelphys or a bicornuate uterus) can also cause an incarcerated uterus.

More About Gynecological Complications

Sources:

Lettieri, L., J.F. Rodis, D.A. McLean, W.A. Campbell, and A.M. Vintzileos, "Incarceration of the gravid uterus. Obstetrics and Gynecology Survey Sept 1994. Accessed 21 Feb 2008.

University of Maryland Medical Center, "Retroversion of the uterus." 8 Nov 2006. Accessed 21 Feb 2008.

Medline Plus. Pelvic Inflammatory Disease (2015). 

OBGYN Ultrasound Online. Incarcerated Uterus. Peter W. Callen, MD

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