Norms of the size of the uterus on ultrasound during pregnancy and after childbirth. Normal size of the uterus and ovaries by ultrasound in adolescents and adults. Dimensions of the cervix by ultrasound: the norm

Ultrasound, or echography, is the study of internal organs by means of sound waves. Waves, reflected from internal organs, are recorded with the help of special tools and create images of anatomical details. In this case, ionizing radiation (X-ray) is not used. The normal size of the uterus for ultrasound in adults is an indicator of the health of the genitourinary system in women.

For women, such a study is most often used to examine the uterus and ovaries before, after, and during pregnancy to monitor the health of organs, the development of an embryo or fetus. Ultrasound images are captured in real time, so they can show movements of internal tissues in organs, such as blood flow in arteries and veins. The norms of the size of the uterus on ultrasound are developed and calculated for any condition of the woman.

Uterus, its dimensions

Uterus is located in a small pelvis. Although this is usually a median structure, lateral deviation of the uterus is not uncommon. The broad ligament of the uterus widens from the sides to the wall of the pelvis. They contain uterine tubes and vessels.

The size of the uterus according to ultrasound is approximately the same. The normal adult uterus measures from 7.0 to 9.0 cm (length), from 4.5 to 6.0 cm (width) and from 2.5 to 3.5 cm (depth). The last figure is called an anteroposterior size.

During the postmenopause, the uterus decreases in size, and the endometrium atrophies. The normal sizes of the uterus and ovaries have been developed and proven by ultrasound.

Norms of the size of the uterus by ultrasound

When the ovaries are involution, there is a related decrease in the production of estrogen. This leads to a gradual atrophy and involution of the endometrium. In post-menopause, the average thickness of the endometrium is marked as 3.2 +/- 0.5 mm.

Studies usually reveal an inverse relationship between the size of the uterus and the time after menopause: the size of the uterus and volume gradually decrease. The greatest changes occur during the first ten years after menopause, and then gradually.

In post-menopause, uterine size norms for ultrasound: 8.0 +/- 1.3 cm in length, 5.0 +/- 0.8 cm in width and 3.2 +/- 0.6 cm in depth (anteroposterior the size).

If there is no menstrual cycle, subsequent changes in the blood supply to the uterus, as a rule, are not determined. If the patient is on hormone replacement therapy, then the size of the uterus, endometrium and cyclic changes may remain. Even the size of the uterus is approaching the parameters of the pre-menopausal state.

In general, estrogen therapy affects postmenopausal endometrium similarly to estrogens in the normal cycle. Conjugated estrogens exert a proliferative effect. Gestagenic therapy can lead to the fact that the endometrium will react as well as the normal secretory endometrium.

And when used together with exogenous estrogens, synthetic progestogens reproduce the characteristic biochemical and morphological changes in the secretory phase of the normal menstrual cycle. The blood flow to the uterus changes also when taking hormone replacement therapy. The thickness of the endometrium increases almost twofold. For example, before treatment, the average thickness was 0.37 ± 0.08 cm. After treatment, the values of steel were 0.68 ± 0.13 cm.

In the study of postmenopausal women, one of the most important applications of ultrasound is the diagnosis and treatment of endometrial cancer. Such studies allow us to determine the normal size of the uterus and ovaries by ultrasound. And in general, intravaginal ultrasound surpasses the possibilities of transabdominal for the visualization of myometrium and endometrium.

M-echo. What is it

During the study, not only the size of the uterus is measured. According to ultrasound, the M-echo norm is also an important indicator. It reflects the development, the state of the endometrium, and its readiness to receive a fertilized egg. It is measured in different phases of the cycle and has certain boundaries.

During menstruation, the endometrium appears as a thin echogenic strip 1-4 mm thick, but varies from 4 to 8 mm in the proliferative phase. In the secretory phase after ovulation, the endometrial glands are stimulated, and the endometrium appears as a more uniform echogenic band with a thickness of 8 to 15 mm.

Rate indicator

We continue to consider such an important indicator as the size of the uterus by ultrasound. What is the norm of the M-echo?

The thickness of the inner shell of 5 mm or less is quite common in postmenopausal women and reliably excludes malignancy in women. However, the thickness of the endometrium to 8 mm can be found in postmenopausal women receiving hormone therapy. It is worth considering further diagnostic studies in postmenopausal women with an endometrial thickness of more than 8 mm to rule out endometrial cancer.

Exclude Cancer

Echographic signs of endometrial cancer in postmenopause include:

• Fluid filled channel;
• A thickened uterine cavity;
• Enlarged uterus;
• Defeat of the uterus with a change in the echo pattern.

Even ultrasound already accurately shows the presence and extent of myometrium invasion. These studies have shown that the most accurate preoperative diagnosis can allow the right choice of therapy, which may lead to better outcomes.

If the thickness of the endometrium is 8 mm or less in patients with post-menopausal bleeding, it is possible to correctly diagnose endometrial cancer by scraping. Therefore, with a thickness of the endometrium in a postmenopause of 10 mm or more, further examination with biopsy or scraping should be performed to exclude malignancy or hyperplasia. Some researchers have demonstrated the usefulness of ultrasound dopplerography in the diagnosis of endometrial cancer. The researchers explained the increase in blood flow in the uterine artery by suspicion of a tumor in patients with malignant diseases: abnormal blood flow can be detected in almost all cases of endometrial carcinoma, as well as uterine sarcomas. With color Doppler, abnormal findings include the presence of irregular, thin and chaotically distributed vessels and the pathological rate of signal flow.

Why measure the cervix

Every pregnant woman is at risk of premature birth, but most people think that this will never happen to them. When they come across this, they remember about prevention and additional research. The most accessible and harmless research is ultrasound, in which the doctor can diagnose threatening premature births.

Numerous studies have shown that an ultrasound index of the cervix from about 20 to 24 weeks of gestation is a strong indicator of premature birth. The length of the cervix is most accurately measured using transvaginal ultrasound. If the woman is not pregnant, then the cervical dimensions by ultrasound (norm) are about 4 cm.

What is the cervix shortening?

It is proved that within 24 weeks of gestation the average size of the cervix is 3.5 cm. If this index is less than 2.2 cm, women face a 20% probability of premature birth. And with a length of 1.5 cm or less, the risk of spontaneous preterm delivery is almost 50 percent. The length is expected to decrease as pregnancy progresses.

Cervical dimensions by ultrasound (norm):

• In 16-20 weeks - 4,0-4,5 cm;
• At 24-28 weeks is equal to 3.5-4.0 cm
• In 32-36 weeks - 3,0-3,5 cm.

Most doctors will appoint a woman transabdominal ultrasound for a period of about 20 weeks. If the length is less than 4 cm, transvaginal ultrasound is done to obtain a more accurate measurement.

A shortened cervix between 20 and 24 weeks is a dangerous symptom.

Using transvaginal ultrasound, you can see both the top and bottom of the cervix. In this case, it looks like a funnel. The widest part of the funnel is closest to the body of the uterus, and the narrowest part is located towards the vagina. When the cervix is shortened even more, it will look like a "V" on ultrasound.

Normally, the cervix is tube-shaped. More than 50 percent of pregnant women with pathology of this organ experience premature birth.

Dimensions of the uterus by ultrasound

The norm during pregnancy depends on the gestational age. The program for calculating the timing of pregnancy is laid down in sonographs according to measurements of the size of individual organs of the fetus and uterus.

If you apply a comparison with fruit, the size of the uterus by ultrasound (the norm in mm) will be as follows.

1. Before pregnancy, the uterus is about the size of an orange and is not determined.

2. At a period of about 12 weeks of pregnancy, the uterus becomes the size of a grapefruit. If the twins are pregnant, the uterus will grow faster. 3. At 13-26 weeks, the uterus grows to the size of papaya. The bottom of the uterus is located from time to time to the navel.

4. Starting from 18-20 weeks, the doctor will measure the distance from the pubic bone to the bottom of the uterus. This is the height of the standing of the bottom of the uterus. The size usually corresponds to the week of pregnancy.

If the size of the uterus coincides with the period of pregnancy, then this is a sign that everything is going well. If the indicator is too large or too small, it can mean some complication of pregnancy. Additional testing may be required. The doctor needs to know the size of the uterus by ultrasound. The norm during pregnancy of this indicator means that everything passes as it should.

5. During the third trimester, the uterus completes growth and becomes the size of a watermelon. When the term of labor arrives, the uterus is at the level of the lower part of the thorax, and before delivery, it should fall lower into the pelvis.

Postpartum period

What are the sizes of the uterus after childbirth? The norm on ultrasound matches the timing of pregnancy. About a day or two after delivery, the uterus will be approximately 18 weeks in size and decrease within the next few days. If the healing goes according to plan, then in a week the uterus will be the size of a 12-week gestation period, and in the sixth week it will return to its normal size.

Ovaries

The ovaries are usually located on both sides of the uterus, although at the examination their determination in places above or behind the uterus is not uncommon. The ovary is most often located in front of the bifurcation of the vessels on the anterior and posterior branches. A successful ovarian imaging requires good access. During the postmenopause, the ovaries undergo changes that are characterized by a decrease in size and the absence of folliculogenesis. In fact, reliable identification of the ovary in many cases can not be done by demonstrating the ovarian cyst when the follicle is surrounded by the parenchyma. Sometimes it is necessary to resort to scanning along the route of internal iliac vessels to detect its location.

Usually, an inverse relationship is found between the size of the ovaries and the time that has elapsed since the moment of menopause: the size of the ovaries progressively decreases over time. However, in patients receiving hormone therapy, you can see no changes in the volume of the ovaries.

Resizing

Normally, after menopause in women, the size of the ovaries is 1.3 +/- 0.5 cm ³ . In menopause, there is no menstrual cycle, so changes in the blood supply to the ovary, as a rule, are not visible when tested in the normal post-menopausal period.

These cyclic changes, however, may be evident if the patient is on hormone replacement therapy. In fact, the pattern of the bloodstream of the premenopausal ovary in postmenopause should aim the doctor for a history of hormone replacement therapy or oncological changes. Ultrasound and Doppler can be of great help in differentiating benign and malignant processes. Performing dopplerography of the uterus for the appendages should be performed:

• Between 3-10 days of the menstrual cycle;
• Between 3-10 days in postmenopause if a woman is on hormone replacement therapy;
• At any time in postmenopausal women without treatment.

Thus, not only in pregnancy is important to know the size of the uterus by ultrasound. The norm of this indicator, as well as the size of the ovaries, is an important sign of a woman's health in any period.

Use of the method in non-pregnant women

There are many reasons for ultrasound, including:

• Pathology of the pelvic structure;
• Unexplained vaginal bleeding;
• Pelvic pain;
• Suspicion of ectopic pregnancy;
• infertility;
• Checking the presence of a cyst or uterine myoma;
• Checking the correct placement of the IUD.

The norms of the size of the uterus on ultrasound depend on how many years the woman, how many she had pregnancies and childbirth, how menstrual function proceeds, etc. Now consider the difference in age.

The size of the adult womb

What are the normal sizes of the uterus for ultrasound in adults? About 7 centimeters long and 4 centimeters wide and thick, plus or minus a couple of centimeters. These are the data of many years of research.

These indicators are the norm of the size of the uterus for ultrasound in adults. As a rule, there is an increase in size if the woman had childbirth. Myoma can make these measurements very large, however, like adenomyosis.

Ovaries are usually in size from 2 to 3 centimeters. Of course, volumes increase if there is a large follicle or cyst.

Dimensions before puberty

What are the sizes of the uterus in this case? The norm in the prepubertal period (before puberty) is about 3.5 cm in length, and the average thickness is 1 cm. Hormonal stimulation, which occurs during puberty, leads to rapid growth and changes in the size of the uterus.

Dimensions after puberty

The normal length in this period is about 7.6 cm, width - 4.5 cm. The average normal thickness is 3.0 cm.

Thus, the normal size of the uterus by ultrasound in adolescents with a normal menstrual cycle is only slightly different from the size of the uterus of an adult woman.

After menopause, the uterus, as a rule, decreases in size, and the ovaries can end up being nothing more than tissue remains. This is so, since the normal size of the uterus and ovaries for ultrasound in menopause is significantly reduced.

Conclusion

So what are the average indicators?

It is generally accepted that the size of the uterus by ultrasound (the norm in mm) in women:

• Length - about 70;
• Width - closer to 55;
• Front-rear size - 40 mm.

Large size is not always considered a pathology. But in this case it is necessary to conduct a study to exclude fibromioma, adenomyosis, malformations, pregnancy.