The form of the uterus changes considerably during pregnancy: the upper
part appears to increase in greater proportion than the lower, a fact
which appears to be proved from the alteration which takes place in the
relative position of the Fallopian tubes, which are situated much lower
down the sides of the uterus at full term than in the unimpregnated state,
nor do they entirely regain their former position after labour, until the
female has attained an advanced age; hence as the cervix diminishes in
length during the latter half of pregnancy, it follows that the difference
in point of size between the fundus and the body of the uterus, and this
part will be continually increasing.
As the uterus increases, the fundus of course rises and can be felt
through the distended abdominal parietes: its anterior surface, especially
in the latter month of pregnancy, lies immediately behind the anterior
wall of the abdominal cavity, and pushes the small intestines upwards,
backwards, and to the sides.
The form of the gravid uterus differs also from that in the unimpregnated
state in other respects, and this difference appears to depend in great
measure upon its increase of size, and upon the form of the cavities which
it occupies. Thus in the unimpregnated state when it occupies the cavity
of the pelvis, its anterior surface which corresponds to the bladder is
flattened; whereas its posterior surface, which is turned towards the
hollow of the sacrum, is convex; it is however the reverse during the
latter half of pregnancy. The anterior surface is now strongly convex,
being merely covered by the yielding anterior wall of the abdomen; whereas
posteriorly the uterus is nearly concave, corresponding to the solid
convexity of the lumbar vertebræ, a fact which may be easily ascertained
by examining the abdomen of a patient in the last month of pregnancy while
lying down. The situation and position of the uterus are also changed in
the unimpregnated state; the fundus is inclined somewhat backwards, the
os uteri being nearly in the centre of the pelvic cavity, but the gravid
uterus during the latter half of pregnancy has its fundus strongly
inclined forwards and the os uteri directed backwards towards the upper
part of the hollow of the sacrum.[14]
Public-domain text, read in full here on John Shaqi.
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