Uterus in early pregnancy

The uterus undergoes a large number of changes in early pregnancy. At first, changes occur in the innermost layer of the uterus - the endometrium - thickening and hyperplasia are observed, and they are not visible to the naked eye, and as the pregnancy progresses, these changes affect all layers of the uterus, which becomes visible externally.

The uterus swells, softens, especially in the area of the isthmus, and eventually it acquires some mobility. The uterine mucosa acquires a cyanotic (bluish) color, which is explained by the intense blood flow and the increase in the number of blood vessels.

An increase in the uterus in the early stages is observed already from the fifth to sixth week of pregnancy in the anterior-posterior direction, and then in the transverse direction. At the same time, a change in the shape of the uterus from pear-shaped to spherical is observed.

• By the end of the fourth week of pregnancy, the size of the uterus is comparable to the size of a chicken egg.
• By the end of the twelfth week of pregnancy, the size of the uterus can be compared to the size of a goose egg.
• By the end of the sixteenth week of pregnancy, the volume of the uterus is comparable to the volume of the average man's fist.

In early pregnancy, the uterus is located in the pelvic area and external signs of pregnancy are not yet noticeable; the abdominal circumference may increase slightly, especially in first-time mothers.

In early pregnancy, the body of the uterus softens and its cervix retains its density, which makes it possible to bring the fingers of both hands closer together when performing a two-handed vaginal examination - this is the Gorvits-Gegar pregnancy sign. Also, when performing a gynecological examination in early pregnancy:

• The uterus contracts slightly and becomes denser, and after the examination is stopped, it becomes soft again - this is an early sign of pregnancy Snegireva;
• In one of the corners of the uterus, a dome-shaped protrusion is noted, which is caused by the implantation of the fertilized egg, as a result, the uterus looks asymmetrical - this is also an early sign of pregnancy Piskachek.
• A characteristic feature is slight mobility of the cervix, due to softening of the isthmus of the uterus - this is an early sign of pregnancy according to Gubarev and Gauss.
• A slight forward bend of the uterus is noted due to softening of its isthmus; in addition, it is possible to detect, but not always, a comb-like thickening along the anterior surface of the uterus along its midline - this is Hunter's sign.

Clinically, in the early stages of pregnancy, a woman may feel minor pulling pains, discomfort in the lower abdomen and/or lower back, which can be observed normally and is associated with:

• implantation of the fertilized egg into the endometrium,
• changes in the hormonal sphere of a pregnant woman,
• changes in the musculoskeletal system, due to the body's preparation for the upcoming labor - the secretion of the hormone relaxin in the pregnant body, under the influence of which connective tissues become elastic and loose, as a result - the pelvic bones become mobile;
• an intensive increase in the body weight of a pregnant woman, which creates an increase in the load on the spinal column, especially if there is a pathology in it - osteochondrosis, scoliosis.

If pain of this nature is not intense, does not increase and is not accompanied by pronounced bloody or other discharge, then there is no need to worry.

But if there is an increase in the intensity of pain, the appearance of profuse discharge of a bloody or brown nature, or a feeling that the uterus is “stone” or heavy, it is necessary to urgently seek help from an obstetrician-gynecologist, as this may indicate increased tone (hypertonicity) of the uterus and the threat of miscarriage.

Hypertonicity of the uterus can be a result of:

• hormonal imbalance in a woman's body,
• inflammatory changes in the pelvic organs,
• developmental anomalies of the uterus,
• stress,
• intense physical exertion,
• bad habits - smoking and drinking alcohol,
• endometriosis or uterine fibroids.

In most cases, it is enough to normalize your lifestyle and eliminate bad habits, but in any case, it is necessary to contact the doctor who is monitoring the pregnant woman in order to quickly identify the cause of uterine hypertonicity, eliminate it and provide favorable conditions for the pregnancy.

The cervix in early pregnancy

The cervix also undergoes changes in early pregnancy, namely, it changes its color, location, consistency, shape, and size. In early pregnancy, the cervix becomes bluish and loosens, and its glands become more branched and dilated. The bluish color of the cervix is associated with an increase in the number of blood vessels and, accordingly, blood flow. The cervix plays a very important role in early pregnancy:

• holds the fetus in the uterus,
• prevents infection from entering the uterine cavity from outside.

In the early stages of pregnancy, a mucous plug is formed in the cervix, which also performs a barrier, protective function - it prevents bacterial infectious agents from entering the uterus.

In the early stages of pregnancy, discharge is usually not abundant, spotting, or may be absent altogether. The color of the discharge may be creamy, pink, with a yellowish or brownish tint, bloody in nature. Minor discharge, brownish or bloody, odorless, passing quickly and not accompanied by severe pain, may be normal in the third to fourth week of pregnancy due to the implantation of the fertilized egg into the endometrium.

If the amount of bloody discharge is large and increases, and at the same time there is severe pain in the abdomen and/or lower back, and it feels like the uterus is very tense, then you must immediately go to a gynecologist.

Bloody discharge in the early stages of pregnancy can also be caused by cervical erosion, which was present before pregnancy. And due to the increased blood flow to the cervix in the early stages, it becomes aggravated. Most often, bleeding with cervical erosion occurs after intimacy or without apparent reason, is not profuse and is not accompanied by pain, and can go away on its own. But it is better to consult a gynecologist, because local therapy may be needed.

In early pregnancy, cervical insufficiency (isthmic-cervical) may be observed, which is characterized by insufficient or no contraction of the muscles in the isthmus of the uterus, as a result of which the cervix may open prematurely, not hold the fetus, and a miscarriage will occur. The risk of miscarriage increases as the pregnancy progresses. Isthmic-cervical insufficiency may be caused by:

• hormonal disorders in the female body,
• injuries from previous births or abortions,
• pathology of uterine development.

Usually, isthmic-cervical insufficiency is asymptomatic and it is impossible to detect it on your own in the early stages of pregnancy, so it is advisable to regularly visit an obstetrician-gynecologist in order to recognize it in a timely manner.

Thus, the uterus in the early stages of pregnancy creates comfort and favorable conditions for the formation and development of the future child.

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