Changes to the Uterus and Ovaries During Pregnancy
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There are multiple changes that occur in
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the uterus and adnexa during pregnancy.
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The first and most obvious is that the
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uterus is going to increase in size, and this
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happens in a pattern of predictable growth.
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When patients come into the clinic,
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we can measure their fundal height,
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and we can estimate their gestational
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age based on the size of the uterus.
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Remember that hormonal support of the
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pregnancy is ovarian, and up until about
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10 to 12 weeks of pregnancy, progesterone
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that's secreted by the corpus luteum is
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going to maintain the pregnancy until the
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point at which the placenta takes over.
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As the uterus increases in size and
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ascends into the abdomen, the abdominal
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viscera, the bowel, the ovaries, are
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all displaced laterally and superiorly.
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We can see for this patient, who has a
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third trimester pregnancy, that the uterus
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has significantly increased in size
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from what we saw in the cases that we
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just reviewed for non-pregnant patients.
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We see the fetus, which is
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in cephalic presentation.
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This is T2 bright amniotic fluid.
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And again, we see the T2 heterogeneous
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ovaries with T2 bright follicles.
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So this is the right ovary
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and this is the left ovary.
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So we see that the ovaries have
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been displaced superiorly and
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laterally in the context of pregnancy.
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Another change that occurs is the overall blood
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volume within the maternal body increases, and
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the vasculature in the pelvis proliferates
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significantly to accommodate nutrient
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supply and oxygen exchange with the fetus.
Erin Gomez, MD
Assistant Professor of Radiology
Johns Hopkins Hospital
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