Anteverted retroflexed uterus: a common consequence of cesarean delivery

The purpose of this study was to determine in a sequential unselected sample of nonpregnant women whether an anteverted retroflexed uterine position develops after cesarean delivery and to see whether the amount of myometrial thinning related to cesarean delivery affects the development of an anteverted retroflexed uterine position.

Images from 641 consecutive transvaginal ultrasound examinations performed between 2008 and 2011 in which a uterus was present were reviewed and archived. The series was analyzed in three groups: patients who underwent cesarean delivery, patients who were parous but had not undergone cesarean delivery, and patients who were nulliparous. The uterine axis was categorized as anteverted, anteverted and anteflexed, retroverted, retroverted and retroflexed, anteverted and retroflexed, retroverted and anteflexed, and axial, that is, in the same axis as the vagina.

An anteverted retroflexed uterine position was found in 27% of women after cesarean delivery. It was rare when no cesarean section had been performed, being found in 1% of those women, and was not seen in nulliparous women.

An anteverted retroflexed uterine position is a common consequence of cesarean delivery but is rarely seen in other parous women.