[Flexion and version of the uterus on pelvic ultrasound examination]

In the longitudinal (sagittal) plane, the angle between the axis of the uterine body and the cervix defines the flexion, whereas the angle between the axis of the cervix and the axis of the vagina defines the version of the uterus. In that regard, there are four uterine positions in the pelvis: anteflexion, retroflexion, anteversion and retroversion. The anteflexion with anteversion of the uterus is considered the natural position of the uterus in the pelvis. The transabdominal ultrasound examination of the female pelvis is most frequently performed if, for any reason, it is not possible to make a more appropriate transvaginal ultrasound examination. Suprapubic region is scanned with a high-frequency convex transducer in the longitudinal and transverse plane. The prerequisites for appropriate ultrasound examination are the filled urinary bladder, optimal quality of the ultrasound image, consistency in the sonographic technique and excellent knowledge of echomorphology of the pelvic organs. The commonest of the less common variants of the uterine position is retroflexion with retroversion. Although sometimes related with serious problems during childbirth as well as miscarriage, it usually does not cause any major problems. Yet, data on the uterine position may help the clinician in planning of various procedures.