The Normal Uterus

  • Khaled Sakhel
  • Alfred Z. Abuhamad
  • Callum Andrew Potts


The uterus as a reproductive organ undergoes changes in response to ovarian hormones in preparation for implantation of the fertilized ovum and maintenance of pregnancy. Most changes are at the level of the endometrium and can be detected by pelvic sonography. Ultrasound is the modality of choice for pelvic organ imaging. Early proliferative endometrium appears as a thin echogenic line. Under the influence of increasing estradiol hormone levels (secreted by the growing ovarian follicles), the endometrial proliferation occurs. Sonographically, this is visualized as thickening of the lining into the so-called trilaminar layer with an anterior and posterior hypoechoic layer bordering the myometrium separated by hyperechogenic central line. The postovulatory endometrium is under the influence of progesterone secreted by the corpus luteum, and the lining is characterized by loss of the trilaminar appearance and the development of a uniform echogenic stripe. The cervix also undergoes cyclical changes that are detectable on sonography. Advancements with 3D image reconstruction allows for enhanced visualization of the uterus and potential pathologies.


Ultrasound Pelvic Endometrium Myometrium Cervix 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Khaled Sakhel
    • 1
  • Alfred Z. Abuhamad
    • 2
  • Callum Andrew Potts
    • 3
  1. 1.Inova Fairfax Hospital, Department of Obstetrics and GynecologyFalls ChurchUSA
  2. 2.Department of Obstetrics and Gynecology, Eastern Virginia Medical SchoolNorfolkUSA
  3. 3.Inova Fairfax Hospital, Women’s and Children’s HospitalFalls ChurchUSA

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