The Tilted Womb
Normally the uterus is in a vertical position, tilting slightly forward at the cervix. In some cases, in fact in about one out of every five women, the womb is tilted backwards. This is known as uterine retroversion, a retroverted uterus or a tilted or tipped uterus. There are many possible causes for this uterine position — scarring from endometriosis or pelvic inflammatory disease, pregnancy or the weakening of ligaments due to menopause. It is also possible that the womb tips backwards naturally as a woman matures.
A tilted uterus often does not cause any symptoms and may or may not require treatment. It should not have a negative effect on pregnancy or on ultrasound testing.
Ultrasounds and the Tilt
An ultrasound is generally performed at twenty weeks to make sure the placenta is attached properly, that growth and development of the fetus is normal and, if desired, the gender of the baby. For pregnant women who do happen to have a tilted womb, ultrasound testing at this point will be normal. In fact, by week ten or twelve the womb moves into the vertical position and is no longer tipped. In rare cases where this does not happen, it is possible for a miscarriage to occur.
Some women may have an ultrasound performed towards the beginning of the pregnancy. This may be done topically or with a tubular probe. An early first ultrasound may be performed to find out if there is more then one fetus, to try and determine an accurate age of the fetus or it may be used to check for any potential problems. Having a tilted uterus does not affect the ultrasound, even when the tilt may still be in place at the beginning of the pregnancy.
If an ultrasound test does not detect the developing embryo it is not because of uterine retroversion. It may simply be that dates are off and the pregnancy isn't far enough along yet. An ectopic pregnancy is another possibility.
What to Do
Always talk to your doctor about any concerns you may have concerning a tilted uterus and the results of your ultrasound. If a first ultrasound does not seem to work another one can be done a week or two later to check for the embryo. Blood tests can also be done to help give your doctor an idea of how the pregnancy is progressing and what may be going on. A tilt is not necessarily a problem but rather a common abnormality. If symptoms are present, such as pain during intercourse, pain during menstruation, incontinence problems and urinary tract infections, your doctor may recommend surgery to correct the tilt. This is not an option during pregnancy however. If pregnant, the womb should move into place naturally on its own and ultrasound testing should not be affected.
PubMed Health. Retroversion of the Uterus. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002475/
American Pregnancy Association. Tipped Uterus. https://www.americanpregnancy.org/womenshealth/tippeduterus.html
WebMD. Prenatal Ultrasound. https://www.webmd.com/baby/ultrasound