Pregnancy 3 months, the uterus is small, which threatens. What to do if you have a small uterus. What is a “baby” uterus?

In order for the genital organs to develop correctly, in childhood and adolescence it is necessary to monitor the physical development of girls and young women: to prevent colds and infectious diseases, to avoid physical and mental overload.

Doctors worry about women with a small uterus during pregnancy. But the statistics are comforting: if, in addition to the insufficient size of the uterus, you have no other deviations in the development of the genital and reproductive organs, the probability of safely carrying and giving birth to a healthy baby is quite high. Moreover, some mothers sometimes find out about their “problem” after childbirth, when the actual carrying of the baby was successful. So, insufficient uterine size does not always become a problem for expectant mothers.

Treatment of sexual infantilism and, in particular, a small uterus is not a quick process, it takes from six months. In addition to taking medications containing hormones, they practice massage therapy (the uterus is massaged from the outside and inside to increase its size at least a little). There are many non-traditional methods - acupuncture, folk remedies, herbal medicine.
You can also slightly increase the size of the uterus with the help of gynecological massage. Its principle is that the doctor massages the uterus and other reproductive organs from the inside and outside. This massage stimulates blood circulation and can also improve bowel function. Massage does not cause any harm to the body, and as a result the uterus can increase by two centimeters, which is often enough.

Women usually find out that they have a small uterus either after an examination by a gynecologist in a chair, or after undergoing an ultrasound. Many of them hear the diagnosis at a fairly young age, others - after becoming pregnant. Some women are told that their uterine sizes are simply smaller compared to the norm, and some are given specific real diagnoses: hypoplasia, infantilism, aplasia. Very often, doctors scare young girls that they are unlikely to be able to get pregnant and carry a child in the future due to the fact that they have a small uterus; but also often women with such an anatomical feature easily become pregnant and give birth safely (and more than once) after undergoing hormonal therapy or even without it!

In general, we are leading to the conclusion that when a doctor says “you have a small uterus,” in absolutely every individual case it can mean anything: from a subjective visual assessment of the organ by a specific doctor to a very serious pathological condition in which infertility and miscarriage occur. . Therefore, it is impossible to measure everyone with the same yardstick, and such a diagnosis - a small uterus - does not exist in obstetrics and gynecology.

Small uterus: causes, symptoms

The uterus of the average sexually mature woman usually reaches 7-8 cm in length, 4-5 cm in width and has a myometrial thickness of about 2-3 cm; The length of the neck is on average 2.5 cm. These dimensions are not standard, but normally doctors are guided by these parameters. Due to the anatomical and physiological characteristics of the body, a woman may have a normally functioning organ of a different size. Visually, a doctor can determine that a woman’s uterus is medium, large or small, but this is not about pathology in the structure and functioning of the organ. A small uterus is often found in fragile, petite, thin young ladies, which is explained by their configuration, body type, and physiology (accordingly, in large ladies it is often larger than average).

However, very often this definition means precisely the abnormally small size of the female organ, at which it is not able to perform the functions assigned to it by nature - to participate in the production of offspring. Pathologically, a small uterus is diagnosed with the following diseases:

• hypoplasia- insufficient development of the female organ in size, accompanied by underdevelopment of other genital organs and hormonal disorders (such a uterus is equated in size to that of a teenager or a child);
• infantilism (children's uterus)- pathology in which the size of the organ in a woman of childbearing age corresponds to the size of childhood (does not exceed 5.5 cm);
• aplasia (uterine uterus)- a pathology in which the size of an adult woman’s organ corresponds to its size in a newborn girl (does not exceed 3 cm).

As a rule, a small uterus is diagnosed during an ultrasound examination, the results of which are then interpreted by a gynecologist. The diagnosis is confirmed by the presence in a woman of at least one or more symptoms accompanying underdevelopment of the uterus:

• absence of menstruation;
• irregular menstrual cycle;
• painful menstruation;
• low sex drive;
• difficulties conceiving and/or bearing a child.

Doctors believe that disturbances in physiology occur either during the formation and formation of the female organ in utero (at the end of the first - at the beginning of the second trimester of pregnancy), or during the girl’s puberty.

In the first case, it may be infectious diseases suffered by the mother during pregnancy, hormonal imbalance, nutritional deficiencies, or her exposure to other unfavorable factors. Diseases (especially the genitourinary system, infectious viral diseases), insufficient or poor-quality nutrition, lack of vitamins and minerals, physical exhaustion, hard work, and stress can prevent the full growth of the uterus in adolescence.

A small uterus, which is the cause of underdevelopment, and not a physiological feature of the body, is almost always accompanied by other disorders, which individually and in combination with each other, one way or another, affect the conception and bearing of a child. Quite often, pregnancy with a small uterus becomes problematic if at the same time a hormonal imbalance is detected in the woman’s body, underdevelopment or pathologies in the structure of the cervix and fallopian tubes.

How to get pregnant if your uterus is small: pregnancy planning

Typically, women who have such an anatomical feature are worried about whether it is possible to get pregnant in this case, what to do, and what kind of treatment can be carried out.

If a woman is diagnosed with a small uterus and other problems of the reproductive system, then she will most likely have to prepare in a special way for the upcoming pregnancy. However, such preparation often does not provide for anything special.

In rare cases, to increase blood circulation and promote the growth of the uterine epithelium, a woman planning to conceive may be prescribed a special gynecological massage or physiotherapeutic procedures. Much more often, pregnancy planning with a small uterus takes place against the background of hormonal therapy. It usually happens that after a course of oral contraceptives, a woman becomes pregnant in the first or one of the next menstrual cycles after stopping OK. Together with other effects, hormonal drugs also contribute to an increase in the size of the organ. However, hormonal therapy for uterine hypoplasia can be prescribed only after a comprehensive examination of the woman’s health, because for some diseases that cause infertility, taking hormonal drugs is strictly contraindicated!

There are also frequent cases when pregnancy with a small uterus occurs only after vitamin therapy: as soon as the expectant mother takes vitamin and mineral supplements, balances her diet and optimizes her daily routine (lead an active lifestyle, but at the same time ensure adequate sleep and rest), the desired pregnancy occurs without any difficulties.

Small uterus during pregnancy

It should be noted that a small uterus is not such a rare phenomenon. Women often hear similar conclusions addressed to them. True, we are not always talking about pathology and it is not at all necessary that a preliminary medical diagnosis will be reliable. Therefore, you should not be upset when you hear such a verdict. And you always need to confirm the gynecologist’s preliminary conclusion with an ultrasound examination, and also, possibly, visit not one, but several doctors.

Life experience shows that a small uterus and pregnancy are completely compatible concepts in a large number of cases. Moreover, just with the onset of pregnancy, many ladies find out that their uterus is small. Doctors reassure: it’s not scary, as the period increases, the organ will enlarge and grow along with the fetus, which is also facilitated by the hormones intensively produced by the female body during this period. But in order to reduce the risk of miscarriage and premature pregnancy due to insufficient uterine size, you may have to take hormonal medications and exercise increased caution on dangerous days for pregnancy.

In general, a small uterus in itself is neither a contraindication nor an obstacle to pregnancy.

And if, in addition to this feature, no other disorders have been identified in the expectant mother’s body, then we can hardly expect problems caused by this feature. Difficulties with pregnancy will most likely be associated with hormonal deficiency, thin loose myometrium, short uterine cervix and other features. The consequences of such deviations can be premature birth and miscarriages (miscarriage), difficult dilatation of the cervix during childbirth, and weak labor. But modern medical methods of pregnancy make it possible to minimize all risks and safely carry a baby even with a small uterus.

After childbirth, the uterus, enlarged during the period of bearing a child, will again regain its previous parameters. For many women who have given birth to a child or several, it remains small, like a nulliparous girl. Meanwhile, it happens that the pathology after childbirth disappears without a trace, and along with it other disorders: a small uterus, a bend of the uterus or fallopian tubes - everything returns to normal with the birth of the baby.

Be that as it may, you can get pregnant with such a pathology. Real difficulties arise mainly with a very small, completely undeveloped organ. And when aplasia is diagnosed, it becomes completely impossible to become pregnant naturally. But even in such situations, assisted reproductive technologies can help a couple become parents.

Especially for - Ekaterina Vlasenko

After several years of happy family life, my husband and I thought that it was time to have children. Well, as an exemplary expectant mother, I decided to prepare my body for pregnancy, which means I had to not only eat right, lead a healthy lifestyle, but also undergo the necessary examination, first of all visiting a gynecologist. I have always had problems with my menstrual cycle, but I had no idea what it could be connected with. As it turned out, I had lived with a small uterus all my life - this is what I was told after an ultrasound examination.

“You have a small uterus, you may have problems with conception and pregnancy” - these words of the doctor significantly undermined my faith that we would someday be able to become parents. So how dangerous is having a small uterus for pregnancy? Why don't female reproductive organs develop? What to do if you are diagnosed with a small uterus?

Little uterus. Why is this happening?

The genitals of a little girl are identical to those of an adult woman, and differ only in size. During adolescence, the amount of sex hormones in a young person’s body increases, under the influence of which she turns into a young woman. In addition to external changes such as enlargement of the mammary glands, rounding of the hips, growth of pubic and axillary hair, during puberty the uterus increases in size.

Normally, the uterus of a sexually mature woman has the following dimensions: length about 7 cm, width about 4 cm, length of the cervix within 2.5-3.5 cm. These parameters are generally accepted and can vary depending on the individual characteristics of the woman (height, nationality, heredity, etc.).

Uterine hypoplasia (infantile, embryonic, small uterus) is a condition caused by low levels of sex hormones during puberty, as a result of which the uterus lags behind in development.

Factors that reduce the level of sex hormones in the body include:

• surgical interventions on the ovaries;
• anomaly of organ formation;
• violation of microcirculation of the pelvic organs (metabolic disorders, vascular diseases, pathology of the cardiovascular system);
• hard training;
• stressful situations;
• exhausting diets;
• frequent colds, chronic inflammatory diseases;
• alcohol abuse, smoking;
• avitaminosis;
• hormonal imbalances.

In other words, the cause of a small uterus can be any factor that affects the body and interferes with the synthesis of sex hormones.

How to identify a small uterus?

Hypoplasia of the uterus is accompanied by disruption of the menstrual cycle in a woman, which can be expressed as:

• irregular periods;
• complete absence of menstruation;
• deterioration during menstruation (severe pain in the lower abdomen, nausea, weakness, dizziness);

• infertility;
• spontaneous abortions;
• decreased sexual desire.

In addition, the infantile uterus is often accompanied by underdevelopment of the external genitalia, as well as the organs of the genitourinary system. It is also possible that there will be a lag in physical development compared to peers in adolescence.

Women with a small uterus sometimes experience sexual problems, such as lack of orgasm during intercourse.

Medical diagnosis.

Hypoplasia of the uterus can be determined at an appointment with a gynecologist, who, during a bimanual examination, evaluates not only the location of the uterus, but also its size. In addition, a small uterus can be diagnosed using ultrasound. Depending on the degree of hypoplasia, there are:

• teenage uterus (the size of the organ is reduced by no more than 2 cm);
• a child’s uterus (the cavity is almost halved);
• embryonic uterus (the organ is practically undeveloped and has no cavity).

IMPORTANT! If you have a teenage uterus, pregnancy is quite possible. In women with a child's uterus, pregnancy is possible only after a course of treatment. The embryonic uterus reduces the possibility of independent conception and gestation to zero.

The risk of complications during pregnancy with a small uterus.

There are many cases where a woman with a small uterus became pregnant without requiring any treatment. The uterus has amazing elasticity, so even an infantile uterus can become a complete refuge for the baby.

However, there is a fairly high risk of developing complications with uterine hypoplasia associated with pregnancy. Even if pregnancy occurs, the likelihood that it is ectopic is very high. Tortuous tubes with uterine hypoplasia often become twisted, resulting in an ectopic pregnancy (the fertilized egg implants in the tube because it cannot enter the uterine cavity).

One of the complications of a small uterus is recurrent miscarriage - the termination of two or more pregnancies in the early stages, due to low levels of sex hormones.

Small uterus and pregnancy. What you want is possible!

As practice shows, uterine hypoplasia for many women is not an obstacle to motherhood. A small uterus is no longer a death sentence; modern clinics are successfully solving this problem, using simple and affordable treatment methods.

So, you can increase your chances of getting pregnant with a small uterus by:

• Vitamin therapy.

Sometimes, for pregnancy to occur, it is enough to provide the body with all the necessary substances.

• Gynecological massage.

The procedure is aimed at improving blood supply to the pelvic organs, as a result of which the uterus may increase in size. Prescribing a course of gynecological massage in combination with other physiotherapeutic procedures often gives good results.

Collapse

Hypoplasia, infantilism or a child's uterus in a woman, this pathology is not so rarely diagnosed. According to statistics, the disease occurs in 16% of the fair sex. In some cases, the pathology is considered the cause of infertility and is diagnosed in women at a time when attempts to conceive a child fail over and over again.

What is a baby's uterus?

The diagnosis of a child's uterus indicates that the woman's reproductive organ is small. It does not correspond in basic parameters to the patient’s age and hormonal level. With such a uterus, a woman cannot become pregnant and carry a child.

Various problems arise with a small uterus, such as:

1. Decreased sexual desire.
2. Changes in the duration of menstrual bleeding.

Infantility and hypoplasia are a set of conditions that are characterized by one common feature - underdevelopment of the uterus. In this case, the organ may have:

• changed structure;
• insufficient width;
• small length.

Often the uterus is an organ 1-2 cm in size, its structure is changed, the main part is the cervix. In this case, we are talking about the presence of a pathology, which in gynecology is referred to as the uterus of a newborn.

General concepts of what a baby’s uterus is:

1. An organ with a changed structure.
2. Has not reached the proper size (determined according to the patient’s age).

When a girl is born, the size of her reproductive organ does not exceed 4 cm, but in the process of growth and maturation, the organ shrinks and decreases in size to 2.5 cm. Afterwards, the uterus begins to grow only when the girl reaches puberty. At this time, the uterus increases under the influence of hormones, its size reaches 6–7 cm, which is considered quite normal.

If for one reason or another during puberty the level of hormones does not change and remains stably low, then the reproductive organ does not develop enough. In other words, the uterus is growing, but this process is slow and very unstable.

As a result of a lack of hormones in the blood, the body is not formed according to the standard pattern, and problems with the ovaries and uterus may arise.

Causes

The causes of the pathology are different. There are several assumptions that allow us to calculate the root cause of the condition.

Most often, underdevelopment is observed:

• with a hormonal imbalance in a girl’s body (during puberty, the pituitary gland does not sufficiently produce the sex hormones necessary for the body);
• with frequent infectious diseases (infections affect the process, development and maturation of the internal organs of the reproductive system);
• in case of disorders of psychological development (the psycho-emotional background is of great importance; in the presence of psychological diseases, certain problems may arise with the development of the reproductive organs);
• during surgical interventions of various types (operations performed on the ovaries have a detrimental effect).

A girl with underdevelopment of the main reproductive organ experiences a whole list of symptoms. Most often, patients complain of:

1. Cycle instability (menstruation can come 1-2 times a year or six months).
2. Inability to conceive and bear a child (the uterus is simply not capable of performing the functions assigned to it).
3. Too little or too much menstrual bleeding (a specific symptom that can also be observed with other diseases of the reproductive system).

A woman with a baby uterus also experiences other nonspecific symptoms:

• frequent headaches;
• lack of orgasms;
• frigidity.

Pain in the uterus during menstruation can also bother the patient, but these signs are considered so frequently diagnosed that attention is paid to them last.

Symptoms can vary; in some cases, nothing bothers the woman, she simply cannot get pregnant and for this reason turns to a doctor for help. As a result of the examination, the patient is diagnosed with underdevelopment of the genital organ, infantilism.

Diagnostics

The size of the uterus is of great importance when making a diagnosis. The thing is that the norm when making a diagnosis is determined in accordance with standard indicators.

How does the diagnosis process work?

1. The doctor feels the area of ​​the abdominal wall, palpating the uterus, as a result of which its size and main indicators are determined.
2. The doctor conducts an ultrasound, the study helps determine not only the size of the reproductive organ, identify its structure and condition, but also understand the parameters and possibility of reproduction.

Why is palpation inferior to ultrasound in accuracy? The fact is that examination through the abdominal wall does not provide complete information sufficient to make an accurate diagnosis. For this reason, if a patient is given a similar diagnosis, it is necessary to double-check it using ultrasound.

If the uterus is small based on palpation results, then it is worth doing an ultrasound examination using the transvaginal method. The procedure is carried out as follows:

• the patient is placed on the couch;
• A supersensitive sensor is inserted into the vagina.

The procedure is simple and safe; its implementation provides the maximum amount of information that allows the woman to make an accurate diagnosis, determine the size of the uterus and its structure.

An undeveloped uterus has significant deviations from the norm, many girls think so, but in reality this pathology is classified. That is, it has several types and everything is not as simple as it seems at first glance.

Classification or types

A small uterus in a woman is a very broad concept that includes several types of pathology.

So, the uterus can be:

• vestigial;
• infantile;
• hypoplastic.

Vestigial

Rudimentary is a poorly developed uterus, the main volume of the organ is the cervix and tubes. It is impossible to give birth and become pregnant with such a pathology. Even with hormonal therapy, the prognosis is ambiguous. The likelihood of conception is extremely low, and the woman is diagnosed with infertility. The size of the organ of the reproductive system is only 1–2 cm.

1st degree

Uterine infantilism of the 1st degree - this diagnosis is more favorable in terms of prognosis. With a pathology of this nature, there is a chance of pregnancy. If the patient has been diagnosed with an infantile uterus, this means that the size of the reproductive organ can vary from 3 to 5 cm.

If hormonal therapy allows the organ to increase in size by several centimeters, then the prognosis is favorable; with a uterus of 5–7 cm, pregnancy cannot be ruled out.

Hypoplastic

Hypoplastic is an underdeveloped uterus, which corresponds to a size of 6-7 cm, approximately the same size as the reproductive organ of a teenager. This is the most favorable diagnosis; in the presence of a pathology of this type, the prognosis is favorable. Since the size of the uterus allows a woman to bear and give birth to healthy offspring even in the absence of hormonal therapy.

But hormones can still be prescribed to the patient to increase the chances of conception and pregnancy.

What is the main danger?

A small uterus poses certain dangers. In addition to the fact that a woman experiences certain problems with conception, underdevelopment of the organ is fraught with the following consequences:

1. Hormonal imbalance in the body (the pituitary gland and hypothalamus produce sex hormones in insufficient quantities).
2. Problems with the ovaries (against the background of unstable hormone levels, cystic formations and diseases of the genital area occur).
3. Diseases of an infectious nature (in women with underdevelopment of the uterus, infections are diagnosed several times more often).

An undeveloped reproductive system affects the functioning of the whole organism; disturbances occur in metabolic, metabolic and regenerative processes. As a result, endocrine and gynecological diseases may develop.

To avoid consequences, high-quality drug therapy is required. With adequately selected treatment, the situation can be stabilized and complications and consequences can be avoided.

Is it possible to get pregnant and give birth?

A child's uterus and pregnancy, according to some gynecologists, are incompatible things, but today the situation has changed.

There are cases when it is difficult, almost impossible, to correct the situation. But there are cases when hormonal therapy and other therapeutic procedures will help a woman conceive a child, carry it to term and give birth.

So is it possible to get pregnant if you have such a pathology? If the reproductive organ does not exceed 2–3 cm in length, then the chances of conception are zero. Even with hormonal therapy, it will be possible to increase the organ’s volume by only a few cm, which is not enough for pregnancy to occur.

If the reproductive system is developed in accordance with the specified standards and only the uterus is smaller than the specified dimensions, while its length is not less than 5-6 cm, then with appropriate treatment the chances of conception remain.

Hormonal therapy will help enlarge the organ; if it is carried out in a timely manner, then pregnancy is quite possible.

If the reproductive organ is 6 cm or more in length, then even in the absence of adequate therapy, pregnancy is quite possible.

Hormones will only increase the chances of conception; some drugs of this class can be prescribed to women after pregnancy, for its successful completion.

Treatment

There are several methods that will help cope with pathology and normalize the functioning of the organs of the reproductive system.

So, how to increase the size of the uterus:

• using hormonal therapy;
• using physiotherapeutic procedures;
• using psychotherapeutic procedures.

If we talk about compensatory, stimulating therapy with the use of hormones, then it is carried out in order to optimize the activity of the pituitary gland and hypothalamus. As a result of therapy, the level of LH and FSH in the blood increases, which allows normalizing the functioning of the reproductive system in general and stimulating the growth and development of the reproductive organ in particular.

Physiotherapy

Physiotherapeutic procedures are part of combination therapy. For women with a similar diagnosis, they may be prescribed:

1. Laser procedures.
2. Warming up with paraffin.
3. Magnetic therapy.
4. Treatment with mud.
5. UHF therapy.

The procedures are aimed at stimulating blood flow to the organ, which makes the reproductive system work fully. Blood flow improves, the condition of the uterus stabilizes, and there is an influx of nutrients and oxygen to the tissues.

Psychocorrection

A small uterus during pregnancy is a pathology; it is diagnosed in women when determining the cause of infertility or during a routine examination. Such a diagnosis can put a woman into a stupor and cause a change in her psycho-emotional state.

In addition, against the background of hormonal imbalances in the body, a depressive state may develop. Hormones and work with a specialist will help bring a woman out of depression.

Conclusion

A child’s uterus is not a death sentence; modern medicine has learned to correct the condition and treat it with the help of various drugs and physiotherapeutic procedures. For this reason, you should not fall into despair; if therapy is provided in a timely manner, then the chances of conception and pregnancy exist.

Video

In official terminologies, this term is called uterine hypoplasia - underdevelopment of the org and is included in a larger group of diseases of the female genital organs - genital infantilism, from the word “infant” - “child”.

This is a fairly broad group of conditions, which includes various options for underdevelopment, reduction in size, and reduction in the functional load of the genital organs - the uterus, cervix, ovaries, fallopian tubes, and vagina.

There is an isolated decrease in size of the uterus with preserved volume of the ovaries and other genital organs - “pure” hypoplasia. In some cases, in addition to a decrease in the size of the uterus, there are congenital anomalies and underdevelopment of other reproductive units. An extreme manifestation of such anomalies of the gastrointestinal tract, for example, is Rokitansky syndrome - congenital severe underdevelopment of the body of the uterus, its cervix, and vagina.

There are many reasons for a small uterus. It is important to separate the two initial, so to speak, embryonic situations of the formation of an organ defect:

• Congenital defects of an organ are, so to speak, the initially incorrect formation of an organ and its subsequent incorrect development.
• Secondary changes in the complex system of hormonal and neurohumoral regulation of the growth and development of female genital organs in adolescence.

The fact is that initially a girl is born with a “baby” uterus - this is clear and logical - it is small, like all the organs in the baby’s body. Its structural features are the volume of the uterine body, the special ratio of the length of the uterine body and the length of the cervix, the location of the ovaries and fallopian tubes.

However, gradually with age, the female genital organs, like all systems of the child’s body, grow, increase in size, and change their position. The main growth spurt of the genital organs occurs during adolescence - under the influence of progressively increasing levels of sex hormones. If at this stage there are any provoking factors, the uterus may slow down in growth and development.

In this picture you can see how the uterus in girls and young women looks and changes with age.

Changes in the uterus with age. Source: http://prozachatie.ru

So, the factors in the development of primary genital infantilism, in which there are initial defects in the anlage of the organ.

Genetic diseases and disorders are the most common and widespread group of causes of developmental disorders of the reproductive organs in women. The most important in this matter are the so-called sex chromosomes - XX in women.

There are a lot of well-studied and little-known diseases associated with defects in sex chromosomes. The most common of them is Shereshevsky-Turner syndrome, in which a girl is missing one sex chromosome from the moment of conception. This syndrome occurs in a pure form with clear clinical manifestations and a typical appearance of patients, and so-called mosaicism, in which some cells have a normal set of chromosomes, and some have a pathological one.

Exposure to toxins and so-called teratogenic or disfiguring factors - certain drugs, poisons, ionizing radiation, chemicals. All these factors act on the female fetus in the womb, through the body of the pregnant mother. This is why a pregnant woman’s healthy lifestyle, her work schedule, and the rational use of medications are so important.

It is important to understand that this section of genital infantilism rarely has a small uterus as the only manifestation of the pathology of the genital tract. In this case, combinations with other anomalies of the structure of both the genital organs (anomalies in the shape of the uterus, the absence of ovaries or their underdevelopment, a short or rudimentary vagina) and defects of other organ systems - urinary, cardiovascular, musculoskeletal, and so on are extremely common.

Such patients, as a rule, come to the attention of doctors in childhood or adolescence and by the time they reach puberty they already have one or another diagnosis.

Factors in the development of secondary infantilism of the genital organs, in which an initially correctly laid and formed organ begins to lag behind in growth and development:

• Poor nutrition, starvation, vitamin and mineral deficiency. Fortunately, such risk factors are mainly relevant for third world countries and socially disadvantaged sections of the population, but they still occur. It is very important to monitor the child’s nutrition, provide him with a nutritious diet, especially during puberty, when girls go on diets en masse, give up many foods, join the vegan movement, and so on.
• Infectious diseases, mainly of a viral nature. There are a number of diseases, the severe course of which can have a fatal effect both on the genital organs themselves and on the organs that affect their development (brain structures, adrenal glands, thyroid gland). Such diseases include mumps or mumps, severe flu, meningitis and other neuroinfections, and a common herpetic infection.
• Diseases of the endocrine system, especially dysfunction of the thyroid gland, adrenal glands, hormone-producing pituitary adenomas, adrenal tumors, hormone-active ovarian tumors, type 1 diabetes mellitus.
  Severe emotional stress, overload, lack of sleep, improperly organized rest regime. This, unlike fasting, is a real scourge of our time. Children and teenagers study a lot, do not spend time in the fresh air, sleep poorly, and constantly experience stress at home and at school.
• Radiation and chemotherapy of cancer. Unfortunately, cancer sometimes does not spare even very young children. A number of therapeutic measures negatively affect the condition of the gonads and can cause secondary genital infantilism.

The size of the uterus can also change in adulthood, for example, during long-term treatment with antihormonal drugs (Tamoxifen, Zoladex, etc.) after operations for breast cancer and other hormonally dependent types of cancer.

Symptoms

We move on to the most important section in our article - namely the clinical manifestations of this condition.

It is very important to understand that it is not enough to simply say that a woman has a small uterus by measuring its size on an ultrasound examination. This is NOT a diagnosis! Uterine hypoplasia is always a combination of instrumental methods for measuring the three sizes of the uterus and clinical manifestations!

Menstrual irregularities are the basis for the diagnosis of genital infantilism. The options here can be primary amenorrhea - that is, the complete absence of menstruation from the very beginning of puberty, secondary amenorrhea - long, over 6 months of delay in menstruation, oligomenorrhea - rare and scanty menstruation. Irregular (once every 2-4 months), insufficiently heavy menstruation is the main clinical symptom of uterine hypoplasia.

Infertility is the absence of pregnancy in a married couple with regular sexual intercourse for a year without the use of any contraception. This is the second significant symptom, which can be combined with both the small size of the uterus, the inferiority of the mucous membrane of the uterine cavity, and other associated disorders in the sexual sphere - underdevelopment of the ovaries, low hormonal levels, hypoplasia of the fallopian tubes, and so on.

Recurrent miscarriage is two or more consecutive spontaneous abortions. Uterine hypoplasia is characterized by early spontaneous miscarriages, often after several days of missed menstruation with a positive pregnancy test.
Diagnostics

As a rule, the primary diagnosis of genital infantilism is not particularly difficult. It is more difficult to determine the primary cause of this condition.

The patient's appearance is often the first clue to the doctor. Patients, especially those with genetic diseases, have a fairly typical appearance, like... For example, patients with Shereshevsky-Turner syndrome. It is also important to pay attention to the nature and intensity of hair growth, the degree of development of the mammary glands and external genitalia, the shape and size of the pelvis.

The chairside examination is also very important. The doctor can evaluate the size and shape of the cervix, the size of the uterine body, and the hormonal nature of vaginal discharge.
Ultrasound examination is a real help to the gynecologist, allowing him to assess the size of the uterus, its relationship with the cervix, determine the size and follicular apparatus of the ovaries, and also evaluate the effect of the treatment.

The size of the uterus depends on the patient’s age, the number of pregnancies and births in the past and is compiled in special tables. Once again, we emphasize that only measuring the size of the uterus during scanning does not give the right to make a diagnosis of uterine hypoplasia!

The diagnosis is made with a combination of reduced size and symptoms! It is impossible to tell a patient with a reduced size of the uterus according to ultrasound or an incorrect length index of the cervix and body of the uterus that she has genital infantilism if she has had normal regular full periods since the age of 12. We must not forget about the individual characteristics of each organism.

Hysterosalpingography or HSG is a very valuable x-ray method for studying the condition of the uterine cavity and the patency of the fallopian tubes. Such a study is necessarily indicated for patients with infertility, since underdevelopment of the uterus is quite often combined with similar hypoplasia of the fallopian tubes, and pathological tortuosity and, accordingly, obstruction.

A blood test for sex hormones, adrenal hormones and thyroid hormones, blood sugar and insulin are very important diagnostic criteria that make it possible to exclude secondary causes of infantilism and determine the direction of treatment.

Karyotyping - determination of the set of chromosomes and consultation with a geneticist are necessarily indicated for patients with primary amenorrhea and long periods of secondary amenorrhea, to exclude genetic defects.

Treatment

Treatment of a “small uterus” is a very complex and rather lengthy process that occurs at the intersection of specialties. This process involves gynecologists, endocrinologists, and when monitoring a patient for infertility, reproductive specialists.

The basis of treatment is the elimination of the root causes of this condition. It is the basis for the development of hypoplasia that will determine the line of therapy.

If you are underweight, a nutritious, varied diet is required for normal synthesis of sex hormones and uterine growth.

In case of hormonal imbalances, its correction is necessary, for example, in case of hypothyroidism, thyroid hormones are prescribed, in case of hyperprolactinemia - bromocriptine preparations, in case of disorders of the adrenal glands - glucocorticoids.
With a combination of deficiency of sex hormones and a decrease in the size of the uterus, replacement regimens for sex hormones - estrogens and gestagens according to the phases of the cycle - have proven themselves to be excellent.

In recent years, drugs originally created for hormone replacement therapy for menopause have been successfully used for this purpose, for example, Femoston, Estrogel, CycloProginova and others. Such drugs, over the course of 1-2 years of constant use, help enlarge the small uterus to normal size and help the patient become pregnant.

Physiotherapy works well in combination - pulsed stimulation of the cervix, magnetic therapy, laser, various types of electrophoresis, which improves blood flow in the genitals, which stimulates both growth and function.
Features of the onset and course of pregnancy.

Small uterus and pregnancy

I would like to immediately reassure our readers that a small uterus during pregnancy is not a death sentence. With proper and timely treatment, a natural pregnancy can occur, its normal course and the birth of a healthy child.

Features of such pregnancies are:

• Frequent occurrence of pregnancy against the background of hormonal support, for example, while taking Femoston and similar drugs. It is important to understand that such drugs should be discontinued immediately after the first positive test in consultation with the doctor.
• As a rule, immediately after discontinuation of the combination drug, the patient is prescribed a progestin or another gestagen to support pregnancy. The patient must clearly know what exactly she needs to take when pregnancy occurs immediately after stopping the estrogen-progestin drug.
• Quite often, such pregnancies are accompanied by the threat of termination at various stages, so such patients are identified as at risk for miscarriage and appropriate preventive measures are taken.
• Often such patients have peculiarities of the course of labor - namely, primary and secondary weakness of labor, incoordination of labor, delayed ripening of the cervix before childbirth, and therefore childbirth often ends with a cesarean section.

Unfortunately, for genetic disorders associated with loss or defect of sex chromosomes, treatment is mainly symptomatic. Hormone replacement therapy allows the patient to acquire secondary sexual characteristics and have a menstrual-like reaction, but their own pregnancy is almost impossible for them. However, modern reproductology works wonders - there are children born from donor eggs, surrogacy, which makes it possible for such patients to have a child.