Cardiovascular system · Pelvis · Female
Uterine artery !
The uterine artery is the main blood supply of the uterus; it runs beside the cervix, crossing above the ureter, and grows much larger in pregnancy.
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What it is
A branch of the internal iliac artery that runs to the side of the cervix and up the side of the uterus; on the way it crosses over the ureter.
What it does
The main blood supply of the uterus; it grows a lot in pregnancy.
Key facts
- Origin
- Anterior division of internal iliac artery
- Branches
- Vaginal and cervical branches; spiral ascending branch along the uterus; ovarian and tubal branches (anastomose with the ovarian artery)
- Supplies
- Uterus, cervix, upper vagina, medial tube and ovary; crosses OVER the ureter about 1.5–2 cm lateral to the cervix
Relations
- Course
- From the internal iliac artery it runs forward and medially on the pelvic side wall, then through the base of the broad ligament (cardinal ligament, parametrium) to the cervix near the internal os, turns up along the uterus and ends near the uterine tube, joining the ovarian artery
- Below
- Ureters, which pass beneath it close to the cervix and the lateral vaginal fornix
- Lateral
- Near its origin, the pelvic side wall with the obturator internus and the obturator nerve and vessels
- Medial
- Cervix and lateral border of the uterus, wrapped in the uterine venous plexus
How to find it
Transvaginal Doppler finds it lateral to the cervix at the level of the internal os. In surgery it is identified at the base of the broad ligament, or traced from the internal iliac artery in a retroperitoneal approach, with the ureter followed beneath it.
On imaging
Doppler ultrasound measures its flow: in pregnancy, high resistance or an early diastolic notch suggests poor remodelling of the placental bed, associated with pre-eclampsia and fetal growth restriction. Angiography maps it before embolisation.
Common problems
- Bleeding after birth when the uterus does not contract.
- Feeds fibroids.
How it is diagnosed
Doppler ultrasound; angiography before an embolisation.
Treatment
- Clamped and tied in a hysterectomy, away from the ureter.
- Blocked from inside (uterine artery embolisation) to shrink fibroids or stop bleeding.
Clinical notes
- Uterine artery embolisation blocks both arteries through a catheter introduced in the groin or wrist, to shrink fibroids or to stop postpartum haemorrhage
- Bilateral uterine artery ligation (sutures around the vessels beside the lower segment) and internal iliac artery ligation are surgical options described for postpartum haemorrhage
- Its anastomosis with the ovarian artery keeps the uterus perfused after ligation, and ovarian collaterals can keep some fibroids perfused after embolisation
Anatomical variants
- Its origin varies: usually a separate branch of the anterior division of the internal iliac, but it can share a trunk with the umbilical artery or arise from other internal iliac branches
Memory aid
«Water under the bridge»: the ureter (water) runs under the uterine artery (bridge).
Related conditions
- Preeclampsia
- Uterine rupture
- Intrapartum fetal compromise (non-reassuring fetal status)
- Fetal growth restriction
Test yourself
Think of the answer, then tap the question to see it.
From which artery does the uterine artery arise, and what does it cross on its way to the cervix?
The anterior division of the internal iliac artery; it crosses over the ureter beside the cervix.
Why is the uterine artery tortuous along the side of the uterus?
The slack lets it lengthen as the uterus grows in pregnancy.
What does uterine artery Doppler in pregnancy suggest if it shows high resistance or an early diastolic notch?
Poor remodelling of the placental bed, associated with pre-eclampsia and fetal growth restriction.
Why does the uterus stay perfused after uterine artery ligation?
The uterine artery anastomoses with the ovarian artery near the uterine tube.
What is uterine artery embolisation used for?
To shrink fibroids or stop postpartum haemorrhage, by blocking both arteries through a catheter from the groin or wrist.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- arteria uterina TA2 4330
- Official Spanish (DeCS)
- Arteria uterina DeCS D055988
- English (TA2)
- Uterine artery
Related
- Cardinal ligament
- Ureters
- Ureter under the uterine artery
- Body of uterus
- Fundus of uterus
- Cervix
- Uterine tubes
- Vagina
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis: Uterine Arteries.
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Representative model, for educational purposes only.
