The Blood Supply of the Uterus

Abstract

Summary A detailed study of the arterial system of the human uterus is described using an injection technique coupled with microradiography and histology. The micro‐vascular patterns and their variations during the menstrual cycle are illustrated.

Dynamic contrast-enhanced MR imaging to assess physiologic variations of myometrial perfusion

“…These findings are in line with previous studies suggesting a discontinuity exists within the myometrium itself in addition to uterine vascular organization [5,26,[34][35][36][37][38][39]. Angiographic studies described the human uterus vascularisation as an anastomotic blood supply arising from the uterine, ovarian and vaginal arteries.…”

“…According to histological studies [4,5], density of vasculature in the subendometrial zone is very low and this area is very thin. In a stereological study [40], Aitken et al confirmed that a decreasing gradient of vascular smooth muscle abundance (found in arteriolar and venular vessels) exists within the myometrium which is consistent with previous angiographic studies outlining the distribution of arteries and veins within the myometrium [4,5]. However, Aitken et al demonstrated also that distribution of capillaries was uniform throughout the myometrium.…”

“…These in turn branch to form the radial arteries, which transverse the myometrium and perforate the endometrium as small caliber conductance vessels, known as spiral arterioles. In addition to vascular organization, the myometrium itself appears to be layered and shows gradient properties [5,34]. Measurements performed on uterine specimens have demonstrated a higher vascular perfusion rate in the inner third of the myometrium compared with the outer myometrium [35].…”

“…Angiographic studies described the human uterus vascularisation as an anastomotic blood supply arising from the uterine, ovarian and vaginal arteries. Bilateral uterine arteries penetrate the myometrium and give rise to the circumferential arcuate arteries [5,34]. These in turn branch to form the radial arteries, which transverse the myometrium and perforate the endometrium as small caliber conductance vessels, known as spiral arterioles.…”

“…This process results in rapid, periodic growth and subsequent regression of tissue accompanied by rapid and important changes in blood flow [4][5][6]. The changes in blood flow occur in both large vessels and capillaries.…”