In the normal woman the long axis of the body of the uterus is inclined forward at an obtuse angle with the long axis of the cervix. In other words, the uterus is normally anteflexed. This angle is subject to rather wide variations within the limits of health. It is greater in the multiparous than in the nulliparous woman. It varies with the distention of the bladder, the position of the woman, and the intensity of intra-abdominal pressure. The axis of the uterus when removed from the body is usually straight. The anteflexion found in the organ when _in situ_ in the living woman rarely persists. The normal or physiological anteflexion is maintained during life by the utero-sacral ligaments, which hold the cervix back, and the intra-abdominal pressure, which, acting upon the posterior aspect of the fundus, pushes the body of the uterus forward.
In the fetus and in early infancy the cervix is relatively much more developed than the body of the uterus, and there is a very marked angle of flexion between them.
Anteflexion of the uterus becomes pathological when the bend in the cervical canal is sufficient to impede the escape of menstrual blood or other uterine discharges.
Obstruction of this kind depends upon two factors--the degree of the flexion, and the rigidity of the uterus, which diminishes the mobility that normally exists at the angle of flexion.
No matter how sharp the angle of flexion, it should not be considered a pathological condition unless obstruction in the cervical canal is present--unless the woman presents the symptoms of dysmenorrhea and sterility.
Three varieties of anteflexion have been described:
I. _Corporeal anteflexion_, in which the cervix has the normal backward direction, and the body of the uterus is bent forward upon it (Fig. 80).
[Illustration: FIG. 80.--Corporeal anteflexion.]
II. _Cervical anteflexion_, in which the axis of the body of the uterus is inclined forward to the normal degree, and the cervix is bent forward upon it (Fig. 81).
III. _Cervico-corporeal anteflexion_, when the cervix and body of the uterus are both bent forward upon each other (Fig. 82).
Anteflexion of the uterus is a disease of single and sterile married women. It is very rarely found in women who have borne children. The disease is congenital or is caused by imperfect development during childhood.