Full Arborization of Uterine Arteries

Description

Running within the broad ligament to reach the lateral uterine wall, the right and left uterine arteries course medially from their origin on the internal iliac artery, then ascend in a tortuous fashion along the uterus toward the fundus. Arcuate arteries circle within the myometrium and give off radial arteries that penetrate toward the endometrium, where they branch into straight (basal) and spiral arteries supplying the stratum basalis and stratum functionalis. Spiral arteries extend superiorly and centrally to approach the uterine cavity, while venous channels typically parallel the arterial tree more laterally and posteriorly within the uterine wall. Depth is the story here. This arterial pattern underpins normal menstruation and placentation. Spiral artery remodeling by extravillous trophoblast, with loss of muscular and elastic components, converts high resistance vessels into low resistance channels, and failure of this process is a key pathophysiologic feature in preeclampsia and fetal growth restriction. The uterine artery also forms anastomoses with the ovarian artery near the uterine cornu, a practical point during hysterectomy or uterine-sparing procedures because it influences collateral flow and bleeding risk. Use this illustration for reproductive anatomy and histology teaching blocks, OB-GYN board review materials, and figures in manuscripts discussing abnormal uterine bleeding, endometrial perfusion, or placental bed disorders. It also fits procedural education on uterine artery ligation or embolization for postpartum hemorrhage and symptomatic fibroids, where understanding the arcuate to radial to spiral hierarchy guides both targeting and complication avoidance. Anatomical accuracy verified by SciePro's Medical Advisory Board.