Ligaments supporting the cervix: uterosacral, cardinal and pubocervical
Three ligaments hold the cervix (the neck of the uterus) in place, running to the back, the sides and the front: the uterosacral, cardinal and pubocervical.
Remember
Each ligament has its own direction: the uterosacral ligament holds the cervix back, the cardinal ligament holds it sideways and the pubocervical ligament holds it forwards.
Memory aid
pubocervical to the front, uterosacral to the back, cardinal to the sides
Picture the cervix as the centre of a compass and give each ligament its direction.
A ligament is a tough band that holds structures in place. Three ligaments support the cervix, and the names uterosacral and pubocervical each point to the two ends of the ligament.
The uterosacral ligament runs from the cervix back to the sacrum, a triangular bone at the back of the pelvis, so it supports the uterus from behind. It is also called the rectouterine ligament.
The cardinal ligament, also called the transverse cervical ligament, passes sideways from the cervix to the side wall of the pelvis at the level of the ischial spine, a bony projection of the pelvis. It holds the cervix from each side.
The pubocervical ligament runs forward from the cervix to the back of the pubic symphysis, the joint between the two pubic bones, so its support is at the front.
Because several ligaments attach to the cervix, it helps to give each one a direction: front, back or side. When support fails, the uterus can descend into the vagina, which is uterine prolapse.
Key facts
- Uterosacral ligament
- runs from the cervix back to the sacrum and gives posterior support to the uterus; also known as the rectouterine ligament.
- Cardinal ligament
- runs from the side of the cervix to the lateral pelvic wall at the level of the ischial spine; also called the transverse cervical ligament.
- Pubocervical ligament
- runs from the cervix to the posterior surface of the pubic symphysis, at the front of the pelvis.
- Compass
- pubocervical to the front, uterosacral to the back, cardinal to the sides.
- Prolapse
- poor support contributes to uterine prolapse, in which the uterus descends into the vagina.
Exam traps
- The pubocervical ligament does support the cervix, but it passes forwards to the pubic symphysis, so its support is anterior rather than posterior.
- The cardinal ligament also supports the cervix, but it runs sideways to the lateral pelvic wall rather than backwards to the sacrum.
- The uterosacral ligament also supports the cervix, but it runs backwards to the sacrum instead of sideways to the ischial spine, so it gives posterior support.
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