Round ligament of the uterus
The round ligament of the uterus is a remnant of the gubernaculum, a fibrous band in the embryo that guides the gonad (the future ovary or testis) downwards.
Remember
In women the gubernaculum persists as two ligaments: the ovarian ligament, which joins the ovary to the uterus, and the round ligament, which runs from the uterus through the inguinal canal (the passage through the lower abdominal wall) to the labia majora (the outer folds of the vulva). The round ligament also helps keep the uterus tipped forwards.
In the embryo, the gubernaculum is a fibrous cord that connects the developing gonad to the tissue that becomes the labia majora in women. In women the ovary stays in the pelvis because the developing uterus holds it there, so the cord is left in two parts.
One part joins the ovary to the uterus and is the ovarian ligament. The other part continues beyond the uterus and is the round ligament of the uterus.
The round ligament leaves the uterus at the uterine horn, the upper corner of the uterus. It then runs forwards through the inguinal canal and ends in the labia majora.
By pulling the top of the uterus forwards, the ligament helps to maintain anteversion, meaning that the uterus is tipped forwards. In pregnancy the expanding uterus places extra force on the ligament, which can cause groin pain.
Do not confuse it with other named ligaments of the uterus and ovary. The suspensory ligament of the ovary (which carries the ovarian vessels), the broad ligament (a sheet draped over the uterus) and the uterosacral ligament (which runs backwards to the sacrum) are not remnants of the gubernaculum.
Key facts
- Origin
- a remnant of the gubernaculum that is fibromuscular, made of fibrous tissue and muscle.
- Course
- it starts at the uterine horn, runs forwards through the inguinal canal and ends in the labia majora.
- Function
- it helps to maintain anteversion, meaning that it helps keep the uterus tipped forwards.
- Pregnancy
- the expanding uterus puts extra force on it, so it can be a source of pain.
- Other remnant
- the ovarian ligament, which joins the ovary to the uterus, is the other part of the gubernaculum.
Exam traps
- The ovarian ligament is also a remnant of the gubernaculum, but it only joins the ovary to the uterus, so it stays inside the pelvis and does not reach the labia majora.
- The uterosacral ligament is not a remnant of the gubernaculum: it passes backwards to the sacrum, whereas the round ligament runs forwards to the groin.
- The cardinal ligament is also a support of the uterus, but it runs sideways rather than out through the groin, so it is not the round ligament.
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