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Uterus is ‘large for dates’: what does this mean?

by Peg Plumbo

question
My doctor did an internal exam when I was two months pregnant and said my uterus was ‘large for my dates’. This is my first pregnancy. What are the main causes of a ‘big’ uterus?

answer
The principal causes of a uterus that appears to be ‘large for the dates’ are inaccurate dates and multi-foetal gestation (twins).

A rather common cause of a uterus being ‘large’ is inexperience in estimating uterine size. Or perhaps the exam was done too quickly or when you had a full bladder. A second opinion or another exam in two weeks would help clarify this situation.

There are rare problems that can cause the uterus to grow too rapidly. One of these is a molar pregnancy, which is an uncontrolled growth of tissue that was originally a product of conception but is no longer an embryo.

Any condition favouring enlargement of the uterus prior to pregnancy would also cause the uterus to be ‘large for dates’ during pregnancy. Such conditions include benign tumours, such as a fibroid growing within or on the uterus, or an endometrioma. Rarely, another type of pelvic mass can be mistaken for an enlarged uterus; for example, a mass in the area next to the uterus or an ovarian mass.

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