Round Ligament

What is the round ligament?

The round ligaments are rope-like bands of connective tissue that support the uterus (womb). The scientific term for this round ligament is the gubernaculum.

There are two round ligaments of the uterus, one on either side. Each is about 4 inches (10 centimeters) long.

When people refer to “round ligaments,” they generally mean round ligaments of the uterus. Another round ligament, the round ligament of the liver, is what remains of the umbilical vein. This blood vessel carries blood from the placenta to the fetus in the womb. In adults, it doesn’t have a function.

What are ligaments?

Ligaments are strong bands of fibers interconnected in strong, cordlike ropes. Typically, ligaments attach bones in a joint. In places like the elbow, ankle or knee, strong ligaments make crisscross connections that help stabilize the joint.

Other ligaments, like the round ligament, help support internal organs. Rather than connecting bones to stabilize a joint, the round ligament supports the uterus.

Do men have round ligaments?

All fetuses begin developing the same way. Later in pregnancy, sex differences appear. Male fetuses do have round ligaments. As the sex organs form, the round ligament in a baby boy moves down into the scrotum (sac outside the body that holds the testicles).

What is the purpose of the round ligament?

The round ligaments support and anchor the uterus. During pregnancy, the round ligaments stretch. They get wider and longer to support the growing uterus.

Where is the round ligament located?

There are two round ligaments, one on each side of the uterus. The uterus is a hollow, pear-shaped organ in the pelvis (bowl-shaped area of bone that connects your torso and legs). During pregnancy, a developing baby grows in the uterus. The muscular uterus can expand as the baby grows.

Several structures come off of the top corners of the uterus and briefly run together: the round ligament, the Fallopian tube and the ligament that holds the ovaries close to the uterus. From there, the ligament enters the abdominal wall and travels through groin (in the inguinal canal), and eventually inserts into the labia. This is often why women experience round ligament pain in the groin, or as vaginal tugging.

What conditions affect the round ligament?

Several conditions can affect the round ligaments during a woman’s reproductive years. These include:

• Endometriosis: This condition causes cells similar to the uterine lining to grow outside of the uterus. In some cases, endometriosis develops in or on the round ligaments. Endometriosis can lead to pelvic pain, disrupted menstrual cycles and infertility.
• Round ligament pain: Round ligament pain is a common pregnancy symptom as ligaments stretch and contract. It can start in the second trimester of pregnancy (after 13 weeks). You may experience sharp pain in the hips, abdomen or groin (the area between your stomach and thighs).
• Round ligament varicosity (RLV): Varicose veins can develop in the veins of the round ligament during pregnancy, most often the second trimester. RLV can cause pain and swelling. People sometimes mistake the condition for a hernia. Your healthcare provider should monitor RLV throughout your pregnancy. It generally resolves on its own after you deliver your baby.

Why does pregnancy cause round ligament pain?

During pregnancy, the uterus grows and expands to accommodate a developing baby. The uterus starts about the size of an orange. By the end of a pregnancy, it is about the size of a watermelon.

The round ligaments also expand to support the uterus as it gets bigger and heavier throughout pregnancy. As the ligaments stretch to hold up the expanded uterus, you may experience round ligament pain.

How can I keep my round ligaments healthy?

During pregnancy, it may help to do gentle stretches of the pelvis and hips. If you experience round ligament pain, stop doing the movement that triggered the pain and rest until it goes away.

When should I call my doctor?

You should call your provider or seek emergency care if you experience severe round ligament pain that lasts more than a couple of minutes along with:

• Cramping.
• Fever or chills.
• Nausea or vomiting.
• Vaginal bleeding.

A note from Cleveland Clinic

The round ligaments help support your uterus. During pregnancy, they stretch and can become painful. Talk to your healthcare provider about how to recognize round ligament pain during pregnancy. They can show you gentle stretches to help keep the round ligaments healthy.