Uneven hypoechoicity in the anterior wall of the uterus is often considered the cause of fibroids or cysts in the uterine wall. Fibroids detected during pregnancy need to be reviewed regularly, and most small fibroids are not harmful to the fetus. However, larger uterine smooth fibroids grow faster during pregnancy and have the potential to develop red degeneration. If a uterine wall cyst is identified, treatment measures need to be made according to the size of the cyst, growth rate and the presence of clinical symptoms. If the cyst is small and the growth rate is slow after review, observation can be continued. If the cyst is large, growing rapidly and bleeding occurs, surgery may be performed if necessary. Therefore, if the anterior wall of the uterus is uneven and slightly hypoechoic during pregnancy, whether it is a fibroid or a cyst on the wall of the uterus, you should consult with a medical professional and follow up with a doctor for regular review, and if it endangers the mother or the fetus, you should take professional measures to treat it in a timely manner.