When I found out i was pregnant with my second they told me I have a tilted uterus. I didn't with my first but with this one I do. It just made it a little harder for them to find the heartbeat at first. I don't have any complications or anything. They could always see baby and everything. They said I will be able to deliver vaginally as long as there aren't any unforseen complications.
Sometimes a retroverted uterus can get stuck in the pelvic cavity in early pregnancy resulting in what is called an incarcerated uterus. If so, a procedure can be performed to reposition it. Common sign of incarcerated uterus is inability for mom to urinate. As far as ultrasound is concerned, yes, it can be more difficult to evaluate the fetus in the 1st trimester. Most women have an anteverted uterus. Retroverted is just a normal variant.