During examinations by an obstetrician-gynecologist, many expectant mothers often heard the expression “the cervix is closed” and did not attach much importance to these words. In fact, the state of this organ largely influences the development and continuation of pregnancy. After all, the cervix is, figuratively speaking, a “corridor” into the uterus itself, where the future human being grows and develops.
A little anatomy and physiology
The uterus is a hollow muscular organ that distinguishes between the body of the uterus and the cervix. Body upper part of the uterus (wider) is pear-shaped, cervix lower part of the uterus (narrower) has a conical or cylindrical shape. The cervix makes up approximately 1/3 of the entire uterus, it consists of connective and muscle tissue and forms a kind of muscle “ring” that should hold the fertilized egg in the uterine cavity.
There is a small opening in the cervix of the uterus - the cervical canal (os of the uterus), through which menstrual blood is released from the uterus, and sperm from the vagina, on the contrary, enter the uterus. Normally, during pregnancy, the external opening of the cervical canal (it faces the vagina) should be closed.
There are special glands in the cervical canal that produce mucus; the quality and composition of cervical mucus changes during the menstrual cycle under the influence of hormones. Early in pregnancy, cervical mucus becomes thicker and more viscous and forms a mucus plug that closes the cervical canal. The mucus plug is a physiological barrier that makes it difficult for bacteria and viruses to penetrate the uterine cavity and protects the fetus from infections. Shortly before childbirth, the mucus plug comes off; outwardly it looks like a discharge of colorless or yellowish mucus, sometimes slightly stained with blood. The mucus plug may come off 2 weeks before birth, or maybe 23 hours before it.
Immediately before childbirth, the cervix softens, shortens, and the lumen of the cervical canal expands. With the onset of regular contractions, the cervical canal opens more and more: first by 23 cm, as labor progresses, the dilation of the cervix increases to 810 cm. When the cavity of the uterus and vagina is a single birth canal, they speak of complete dilatation of the cervix it is usually 10 cm.
Possible problems
The course of pregnancy is reflected in the incompetence of the cervix isthmic-cervical insufficiency (ICI). In this case, the cervix opens and cannot hold the growing fertilized egg (this happens most often at 16-18 weeks), and pregnancy is in jeopardy.
Most often, isthmic-cervical insufficiency develops due to an increased amount of male sex hormones (androgens), as a result of which the cervix softens and can open under any stress or tone of the uterus. In addition, ICI is possible with excessive pressure on the cervix during multiple pregnancy, with various injuries to the cervix (they can arise as a result, for example, of gross expansion of the cervical canal during diagnostic manipulations in the uterine cavity, after deep ruptures of the cervix in previous births), and also with abnormal development of the uterus.
In order to diagnose and prevent the development of ICI in a timely manner, it is necessary to consult an obstetrician-gynecologist (it is advisable to do this at the stage of pregnancy planning). During a gynecological examination, the doctor will see the condition of the cervix (whether there are any deformations, tears, etc.), determine the location of the organ, length and consistency (degree of softening), and be sure to evaluate the condition of the cervical canal (closed, slightly open, etc.) . If necessary, the doctor will prescribe an ultrasound examination (after all, during a gynecological examination, only the outer part of the cervix is visible, but with the help of ultrasound you can evaluate both its inner part and the condition of the cervical canal). If the expectant mother is expected to have an increase in the level of male sex hormones, the doctor will prescribe the necessary examination and, in some cases, prescribe special medications that will reduce the level of androgens in the blood and prevent dilatation of the cervix. In addition, if there is a predisposition to the development of cervical incompetence, the obstetrician-gynecologist will definitely recommend that the pregnant woman reduce physical activity, get more rest, and immediately at the first symptoms of any ailment (heaviness in the abdomen, lower back, vaginal discharge, etc.) seek help from a doctor.
In some cases, in order to maintain pregnancy, doctors perform a minor surgical operation: under general anesthesia, sutures made of durable non-absorbable material are placed around the cervical canal; the sutures prevent dilatation of the cervix and prevent premature birth. This operation is usually performed before 24 weeks of pregnancy, and the sutures are removed at 38 weeks of pregnancy or earlier if labor has begun. Sometimes, instead of surgical treatment, special obstetric rings and pessaries are used. Pessary is a device that resembles a ring in appearance, which redistributes pressure and reduces the load on the cervix. It is important that when using a pessary, a mucous plug is preserved, which prevents infection of the cervix, and the pessary can be applied after 24 weeks of pregnancy, when surgical sutures are no longer used due to the risk of possible complications.
Sometimes during pregnancy, the expectant mother is diagnosed with cervicitis, an inflammatory process in the cervix. Typically, cervicitis is combined with inflammation in the vagina (colpitis) and is caused by various bacteria and viruses (staphylococci and streptococci, E. coli, etc.). The main complaint in acute cervicitis is pathological vaginal discharge. Treatment depends on the cause of the disease and is usually limited to local remedies during pregnancy - anti-inflammatory suppositories.
Other diseases of the cervix - so-called erosion, polyps, etc. - usually do not affect the course of pregnancy and childbirth, so they do not require special treatment while expecting a baby.
In order to monitor the condition of the cervix, you need very little to be regularly observed by an obstetrician-gynecologist.
Each process occurring in the female body is characterized by certain characteristics. By cervical position the likelihood of conception can also be determined. A woman can examine the organ independently, taking into account some nuances.
What is this?
Cervix is the organ connecting the uterus and vagina. It has a trapezoidal shape. Among women, an abbreviation term appeared - ShM. It is convenient to use when filling
The size of the neck varies for each individual woman. They depend on age, pregnancy experience and physiological characteristics. Position of the organ just like the structure changes depending on. It can be hard or soft.
On the vaginal side, the cervical cavity is located external os. Through this opening, secretions from the uterus enter the vagina. The pharynx takes on different states, depending on cyclical processes. It can be closed, semi-closed and open.
Determination of the position of the cervix is regularly carried out by touch with mandatory compliance with the conditions. The woman enters all the data in a separate notebook. Information helps to recognize or pregnancy. The most revealing studies will be in combination with the use of tests for.
NOTE! Examinations of the cervix should be carried out with clean hands, as there is a possibility of infection.
Position
The normal position of the uterus in a healthy woman is the center of the pelvis. The CMM analysis method is used. It helps to most reliably determine the fertile period.
This increases the chances of conception. At each organ, the organ takes a special position. Under the influence of hormones, it changes its structure.
A gynecologist can easily determine the position of the cervix most accurately. But some women are able to do this on their own. The main thing is to comply with the basic requirements and adhere to regularity. TO rules for conducting research include:
- The analysis should be carried out in the same position. The best position is lying on your back with your knees bent or squatting.
- For convenience, you can use a specially targeted lubricant.
- The index finger should be inserted into the vagina until it rests on the tip of the cervix.
- It is necessary to pay attention to nature of the discharge and the degree of openness of the external pharynx.
IMPORTANT! During menstruation, it is better to refuse research. If this is not possible, then additional measures must be taken to protect against bacteria.
Before ovulation
At the beginning of the menstrual cycle of the study, the position of the cervix will be low. Its surface is dry and hard to the touch. The external os is tightly closed.
REFERENCE! When analyzing the degree of hardness of an organ, you should imagine the tip of the nose. The neck will resemble this part of the face.
During ovulation
In days increased fertility Significant changes occur in a woman’s body. The characteristic features of this period include:
- in the pelvic area.
- Increased sexual desire.
Signs of ovulation appear under the influence of estrogens. The body begins to prepare for possible conception. This also affects the position of the ball. It gradually rises into the vagina. On the day of release it reaches its maximum point. Getting it becomes problematic.
NOTE! Sometimes women may notice a complete absence of any symptoms. One should remember the individuality of physiology.
The uterus becomes soft to the touch. External os wide open. This is necessary so that they can easily penetrate the fallopian tubes. Their movement is helped by, which becomes more numerous than on other days of the cycle. Their consistency resembles egg white.
After ovulation
Afterwards the pharynx closes. This protects against infection. A woman's fertility gradually decreases. The cervix takes a mid-position, it is hard and dry. Further organ condition depends on the presence of conception. If pregnancy has not occurred, the cervix descends into the vagina and later opens slightly, preparing for the release of menstrual flow.
Condition of the uterus if conception has occurred
If pregnant, the organ rises high, as during. The surface becomes as hard and dry as possible. Minor discharge is acceptable. The pharynx in this case will be tightly closed.
It is important to remember that analysis of the menstrual cycle is not enough to establish the essential processes of the menstrual cycle. It is necessary to pay attention to accompanying signs.
More accurate information can be obtained using tests or ultrasound examination. To determine pregnancy, a hCG level test can be used.
REFERENCE! Tests in most cases only show pregnancy after a delay. This is because the hCG hormone is released into the urine 1–2 weeks after conception.
Studying your body is a good way to recognize important reproductive processes. Lack of skill may cause some problems for beginners. But over time, determining the position of the cervix becomes easier.
During pregnancy, all sorts of problems can arise with health, including reproductive health. Those problems that can interfere with the normal bearing of a child are especially difficult to experience mentally and physically. One of the serious problems of pregnancy is cervical insufficiency or medically called ICI (isthmic-cervical insufficiency). What is it and how serious is this pathology? What is needed to prevent this pathology from developing, and if it exists, how can I carry a child to term normally?
What is isthmic-cervical insufficiency?
Isthmic-cervical (cervical) insufficiency is a pathological process that will be characterized by insufficiency or problems with the functioning of the muscles in the area of the isthmus (between the uterus and cervix) and the cervix itself, which as a result can lead to miscarriage or premature birth in the second and third terms. trimester. To put it simply, this is a change in the cervical area that leads to pathological thinning of the cervix, its softening, and shortening. As a result, the cervix begins to open under the weight of the growing baby, which triggers a late miscarriage or premature birth. If this process occurs before 36 weeks of pregnancy, this can negatively affect the health of the baby, since he will be born premature, and if the period is earlier than 28-30 weeks, it will generally be a matter of life and death.
What causes isthmic-cervical insufficiency?
If we divide all the causes of this deficiency into groups, we can distinguish two fundamental types of pathology. Organic insufficiency in the cervical area, when there are problems in the structure of the cervix, and functional, when there are no anatomical defects in the structure.
Organic insufficiency of the cervix is a consequence of previous pregnancy injuries in the cervical area during previous births, if there were ruptures, during curettage during abortions or cleansing during miscarriages. This occurs because the cervix is forcibly dilated with special instruments called dilators. Injury can occur as a result of diagnostic procedures and curettage, again due to dilation of the cervix in order to insert instruments into its cavity. Injuries can be caused during the treatment of diseases such as polyps, where the cervix is dilated, or erosion of the cervix by methods of conization or excision of part of the cervix, as well as as a result of the use of cauterization (diathermocoagulation of erosion).
As a result of all these actions, the normal muscle fibers in the cervix are torn, injured, and are subsequently replaced by scar tissue, which can become less elastic and harder and more rigid. This leads to the fact that in the next pregnancy the cervix loses its extensibility and elasticity. During a normal pregnancy, the cervix is closed from the inside and outside, tightly holds the baby with all its membranes, does not soften, and does not open its throat.
With organic lesions in the cervix during pregnancy, it cannot fully stretch or contract normally, which does not allow it to contain the fetus with membranes inside the uterine cavity until the due date.
With functional cervical insufficiency, disorders develop not due to defects in the structure of muscle tissue, but due to disturbances in the normal functioning of the muscle elements and connective tissue inside the cervix, or when its sensitivity to hormonal stimuli is impaired. As a result of such changes, the cervix may become excessively soft and too pliable during pregnancy; it opens as the size of the fetus and membranes increases. The development of functional cervical (isthmic-cervical) insufficiency can be expected in women with impaired ovarian function; the same condition can be congenital. This mechanism for the development of this type of insufficiency in the cervical area is still poorly understood by scientists; it is usually believed that each case of such insufficiency is unique and individual, and is influenced by several factors at once.
Whatever the reason for the formation of isthmic-cervical insufficiency, a disruption of its normal functioning occurs - the cervix cannot maintain its anatomical characteristics, easily succumbs to the pressure of the growing fetus, gradually begins to open and the process of expulsion of the fetus begins. Or the fetus descends into the lower parts of the uterus, and the fetal bladder begins to protrude into the area of the cervical canal (it seems to sag there and becomes a hydraulic wedge). This opens the cervix slightly and can lead to infection of the fetus and its membranes. Sometimes, due to infection, the water begins to leak, which leads to additional difficulties in maintaining pregnancy.
As insufficiency in the cervical area progresses, the fetus will put more and more pressure on it with its weight, and the cervix will open more and more due to weakness. This will ultimately lead to late miscarriage if it occurs between 14 and 20-22 weeks, or to the development of premature birth between 22 and 36 weeks. The slightest suspicion of isthmic-cervical insufficiency should be a reason for a woman to take care of herself and make efforts to maintain pregnancy until the required time.
Why is monitoring needed?
Monitoring of the cervix in women who are at high risk of developing this pathology should be carried out from the very beginning of the second trimester. These women, especially at risk, include women with recurrent miscarriage during the second trimester. If traumatic processes in the cervix and possible complications are suspected, constant monitoring is carried out from 12 weeks of pregnancy, if functional problems in the cervix are suspected - from 16 weeks of pregnancy once every two weeks, and if necessary - weekly. The basis of monitoring is an examination of the cervix with vaginal speculum, a vaginal examination, and, if necessary, an ultrasound examination of the cervix to determine its length and the condition of its internal canal.
How does isthmic-cervical insufficiency manifest?
Cervical insufficiency can manifest itself with different symptoms - this can be a feeling of pressure in the bladder and lower abdomen, a feeling of fullness or stabbing pain in the vaginal area. In this case, discomfort may appear in the lumbar and lower abdomen, there may be mucous discharge from the genital tract, sometimes streaked with blood, and there may be scanty spotting discharge from the vagina. But for the most part, manifestations of isthmic-cervical insufficiency are usually insignificant and subjectively not noticeable; for the time being, it is asymptomatic, and then signs of miscarriage or premature birth suddenly appear.
Among foreign doctors and clinics, there is a special ultrasound classification of signs of cervical insufficiency, which is obtained when examining a woman with a vaginal sensor. In addition, this examination is carried out using stress tests - pressure on the fundus of the uterus, a cough test and a position test when the patient is asked to stand up. In this case, the length (size) of the cervix is measured, and its dimensions according to ultrasound data will then make it possible to identify groups of patients at increased risk for the development of late miscarriages and premature births. But these measurements and studies are used only after 20 weeks of pregnancy.
Until the twentieth week, such tests will not be informative, because the length of the cervix has too large a range of options, so this value cannot be an objective criterion for accurate diagnosis. But with all this, a pronounced change in the size of the cervix from study to study in the same woman - if there is a progressive shortening and opening of the zone of the internal pharynx in the uterus - directly indicates the development of isthmic-cervical insufficiency.
At the period from the 24th to the 28th week, on average, the length of the cervix will be from 35 to 45 mm, by the 32nd week it is 30-35 mm. If there is a shortening of the cervix of 25 mm or less, and the period is from 20 to 30 weeks, this is a sign of great danger for the development of premature birth.
The most important thing that you should not do if you suspect cervical insufficiency is to be nervous and panic. Worry may increase the tone of the uterus, which will only worsen the situation. You may have to go into conservation, but today this problem is dealt with much better than 20-30 years ago. Therefore, there is no need to worry ahead of time - everything will be fine. Tomorrow we will talk in more detail about the diagnosis and treatment of this disease.
It is not for nothing that gynecologists closely monitor the condition of the cervix - changes in this organ signal not only pregnancy, ovulation and the approach of menstruation, but also many infectious diseases and pathological abnormalities.
Typically, the condition of the cervix is affected by endometriosis, cancer and other malignant tumors. Therefore, it is recommended to check the organ before menstruation and during ovulation.
It is considered normal if the cervix is hard to the touch and dry before menstruation. During ovulation, on the contrary, it opens and becomes loose, preparing for fertilization. If pregnancy does not occur, then there will be critical days. The position of the cervix before menstruation is low. A completely different picture during ovulation and conception - the organ softens, becomes moist, and the pharynx opens slightly (pupil symptom). So the cervix before menstruation and during pregnancy are two different things. It is by these signs that a gynecologist can determine conception in the early stages. In addition, the fertilized uterus acquires a bluish tint, since during this period the number of vessels in the organ increases.
Also, many women are interested not only in what it feels like, but also in what the cervix looks like before menstruation. Of course, it is impossible to look into the vagina on your own and examine the organ, but you can determine its type by palpation - the uterus descends and can be easily palpated, and the pharynx contracts tightly. That is, if during ovulation the cervix looks like a tubercle with a dilated “pupil,” then before the critical days the “eye” of the organ is much smaller.
Cervix during menstruation
We found out what the condition of the cervix is before menstruation, now we will find out what it looks like directly on menstruation days. At this time, the pharynx expands slightly, as during ovulation, but the purpose of this opening is different - not readiness for fertilization, but the desire to erupt blood clots. This position of the cervix during menstruation creates fertile ground for the proliferation of bacteria and the addition of infection. That is why on critical days it is not recommended to swim in open water, visit the pool, have unprotected sex and insert foreign objects into the vagina - fingers, a speculum. Although the moderate mucous discharge that is observed during this period is designed to protect the woman from infection, it is still not worth the risk.
The condition of the cervix during menstruation requires maintaining external hygiene. Ideally, you should wash yourself twice a day, not counting the procedures after bowel movements. You cannot wipe the anus in a forward direction - such actions are fraught with infection. It is also strongly recommended not to carry out water procedures inside the vagina during this period - no douching or insertion of intimate hygiene products. Often during menstruation, women experience pain in the uterus. Most often they are associated with the rejection of blood clots. In this case, conventional antispasmodics help. But sometimes painful contractions of the cervix signal an infection or pathology in the development of the organ. Therefore, do not neglect routine examinations with a gynecologist, so as not to lead to infertility from a common illness.
By the way, it is not so much pain, which is often a sign of dysmenorrhea, as heavy discharge that warns of abnormalities - fibroids, endometriosis, bleeding disorders and acute infections. In any case, after your period, especially if the pain in the uterus has not stopped, you should consult a doctor and do an ultrasound. If the cause of discomfort is dysmenorrhea, then it makes sense, along with painkillers or contraceptives, to take a course of vitamins and Omega-3 complex. If the cause of the pain is a serious illness, you should immediately begin treatment prescribed by the gynecologist.
After menstruation
A healthy cervix after menstruation begins to prepare again for conception. Immediately after the end of the critical days, the pharynx narrows, because the bleeding has stopped. Simultaneously with the organ being pulled up, the endometrium begins to grow, into which a fertilized egg can be implanted during conception. In addition to its high location, the conditions of the cervix before and after menstruation are similar - the same dryness and tissue density.
But during the period of ovulation, the organ loosens again and begins to secrete mucus. The norm during this period is contraction of the uterus, but if it is still enlarged, then we can talk about pregnancy, a tumor or an infection.
There is no need to think that conception during menstruation is impossible - despite the reduced fertility of the organ, there is some probability of becoming pregnant. Therefore, if the uterus has not contracted after the critical days, then it is worth getting tested for hCG or having an ultrasound.
It’s another matter if you are not pregnant, but neoplasms are found on the cervix - we can talk about polyps, erosion or fibroids. However, only a gynecologist can determine whether the uterus is enlarged or not. The woman feels unlikely to be able to independently identify suspicious signs.
Naturally, there is a preliminary diagnosis method that is easy to apply at home. This is self-palpation of the cervix. The manipulation must be carried out extremely carefully.
If something is bothering you, it is easier to conduct a preliminary examination at home than to be nervous before going to the gynecologist. It is better to cut the nails on the index and middle fingers of your right hand and put on a sterile glove before starting palpation.
The easiest way to feel the uterus is while sitting on the toilet, squatting or placing one foot on the sofa, the edge of the bathtub, etc. You can try to take a position similar to the one you take in the gynecological chair.
So, insert two fingers into the vagina and feel the tubercle. This is quite easy, the main thing is not to make sudden movements to avoid injury to the organ. But determining the consistency of the cervix is not so easy if you are not a professional. Only the comparison method will help the amateur.
And yet, you can find out something on your own - if the middle finger literally rests on the cervix, it means that it is located quite low, as before menstruation. If you can barely reach it, then the uterus has contracted, as it should after menstruation. Remember, before starting and especially during menstrual periods, it is not recommended to palpate the organ.
What are the risks of self-examination?
If you are used to constantly palpating the cervix, refrain from manipulation at least 2-3 days before menstruation. Even the doctor will prefer to postpone the examination until the end of menstruation and here’s why:
- At this time, partial dilation of the cervix begins, so it is easy to get an infection and get inflammation of the ovaries or fallopian tubes. Against this background, adhesions can form, leading to infertility.
- Even if you use sterile gloves, there is a risk of damaging the cervix. Typically, such injuries heal quickly, unless, of course, an infection occurs.
- For the most part, independent palpation of the organ does not give anything, and only a doctor can identify the pathology. After all, the gynecologist not only feels the cervix, but also examines it with a mirror.
These warnings do not directly prohibit self-palpation, but suggest that in case of any suspicious symptoms, it is better to consult a doctor and clarify the diagnosis professionally.
Educational video: Cervical erosion
During the normal course of pregnancy, the cervix acts as a kind of muscle ring, which prevents the fetus from leaving the uterine cavity before its due date. During pregnancy, the size of the fetus and the volume of amniotic fluid increase, which is why the pressure on the organ also increases.
Ideally, the cervix should withstand the load and open only before childbirth. However, this does not always happen.
Premature dilatation of the cervix during pregnancy is a common and very dangerous phenomenon. Without timely treatment, it can lead to miscarriage. In this case, only timely and correct therapy can save the situation. This is why all pregnant women should know the symptoms and treatment of this condition.
During gestation, part of the muscle tissue is replaced by connective tissue. At the same time, the formation of new collagen fibers begins, which are extremely flexible and elastic than those that were before.
A small percentage of them are absorbed and ultimately form the main substance, which increases the hydrophilicity of tissues. Outwardly, this looks like loosening of the cervix, its shortening and gaping of the cervical canal.
The preparation of the cervix for childbirth itself begins to occur from 32-34 weeks of gestation. During this period, it becomes softer along the periphery. At the same time, the area along the cervical canal still remains quite dense. In women who will give birth for the first time, the tip of a finger can be inserted into the external os, while in multiparous women, 1 finger can be inserted at the same time.
At approximately 36-38 weeks of pregnancy, the cervix becomes almost completely softened. During this period, the fetus moves into the pelvis, due to which it begins to create pressure on the cervix, thereby promoting its rapid opening.
The cervix begins to open from the internal os. In patients who give birth for the first time, the canal takes the form of a truncated cone, the base of which is located at the top. As the fetus moves forward, a gradual stretching of the external pharynx occurs.
It is important to say that in multiparous women, cervical dilatation takes much less time. In addition, their internal and external pharynx opens almost simultaneously.
Immediately before the birth itself, in all women the cervix becomes greatly shortened and emaciated. You can insert 2 or more fingers into its channel. However, the opening of the cervix does not end there. As a result, it opens by 10-12 cm. This hole is enough for the child’s head and torso to pass through.
ICN
Unfortunately, dilatation of the cervix does not always occur on time. Sometimes it happens earlier. This phenomenon is called isthmic-cervical insufficiency (ICI). It is extremely dangerous, as it can lead to premature birth or miscarriage, so the woman must receive medical attention.
As for the causes of the pathological process, they are usually as follows:
- unfavorable obstetric history: abortion, spontaneous termination of pregnancy, premature birth (especially before 28 weeks of gestation);
- cervical erosion;
- multiple pregnancy;
- initial weakness of the neck;
- previous injuries to the cervix: the birth of an oversized fetus, ruptures during previous births, surgical interventions on the organ;
- disruptions in the functioning of endocrine organs;
- premature placental abruption;
- infectious processes and inflammation of the reproductive organs.
Doctors should pay special attention to pregnant women who are at risk. If during previous pregnancies the patient had ICI, then she should under no circumstances hide it. Such women are at increased risk.
Signs
In many patients, ICI does not manifest itself at all.
If signs of cervical dilatation occur during pregnancy, they will differ depending on the period of gestation at which the pathological process began. Thus, in the first trimester, pathology may be indicated by bleeding, which is not associated with pain, but can sometimes be accompanied by mild discomfort.
If the dilatation of the cervix occurs after 18-20 weeks of gestation, then in this case the death of the embryo and further miscarriage already occur. At this time, the woman begins to experience bloody discharge from the genital tract, and unpleasant sensations arise in the lower abdomen (may radiate to the lower back). Some patients at this time complain of severe nagging pain in the lower abdomen and lower back, which is combined with diarrhea and the urge to vomit.
The problem is further aggravated by the fact that even in women who regularly go to see a doctor, ICI is not always detected on time. This is due to the fact that doctors do not always conduct a classic examination to reduce the risk of infection.
However, even during examination it is not always possible to suspect the presence of a pathological process. If a specialist discovers premature softening of the cervix and a decrease in its length, he must definitely prescribe an additional examination. In most cases this is an ultrasound.
Therapy
If a woman’s cervix is slightly open during early stages of pregnancy, then she needs to observe complete rest and a pastel regime. It is very important that during this time she is not exposed to stress or does heavy physical work.
Conservative treatment for this condition may include the installation of a Meyer ring. It reduces the force of fetal pressure on the cervix. These measures are indicated for women who have a slight dilatation of the cervix and whose gestation period is 28 weeks or more.
If the gestation period is less than 28 weeks, the woman does not have infectious diseases of the genital organs, there are signs of the integrity of the membranes and the vital activity of the embryo, then she may be scheduled for surgery. Its essence is to apply sutures to the cervix. There is no need to be afraid of this procedure. During the procedure, patients do not feel any pain or discomfort, since they are first given anesthesia.
The pessary and sutures are removed after the 37th week of pregnancy or before childbirth, if the amniotic sac is opened, a fistula is formed, or bleeding occurs.
Both during conservative therapy and during surgical treatment, patients are prescribed antibacterial drugs. This is necessary in order to prevent the development of the infectious process.
To enhance effectiveness, antispasmodic drugs can be prescribed, and in the presence of uterine hypertonicity, tocolytics.
If the patient’s cervix is slightly open during pregnancy due to a malfunction of the endocrine organs, then she will be recommended hormonal medications.
Prevention
The prognosis for premature dilatation of the cervix will directly depend on the degree of neglect of the pathology. So, if the disorder cannot be diagnosed, the pregnancy may end in miscarriage. It is for this reason that about 20% of pregnancies that have just begun to develop are terminated.
If the cervix is open during early pregnancy and the woman received timely medical care, then she will have every chance of carrying the fetus to term. If the muscle sphincter is weak, there is a risk of precipitate labor. In this case, the patient is urgently sent to the obstetric department.
Prevention of this pathology consists of timely treatment of endocrine pathologies and diseases of the reproductive organs even during pregnancy planning. After conception, a woman should rest as much as possible, avoid stressful situations, and avoid heavy physical activity. If any unusual symptoms occur, she should consult her doctor.
