How to understand that the cervix has dilated. The cervix has not dilated, but the labor process has begun, how is the organ stimulated to dilate? Self-induction of labor

Normal birth never occurs spontaneously. A few weeks before this event, changes in the cervix begin to occur. These changes will help the baby to be born. Some signs indicate that the baby will see the world very soon: the appearance of contractions, the breaking of water. During contractions, the cervix begins to dilate before childbirth, and this process determines how successful the birth will be.

Childbirth: stages

Childbirth is the process of expulsion of the fetus and placenta from the uterus; during its normal course, the process occurs naturally. In cases where it is necessary to resort to various surgical delivery methods, childbirth is called operative.

A woman should approach this important event in her life in full preparedness - if a woman has a good idea of ​​what will happen to her and how, it will be much easier for her to give birth.

Childbirth consists of periods:

Dilatation of the cervix;
expulsion of the fetus;
birth of placenta.

The longest period is the first period, during which, as a result of contractions of the uterus, the amniotic sac is formed, the fetus moves along the birth canal, resulting in full dilatation of the cervix during childbirth and the baby is born. For primiparous women, labor lasts up to twelve hours; for multiparous women, this period of time is much shorter - up to eight hours. Knowing how many cm the dilation of the cervix is ​​during childbirth, you can accurately say what phase of contractions is taking place and how long this process will continue.

The uterus, which is a hollow muscular organ consisting of three parts, is responsible for bearing the fetus:

Dna;
bodies;
cervix.

The processes of pregnancy and childbirth depend on the condition of the cervix.

Cervical dilatation

Preparing the cervix for childbirth begins around the 32nd week. The tissue area near the cervical canal remains dense, but in other places the cervix softens, this process is completed by the 38th week of pregnancy. Now the fetus descends into the pelvis and with its weight presses on the neck, which contributes to its even greater opening.

If a doctor tells a woman that she is only 1 finger dilated, she begins to wonder how long it will take to give birth. But this still suggests that the pregnant woman has only physiologically prepared for childbirth. And they will begin when regular contractions appear. Therefore, dilation by 1 finger will not tell you how much time is left before birth, but will indicate readiness for labor. This readiness can be judged by several other parameters.

In addition to opening to the finger and softening, the neck should be shortened to a length within one centimeter. At the same time, it begins to be located in the center of the small pelvis, although quite recently it was still somewhat tilted to the side. The mucous plug that protected the uterus throughout the pregnancy should also be observed. The removal of the plug indicates that the cervix is ​​ripe and contractions may begin soon. First, the internal os of the cervix opens, and as the fetus moves along the birth canal, the external os also stretches. In women who have given birth, this opening occurs simultaneously, so the whole process takes a much shorter period of time than in a primigravida. And if, for example, the dilation is 3 cm, then how long will labor begin?

By the way, very often obstetricians-gynecologists call the size of the cervical dilation not in centimeters, but based on the size of their fingers. Therefore, it is much more common for a doctor to hear how many fingers should be dilated during childbirth?

Sometimes it happens that labor has already begun, but the cervix is ​​not at all ready and is not going to open. In this case, the doctor will use stimulation, otherwise the fetus will experience a lack of oxygen, because the placenta begins to rapidly age and lose the ability to perform its basic functions.

Period of contractions

Contractions refer to the first, longest stage of labor, which lasts until the cervix dilates to allow the fetus to pass through. Many women are interested in the question - how many fingers should be dilated for labor to begin? We can say that before the onset of labor, the cervix is ​​effaced and open by at least two fingers. To answer the question - if a woman in labor has dilation of two fingers, then how long will it take for her to go into labor, then we first need to consider how dilatation occurs during contractions. But first things first.

The period of contractions is divided into a slow period, called latent, and a fast period (the so-called active phase of contractions). Contractions last 10-12 hours in primiparous women and 6-8 hours in women who have given birth.

The latent phase begins from the moment when the rhythm of contractions is established, they occur with a frequency of one or two contractions every 10 minutes, this phase lasts about six hours and usually passes without severe pain. In primiparous women, this phase always lasts longer. The use of medications is not yet required, but for women who are too young or, conversely, older, the use of antispasmodics may be required. At this time, a dilation of 3 cm is already observed, but it will not be possible to say exactly how long it will take for labor to begin. At this moment, alternating contraction of the muscles of the uterus and their relaxation are just taking place, as a result of which the length of the cervix is ​​shortened, the fetal head is located at the entrance to the pelvis, the fetal bladder begins to put pressure on the internal pharynx, causing it to open.

If a dilatation of 3-4 cm has occurred, then the doctor can see how long it will take for labor to begin. Complete smoothing of the cervix and dilation of 4 cm indicates that the active phase of contractions has begun. This phase for both first-time mothers and women who have already given birth lasts up to four hours. During this period, subsequent opening occurs very quickly. For every hour, the cervix opens by 2 cm in first-time mothers, and by 2.5 cm in repeat births.

If the dilation is 5 cm, then the doctor knows for sure how long it will take for labor to begin. In order for the fetal head and body to pass through the birth canal, the cervix must dilate to 10, sometimes up to 12 cm. Therefore, in the active phase, an experienced doctor can accurately determine both the time of labor and its course. For example, if the dilation is already 6 cm, it is quite simple to answer the question - how long will it take for labor to begin? You just need to count how many centimeters are left until the cervix is ​​completely dilated. At this time, the baby’s head is already moving along the birth canal and the cervix is ​​opening faster and faster. The most painful contractions become after five centimeters of dilation. This pain is natural, but not every woman can withstand this pain. To maintain the condition of the pregnant woman at this time, various methods of pain relief are used. These may be non-drug methods:

Massage;
taking warm baths;
listening to soothing music;
various exercises.

If these methods are not enough, the obstetrician-gynecologist will prescribe a medicinal pain reliever, based on the characteristics of the woman, the complexity of labor, and the pain threshold.

When dilated to 3 fingers, how long will it take for labor to begin - you can answer quite accurately - in about two hours the contractions should end, after which pushing will begin. By the end of the active period of contractions, the cervix is ​​already completely open, or almost completely. Usually at this time the water breaks, it is believed that this is a timely process. However, if the water does not break on its own when the cervix is ​​fully dilated, the doctor must perform a procedure called amniotomy to open the membranes.

Full dilatation of the cervix will occur with sufficient labor activity. With weak labor or its absence, the cervix does not open. In this case, it comes to stimulate labor.

We have looked at what cervical dilation looks like during childbirth. Let's try to consider whether it is possible to influence this process with the help of posture.

Poses

It turns out that the horizontal position we are used to slows down the process of childbirth, prevents the uterus from contracting normally, slows down dilation, and at the same time increases pain. With the help of a correctly selected position, you can relieve pain and stimulate labor. What postures during childbirth are favorable for dilation of the cervix:

Vertical, in which, due to the force of gravity, the child’s weight is directed downward. At the same time, the child puts more pressure on the cervix, forcing it to open faster; when pushing, it is also easier for the child to pass in this position.

Sitting position. In this case, you need to make sure that the surface should be elastic, but in no case hard. Large inflatable balls are well suited for this, as they will help the neck open faster. The legs should not be closed; it is better to spread them apart as much as possible.

True, in some cases, the horizontal position will still remain a necessary option, for example, during rapid labor, during breech presentation of the fetus, and in some other serious violations of the birth process.

Just before childbirth, the cervix changes dramatically. A pregnant woman does not feel these changes, but the unborn child gets a chance to be born naturally. So how exactly does this reproductive organ change and when is medical attention needed to improve the dilatation of the uterus? We are looking for answers to these and other similar questions.

Ideal cervix before childbirth

The parameters characterizing the state of the uterus before childbirth are its location in the pelvis, state of softness and length. The softening of the cervix to the point where it can allow 1-2 fingers of the doctor inside indicates the readiness of the birth canal for the process of delivery. Such changes are accompanied by the release of the mucus plug. That is, the sooner the cervix begins to dilate, the sooner the woman in labor notices this sign of the onset of contractions.

Before childbirth, the cervix shortens. According to medical statistics, its length is about one centimeter. If we talk about the location, then it becomes in the center of the small pelvis, while during pregnancy the cervix is ​​tilted back.

Doctors evaluate all of the above parameters on a five-point scale. A score of 5 indicates that the uterus is ideally ready for childbirth. This condition is called a mature uterus.

Stimulating uterine dilatation

The above are excellent prenatal parameters. But in practice, this does not always happen, and doctors resort to stimulating the process of cervical dilatation.

If a medical examination shows that the cervix is ​​not mature, and you are due to give birth soon, then it is quite acceptable to speed up this process and perform stimulation. Not using it sometimes means dooming the child to oxygen starvation, given that before birth the placenta “grows old” and cannot cope with its functions as before.

In practice, stimulation is done in four ways, sometimes with a combination of them:

1. Sinestrol injections intramuscularly. The drug makes the cervix mature, but does not affect contractions. Read also
2. Insertion of kelp sticks into the cervix. Such sticks, 5 cm long, are placed in the cervical canal. After a few hours, they swell under the influence of moisture and thus open the cervical canal.
3. Injection of a gel with prostaglandins into the cervical canal. This gel works quickly - and the neck opens in 2-3 hours.
4. Administration of Enzaprost intravenously. This drug also contains prostaglandins. Thus, the period of contractions is reduced in time.

Sometimes women use self-induction of labor.

1. Enema. After it, the mucus plug comes off - and the cervix becomes mature. The procedure can only be used by women who have already reached their due date, that is, the baby is full-term.
2. A warm bath is not recommended for loose plugs and waters. The procedure is also dangerous for women with high blood pressure.
3. Sex acts as a medical stimulant because semen contains prostaglandins. That is, it promotes the maturity of the uterus. But pregnant women whose plug has already come out should not have sex. After all, there is a possibility of “catching” an infection in the uterus.
4. Physical activity. This could be a brisk walk, washing the floors, or cleaning. Women with hypertension do not need to overdo these methods.

But such methods can be fraught with dangerous consequences.

Stages of cervical dilatation

The cervix goes through several stages of dilatation before childbirth. The first is called latent or slow. It lasts 4-6 hours with a dilatation of up to 4 cm. In this case, contractions occur every 6-7 minutes.

The second stage is called active or fast. Every hour the cervix dilates by 1 cm. This continues up to 10 cm, and contractions occur every minute.

The third stage is full disclosure. It characterizes the process of the onset of labor. Sometimes the dilation of the cervix is ​​premature. This is evidence of pathology and, without treatment, can cause premature birth or miscarriage.

A pregnant woman should remember that in the period before childbirth she needs to be prepared for the fact that labor will begin earlier. If you feel unwell or have other symptoms, consult a doctor immediately.

Every girl and woman knows well how her reproductive system is located and how it functions. Organs such as the ovaries, uterus, vagina, etc. raise few questions. But no one really thinks about the purpose of the cervix. Although it is she who takes one of the important roles in bearing, conceiving and giving birth to children. An experienced doctor, just by looking at her, can accurately determine whether a woman has given birth or not, whether she had abortions, how soon she can expect her next menstruation, and diagnose pregnancy with 95% confidence.

So what does the cervix represent?

The uterus is an unpaired female muscular organ; it is in it that the human embryo develops. The organ is located in the middle of the pelvic cavity. Gradually passes from below to the cervix.

The cervix is ​​an organ that is like a connecting tube that connects the vagina and uterus. Its form, in most cases, depends on whether the woman gave birth or not. The length of this “tube” is about 3-4 centimeters, and the width is about 3 centimeters.

Changes during pregnancy and cervical dilatation before birth

During pregnancy, the cervix changes and experiences many changes. Before pregnancy, it is light pink in color, and during pregnancy it takes on a bluish tint. The color change is associated with the resulting dense vascular network and blood supply.

If developmental abnormalities or diseases of the cervix are detected in the early stages, then with timely treatment the pregnancy can be saved. The fact is that it is very dangerous. It is this that causes spontaneous termination of pregnancy - miscarriage. To avoid miscarriage, in cases of diseases that cause the cervix to dilate prematurely, doctors use various methods of “strengthening” the cervix, including putting sutures on it, which are removed before the birth itself.

Towards the end of pregnancy, the cervix changes, becomes softer, and “ripens”. In this way, the female body prepares for childbirth. Before their onset, the cervix smoothly passes into the center of the pelvis, its length decreases from 3 centimeters to 10 millimeters. The canal gradually opens by 6-10 cm. The transition of this cervical canal to the lower segment itself becomes smooth.

At the end of pregnancy, before the onset of labor, expansion of the internal os and short contractions with a second sensation of pain suggest the onset of labor. At this time, the cervix gradually opens and eventually has a diameter of about 10 centimeters. It is this pronounced action of the cervix that allows the fetus to emerge through the birth canal.

It happens that the dilation of the cervix is ​​not sufficient and it is not enough for the passage of the child, so the organ ruptures. This rupture can occur not only for this reason, but also due to rapid labor, a large fetus, due to childbirth with weak early attempts, etc.

Therefore, if the woman in labor has already broken her waters, and the cervix is ​​not yet dilated enough to give birth to a child and/or contractions are weak or completely absent, then usually in such cases doctors decide to stimulate labor. To stimulate labor, special medications are used.

If a woman listens to her feelings, it is easy to feel the dilatation of the cervix; the following symptoms arise:

• Unpleasant sensations at the location of the cervix, as if instantly tingling with a needle.
• The back (lower back) and hips begin to “ache.”
• Pain in the vagina, similar to spasms.

After childbirth, the doctor is obliged to examine the patient and check her cervix. If he finds any tears, he will stitch it up. Sutures on the cervix are usually placed with special self-absorbable threads.

Comments

• Anonymous06-12-2012 — 13:13

  Help, my husband and I want to understand, we are having sex and he goes very deep, you can say he reaches the uterus, and he says it happens that the uterus is like a hedgehog, all prickly, what is it?

Most Popular Articles in the Medicine Category0

The period of dilation is the initial stage of labor, when regular contractions begin, repeating at equal time intervals (at first these intervals are longer, then shorter, and the contractions themselves are initially short, but become longer and stronger over time). At the end of this stage, the amniotic fluid is discharged and the cervix is ​​fully dilated. Then a new period begins with attempts.

The period of cervical dilatation is considered the longest stage of labor. If a woman gives birth for the first time, then it lasts from eight to fourteen hours. During the second and subsequent births, this period is shorter: from four to eight hours.

There are three generic periods in total:

• cervical dilatation;
• expulsion of the fetus;
• trailing

Cervical dilatation

The opening period is divided into three phases:

• latent (initial);
• active;
• transitional (or, as it is also called, the deceleration phase).

The latent phase is the longest. It takes from four to six hours. It is characterized by not very strong contractions that resume after five to ten minutes. During this phase, the cervix dilates approximately four centimeters.

During the active phase, contractions are repeated frequently (every 1-2 minutes), and the cervix opens faster, about one and a half to two centimeters per hour for women who are giving birth for the first time, and from two centimeters per hour for mothers who are not expecting their first in your baby's life. The active phase lasts approximately three to four hours. Contractions become stronger and are accompanied by unpleasant and painful sensations. If a woman stands or moves, the muscles of the uterus begin to contract more actively. The sensations can be so strong that some expectant mothers may need painkillers during this phase. When the opening of the uterine yawn reaches 6-8 centimeters, amniotic fluid is released in the amount of 150-200 milliliters. If this is not observed, the intervention of a doctor is required, who performs an amniotomy (opening the amniotic sac). The baby's head begins its movement along the birth canal, reaching the pelvic floor by the end of the active phase.

If contractions are painful for mom, she can try to reduce them on her own. To do this, you need to try to relax your muscles and breathe deeply. Take the position that seems most comfortable to you at this moment. Some mothers find it comfortable to lie down, while others find it comfortable to stand on their knees or even on all fours. Walking helps others. Try different options.

In the deceleration phase (transitional), the final dilatation of the cervix occurs (by 10-12 centimeters). then the shortest phase. However, its duration may vary. For some mothers it lasts no more than twenty minutes, for others – up to two hours. If a woman gives birth not for the first time, then she may not experience a slowdown phase at all. The muscles of the uterus contract less actively at this time.

Symptoms of cervical dilatation are initially almost invisible. Shortly before the baby begins to be born, the expectant mother may feel a nagging pain in the lower abdomen. It can be compared to the sensations that occur at the beginning of menstruation. Also, the “signal” is the release of the mucus plug, which protects the cervix during pregnancy from various infections and other troubles. In most cases, it comes out little by little, over one or several days, in the form of brownish discharge. Sometimes it comes off completely at once, in the form of a lump of mucus measuring 1-1.5 centimeters. The main symptom of cervical dilatation is regular contractions. It is important to understand the difference between them and training contractions (harbingers of labor). False (training) contractions of the uterine muscles occur irregularly, at different intervals and, as a rule, they are not so painful. In addition, they can stop if you take some measures (walk around, massage your stomach a little, etc.). Labor pains do not go away, no matter what you do, they intensify, and are repeated regularly. If contractions occur more than once every seven minutes, it’s time to go to the hospital.

How is cervical dilatation checked? This can only be done by a medical professional. Don't try to do this yourself. The doctor will insert two fingers into your vagina and assess how dilated your cervix is. This is called an internal examination. It is carried out under completely sterile conditions (wearing gloves, using a disinfectant). Doctors can also assess the degree of maturity of the uterus using ultrasound.

Premature cervical dilatation

Premature dilatation can occur in both early and late pregnancy. It is important to know that if you receive timely medical care, you can save your pregnancy. If you do not see a doctor on time, this can lead to miscarriage.

Premature dilatation of the cervix in the early stages (up to 20 weeks) of pregnancy is usually caused by

• deficiency/excess of hormones;
• damage (for example, after an abortion);
• placental abruption;
• infectious and inflammatory diseases of the reproductive system.

After 28 weeks, earlier dilatation occurs due to a lack of hormones. Premature birth begins, during which the baby is born quite viable.

Cervical dilatation that occurs prematurely has obvious symptoms. As a rule, this is severe pain in the lower abdomen, pulling. Nausea and diarrhea may also occur. If you notice these signs, run to the doctor. He will prescribe hormonal treatment, and surgery may be required.

Cervical dilatation

The cervix is ​​a continuation of the uterus itself, which consists of the isthmus (the junction of the uterine body into the cervix), the vaginal and supravaginal parts. The opening of the cervix facing the uterine cavity is called the internal os, the opening facing the vaginal cavity is the external os, and the canal of the cervix itself is called the cervical canal.

It is important that the body of the uterus is represented by smooth muscles, and the cervix consists of connective tissue, collagen and elastic fibers, as well as smooth muscle cells. This information about the structure of the cervix will help us understand the mechanisms of its dilatation in normal and pathological conditions.

How to determine cervical dilatation?

Dilatation of the cervix during pregnancy is a process that normally corresponds to the first stage of labor. In obstetrics, cervical dilatation is measured using the obstetrician's fingers during an internal obstetric examination. When fully dilated, the cervix allows 5 fingers of the obstetrician to pass through, which is equal to 10 centimeters.

Symptoms of cervical dilatation are as follows:

• nagging pain in the lower abdomen. The sensations during dilation of the cervix are similar to those that occur during menstruation, only as the degree of opening increases, the pain increases;
• the discharge of a mucous-bloody plug that is located in the cervical canal during pregnancy and prevents infection from entering the uterine cavity.

The main signs of cervical dilatation are regular contractions that repeat after a certain period of time. Initially it is 25-30 minutes, and as the opening increases it is reduced to 5-7 minutes. The duration and intensity of the contraction also depends on the degree of dilatation of the cervix. The rate of cervical opening during labor is 1 cm/hour from the moment the cervix opens by 4 cm. During normal labor, the degree of cervical dilatation is checked every 3 hours.

What causes the cervix to dilate?

In a normal pregnancy, the due date is considered to be 37-42 weeks. The trigger point for the onset of labor is a decrease in the level of progesterone in the blood (a hormone that is necessary for the normal course of pregnancy).

By the beginning of labor, the dilatation of the cervix by 1 finger is one of the signs of its maturity. Contraction of the uterus leads to a decrease in its cavity and pressure of the presenting part of the fetus on the cervix. In addition, the amniotic fluid of the fetal bladder is divided into the upper and lower poles. During a contraction, the lower pole of the amniotic sac is wedged into the cervical canal, which in turn also contributes to its opening.

Premature cervical dilatation

Early dilatation of the cervix at different stages of pregnancy has its own reasons. At 28-37 weeks, the cause of the onset of labor may be hormonal deficiency. Such births are called premature, and they end with the birth of a viable fetus.

The cause of premature cervical dilatation in the early stages of pregnancy up to 20 weeks can be infections, inflammatory diseases of the pregnant genital organs, hormonal deficiency, placental abruption. In such cases, in the absence of timely qualified medical care, pregnancy may end in spontaneous abortion.

Early dilatation of the cervix can be suspected by the presence of nagging pain in the lower abdomen in the early stages. In this case, you should immediately consult a doctor. If concerns about premature dilatation of the cervix are confirmed, then the woman is offered a suture on the cervix for the entire duration of pregnancy, bed rest and, if necessary, taking hormonal medications that will help maintain the pregnancy.

Don't know what to wear? Become fashionable immediately!Your name *Email address *Other articles:Signs of impending labor Many women giving birth for the first time are afraid that they will miss the onset of labor and monitor their body too anxiously. But experienced mothers know for sure that this is impossible, especially since the first signs appear long before childbirth. Breathing exercises for pregnant women Breathing exercises saturate the body with oxygen, therefore they are extremely useful for pregnant women and the fetus; in addition, it is no less important to master breathing techniques for using it during childbirth, which greatly facilitates the birth process and helps the pregnant woman more easily cope with pain during contractions. 39 weeks of pregnancy - second birth During the second pregnancy, it is unlikely that the lobe will be able to reach 40 weeks; more often, labor begins at 39 weeks or even earlier. You should be prepared for this and take all necessary measures to prepare for childbirth as early as possible.

• Traditional methods of treatment

Childbirth is the logical end of pregnancy and the time of the official beginning of a new life! The onset of labor is accompanied by contractions that begin in the upper part of the uterus and gradually move down to the cervix. During this period, the cervix begins to open, and when it opens enough to release the baby (10-12 cm), the birth can be considered complete. However, there is another scenario for the development of the situation: contractions may begin at the bottom of the uterus, so the cervix does not receive the proper impulse to open. In this case, contractions in a woman in labor occur rarely and weakly. Also, the cervix can dilate halfway, in this case the contractions stop. In any of the last two cases, we can talk about insufficient labor.

So what are the consequences of problems with the cervix? First of all, the slow dilatation of the cervix delays labor; it can last more than 12 hours. In addition, the birth plan itself may go astray. The following sequence of events is considered the norm: dilation of the cervix, breaking of water, birth of a child, abruption of the placenta. However, if the cervix dilates slowly, the labor pattern may follow the wrong scenario, i.e. The expectant mother’s water will have already broken, the placenta will begin to separate, and the cervix will not be fully dilated. In this case, a caesarean section is resorted to.

What reasons can affect problems with the cervix? An important factor is the age of the woman in labor and the experience of giving birth to children. After 35 years, a first-time mother has an increased risk of cervical non-dilatation. The reason for this is a general deterioration in health. After all, during the process of childbirth, as during pregnancy, all the most important systems of the body take part. Women with metabolic disorders, endocrine system disorders, and various gynecological diseases (uterine fibroids, cervical scars) are at risk.

Diagnosis of possible causes of cervical dilatation is the responsibility of the gynecologist observing the pregnant woman. There are no guarantees that diagnostics will help prevent problems that have arisen, however, if possible problems are identified, the woman is sent to the maternity hospital ahead of schedule, so that when labor occurs, she will be under the control of specialists from the first minutes.

The psychological mood of the mother in labor is also important. After all, a positive attitude and confidence in the successful development of childbirth, peace of mind increases the chance of a successful outcome.

To better imagine how labor occurs, let us schematically consider the characteristics of the reproductive organs in women. The uterus consists of 3 sections. The child lives in the widest section, the cervix is ​​located at the bottom, it is a narrow 3-centimeter tube of muscle tissue, one end of which goes into the uterus, the other into the vagina. These two sections are connected by the cervical canal. During pregnancy, the cervix performs important functions of protecting the baby from germs from the vagina and preventing the baby from being born before its due date. Starting from the 37-38th week of pregnancy, under the influence of the so-called “birth hormones”, the cervix begins to prepare for childbirth, and at the very moment of childbirth, the cervix contracts, softens and opens slightly, gradual opening ensures a successful delivery.

It is necessary to dwell in more detail on the causes of problems with the opening of the cervix. There are 4 main reasons:

1. The cervix did not have time to properly prepare for the moment of birth. This can happen, for example, due to a lack of “birth hormones”, thus the cervix does not have time to soften properly. In this case, doctors can compensate for the lack of hormones. A large fetus (or incorrect position of the baby) can also stop labor. This can happen due to insufficient pressure from the baby’s head on the cervix and, as a result, it stops opening. In this case, doctors resort to caesarean section.

2. The second reason for insufficient dilation may be polyhydramnios or oligohydramnios. If there is a large amount of water, the uterus stretches too much, in the second case it becomes too tense. But in both cases, it is difficult for the uterus to contract and the cervix does not open.

3. Problem with the body of the uterus. For example, if a woman has fibroids or an abnormally shaped organ, there is a high probability that the cervix will dilate slowly.

4. The occurrence of the fourth reason depends on the mood of the expectant mother. Excessive anxiety can cause a spasm in the muscles and, instead of relaxing, the neck becomes even more tense. The body instinctively stops labor. In this case, doctors administer painkillers to the woman to continue labor.

The cervix is ​​truly a unique organ with an amazing structure, without which it would be impossible to carry and give birth to a child. Throughout pregnancy, the cervix plays the role of a guard, closing the entrance to the uterus and protecting the fetus from external influences and infections. During childbirth, in a short time, the cervix smoothes out, becomes thinner and, together with the vagina, forms a single birth canal. Within literally a few days after birth, the cervix takes on its previous appearance, once again closing the entrance to the postpartum uterus.

Dilatation of the cervix before childbirth

Normally, throughout pregnancy, the cervix has a dense consistency, length from 3 to 5 cm, the cervical canal is closed and filled with a mucous plug, which serves as additional protection against infection. In multiparous women or in the presence of cervical scars from previous births, the canal may pass a finger to the internal pharynx.

From about 34-36 weeks of pregnancy, the cervix begins to ripen. The maturation process includes:

• shortening of the cervix;
• softening consistency;
• centering the cervix along the axis of the birth canal;
• gradual opening of the external and internal pharynx.

The closer the due date, the more pronounced the processes of ripening and dilatation of the cervix. Multiparous women and women with good labor dominance may already have a dilatation of the cervix of up to several centimeters at the time of the onset of labor in the absence of other signs of labor.

Symptoms and sensations when the cervix dilates

During the process of cervical ripening, a pregnant woman may not feel this at all, feel good and may not even know what changes are occurring in her body. Before the onset of labor, a pregnant woman can sometimes observe:

• periodic irregular painless or less painful contractions;
• nagging pain in the lower abdomen, lower back, sacrum;
• mucous discharge from the genital tract, sometimes streaked with blood.

All these sensations are normal and indicate that the woman’s body is preparing for childbirth. However, if such symptoms appear before 37 weeks of pregnancy - the period when the pregnancy is considered full-term, it is necessary to immediately inform the doctor about this.

How is cervical dilatation checked?

To find out what condition the cervix and birth canal are in, whether the cervix is ​​ready for childbirth or, conversely, there is a threat of premature birth, it is necessary to periodically conduct an internal obstetric examination. This is a routine chairside examination in which the obstetrician inserts the index and middle fingers into the woman's vagina and examines the cervix and birth canal. During the examination, the doctor evaluates the length of the cervix, its softness, the degree of dilation of the canal, discharge from the genital tract, and also determines whether the amniotic sac is intact and what part of the fetus is present. In the same way, every two hours the dynamics of cervical dilatation during labor is assessed.

The second fairly reliable and objective method for measuring the length of the cervix and the degree of its dilatation outside labor is ultrasound diagnostics. This method is called ultrasound cervicometry and is the “gold standard” for early diagnosis of the risk of preterm birth. The method is applicable during pregnancy from 22 to 37 weeks.

Stimulation of dilatation and preparation of the cervix for childbirth

Sometimes it happens that the due date is about to arrive, and the doctor, during the next vaginal examination, states that the cervix is ​​“immature” and is not ready for childbirth. Hearing this news, most pregnant women begin to panic and prepare for a cesarean section. An immature cervix is ​​far from a final verdict. Modern medicine has an arsenal of means for artificial “ripening” of the cervix. Stimulation of cervical dilatation is a purely medical procedure, which is performed only in a hospital and for a number of indications:

• post-term pregnancy over 42 weeks in the presence of signs of aging of the placenta and other signs of post-maturity;
• the presence of pregnancy complications in which the further course of pregnancy is dangerous for the woman and the fetus - fetoplacental insufficiency, decompensation of extragenital diseases of the mother, for example, diabetes mellitus, cardiac and renal pathology.

The following techniques can be used to ripen the cervix:

• Kelp sticks are dried seaweed compressed into pencil shapes. These sticks are inserted into the slightly open cervix, where, in a humid environment, the algae swell and mechanically open it.
• Balloon dilatation of the cervix, when a special balloon is inserted into the cervical canal, which is gradually inflated with air or liquid.
• The use of special preparations of prostaglandins, which accelerate the processes of ripening and dilatation of the cervix. These medications may be in the form of intravenous drips, vaginal gels, tablets, or suppositories. The discovery of prostaglandins was a real breakthrough in medicine, making it possible in a huge number of cases to speed up the onset of labor and avoid surgery.

All these techniques are used only in a hospital under the supervision of medical staff!

How to speed up cervical dilatation at home?

Very often, the obstetrician, having stated that the body is not sufficiently prepared for childbirth, sends the woman to the hospital for special measures. But in cases where the pregnancy is not yet critical, and the woman and child are healthy, the doctor chooses expectant management: the expectant mother goes home. There are many grandma's ways to speed up the ripening and dilatation of the cervix. To be honest, the effectiveness and safety of most of them is highly questionable. These include:

• Washing floors, walking up stairs, cleaning the house. There is no harm from such activities, but excessive physical activity is not recommended for women with gestosis, and.
• Taking castor oil. Indeed, castor oil has been used since ancient times by obstetricians to induce labor. In addition to the laxative effect, the drug stimulates uterine contractions and promotes cervical dilatation. However, these effects can appear already on a fairly mature cervix with good labor readiness. Otherwise, other than diarrhea, there will be no other effect.
• Cleansing enema. The scenario is similar to taking castor oil. However, there is a danger in the presence of a movable head of presentation that is not pressed to the pelvis and prolapse of the umbilical cord loops.
• Taking various herbal remedies, for example, a decoction of raspberry leaves, suppositories with belladonna extract, etc. It is harmless, but there is also no proven effectiveness.
• Sex. This is perhaps the only scientifically proven folk method. Sperm contains the same prostaglandins that are used in maternity hospitals. Therefore, regular sex life can actually contribute to the dilatation of the cervix and the onset of labor. Just don’t hesitate to ask your doctor if you have any contraindications to such stimulation methods.

Perhaps the most important thing in childbirth is the birth dominance of the woman herself, her positive attitude, focus on working in a team with a doctor and midwife. Believe in the best, trust your doctor and everything will work out!

Alexandra Pechkovskaya, obstetrician-gynecologist, especially for the site

Useful video

The cervix changes dramatically before childbirth (and almost imperceptibly for the expectant mother herself) - and this is what allows the child to be born unhindered. What exactly changes does the uterus undergo before childbirth, and in what cases is medical intervention necessary?

What should the cervix look like before natural childbirth?

What matters is its location in the pelvis, length and softness. The fact that a woman’s birth canal is prepared is indicated by the softening of the cervix before childbirth to such an extent that it begins to allow 1-2 fingers of the doctor inside. Due to such changes, the woman observes the release of the mucous plug. It turns out that the earlier the cervix begins to dilate before childbirth, the sooner the woman notices this clear sign of approaching contractions.

In addition, it is shortened. It is known (this is recorded using transvaginal ultrasound) that the length of the cervix before childbirth is no more than 1 cm. And it gradually smoothes out completely.

As for the location, it becomes exactly in the center of the small pelvis, while the cervix during pregnancy, even 3-4 weeks before the onset of labor, is deviated posteriorly.

These 3 parameters are assessed on a two-point scale. With 5 points scored, the cervix is ​​considered mature.

How to stimulate uterine dilatation using medical methods

If an examination of the cervix before childbirth shows that it is not yet mature, whereas, judging by the doctors’ calculations, you should be about to give birth, it is quite possible that you will be asked to speed up the process a little and carry out stimulation. Otherwise, there is a high probability that the child will suffer from oxygen starvation, since by 40-42 weeks the placenta can no longer properly perform its functions; it “grows old.” Stimulation by medical means is possible in a hospital setting. 4 methods are used, sometimes in combination with each other.

1. Intramuscular injections of Sinestrol. This drug speeds up the preparation of the cervix for childbirth, but does not directly provoke contractions.

2. Introduction of kelp sticks - seaweed - into the cervix. This procedure is performed by a doctor, while the patient is on a gynecological chair. The sticks, 5-6 cm each, are placed almost the entire length into the cervical canal. After approximately 3-4 hours, they begin to swell under the influence of moisture, thereby mechanically opening the cervical canal. Within a day, a dilatation of 1 cm is usually observed - a softened and short cervix before childbirth is the key to a quick and easy delivery.

3. Introduction into the cervical canal of a gel containing prostaglandins. For example, Prepidil-gel. It usually acts very quickly, the neck opens in a few hours.

4. Intravenous administration of the drug Enzaprost containing prostaglandins. With its introduction, the cervix becomes soft before childbirth, thereby shortening the period of contractions and expulsion of the fetus.

Self-induction of labor

More often, these techniques are used by women without indications and can be dangerous.

1. Cleansing enema. It is noticed that after it the mucous plug quickly comes away and the cervix opens. This can only be done for those who have already reached their expected due date, that is, the baby is definitely full term.

2. Taking a warm bath. This is not possible if the mucus plug and amniotic fluid have already drained. In addition, it is not recommended for women with high blood pressure.

3. Sex. Sperm contains prostaglandins - the same substances that are part of the drugs used to stimulate labor in a hospital setting. Those who have already lost their mucous plug should not have sex, as there is a high probability of introducing an infection into the uterus. Well, having sex with a condom is useless in terms of stimulating the dilatation of the cervix.

4. Physical activity. Walking up and down stairs, mopping floors while squatting, cleaning the house, etc. But don't overdo it. Especially if you have hypertension or gestosis, or placenta previa.

Now you know what the cervix should be like before giving birth. Just don’t try to independently diagnose how ready she is for childbirth. Leave this task to the doctors.

The neck of the reproductive organ plays the role of a ring that closes the entrance, holding the child inside. Over the course of 9 months, the baby grows and the volume of amniotic fluid increases. The pressure on the pelvic bones is increasing. The organ does not always withstand the load. Symptoms and signs of cervical dilatation during early pregnancy are common. The phenomenon is dangerous and quite common. If timely treatment is not taken, a miscarriage will occur.

During the course of bearing a child, disruptions occur in the body. Muscle tissue is partially replaced by connective tissue. New collagen fibers begin to form. Unlike the previous ones, they are more flexible and elastic. A small amount is absorbed to form the main substance. You can tell that the cervix is ​​dilating by its appearance. It looks loose, shortened, with a visible canal.

The organ begins to prepare for labor at 32–34 weeks. This is manifested by softness on the outside. The channel remains quite dense. Complete softening of the cervix occurs at 36–38 weeks. The baby enters the pelvis at this stage of pregnancy. Pressure on the reproductive organ increases, forcing it to open.

The process begins with the internal pharynx. The baby moves along the birth canal, which has the shape of a cone with a wide side at the exit. The tissues gradually stretch. For women who give birth repeatedly, the procedure is faster. The canal opens on both sides at the same time; the opening of the cervix is ​​practically not felt during pregnancy.

Immediately before the birth process begins, it becomes exhausted and looks too short. 2 or more fingers will fit inside. However, the action doesn't stop. The limit is considered to be 10–12 cm. This width of the hole is required for the successful exit of the baby’s head. The degree of maturity of the cervix is ​​determined according to the Bishop scale.

There are 3 types:

1. immature;
2. maturing;
3. mature.

The first is characterized by density, length greater than 2 cm, and closedness of the external pharynx. The second corresponds to external softness and internal hardness. Shortening occurs to 1 - 1.5 cm. Half of the path becomes passable. The third type is characterized by softness and the ability to insert 2 fingers.

A couple of hours before the start of labor, cramping pain appears when the cervix dilates. They are not long-lasting, low-intensity, and do not cause structural changes. The normal duration is about 6 hours.

Signs of ICN

It is difficult to consider isthmic-cervical insufficiency in the second trimester of pregnancy. The doctor obtains data from examining the vagina using ultrasound, performing an examination using a speculum. You need to find the problem quickly so that a miscarriage does not occur.

Can you feel the dilatation of the cervix? Yes and no. Some women in labor arrive at the maternity hospital with a 2 cm dilation, feeling nothing. Others experience pain when contracting.

Signs of cervical dilatation in the second trimester:

• bleeding;
• pain in the lower abdomen;
• shortening, softening;
• pressure on the vagina;
• on examination the amniotic sac is visible;
• length discrepancy with normal parameters;
• the pharynx is open.

If at least one of these symptoms is detected, immediate treatment is required. Two or more are considered a signal for the woman in labor to be admitted to the clinic. Diarrhea and nausea are also observed when the cervix dilates. Indicates insufficient protrusion of the amniotic sac.

Accommodation options:

1. on top of the internal pharynx;
2. on the line of the hole, but invisible to the eye;
3. in the canal, visible upon examination;
4. moved into the vagina.

What does it feel like when the cervix dilates?

• nagging pain radiating to the thighs;
• feeling of discomfort due to the drooping baby;
• spasms in the vagina.

A gynecologist is able to diagnose ICI having:

1. information about previous miscarriages that occurred in the last trimester of pregnancy;
2. data on premature termination of pregnancy by labor in the early stages;
3. information that conception occurred after IVF;
4. results of prolapse of the membranes;
5. mirror inspection indicators.

Quite often many signs are absent. Therefore, it is difficult to understand that the cervix is ​​opening. Ultrasound examination is considered the most effective method. The method will promptly indicate the deficiency and also determine why it appeared.

Sometimes women end up in the maternity hospital with an opening of 1 - 2 cm. They are not even aware of the ongoing process. Everything happens unnoticed, and the cervix begins to dilate without contractions. Stretching and tingling are rarely observed.

Causes

Premature dilatation of the cervix in early pregnancy often results in miscarriages. Softening provokes expansion, opening. It is difficult for the fetus to hold on.

There are 2 types of ICN:

1. organic;
2. functional.

What a particular woman will have will be determined by the reasons that formed her. Organic is also called traumatic because it is caused by injury. The cervix loses its elasticity and becomes scarred.

• abortions;
• miscarriages;
• cervical injuries;
• treatment of polyps, erosion;
• scraping.

Scar tissue cannot stretch. It is made up of connective fibers. They are characterized by increased rigidity. The ability to contractility is lost. As a result, the baby is not held inside. The ICN appears.

Functional call:

1. changes in hormones;
2. polyhydramnios;
3. pathologies of the reproductive organ;
4. imbalance of tissues.

A large amount of androgen produced or a small amount of progesterone leads to hormone disruption. The consequence is detected at the 11th week of pregnancy. The cervix weakens and opens.

Large accumulation of water is also considered a serious cause. This phenomenon is observed during multiple pregnancies. The load on the reproductive organ increases, and insufficiency occurs.

These reasons contribute to varying degrees of softening. The uterus prepares for childbirth ahead of time and becomes pliable. As the baby grows, the ability to stay inside decreases. Functional failure affects women who have problems with the functioning of the ovaries. Congenital ICI is also sometimes present.

Each woman experiences this disease individually. Instead of one reason, it can be caused by two or more. In any case, it is difficult for the child to hold on, he heads towards the exit. As it goes down, the pressure increases. Low position leads to infection. As a result, a miscarriage or premature labor occurs.

Treatment

The doctor determines the exact causes of the deficiency, then recommends a course of therapy. For functional symptoms, hormonal medications are often prescribed. They restore hormone levels in 1–2 weeks. After the situation improves, treatment does not stop.

How to check the cervix before childbirth:

• manual inspection;
• ultrasound diagnostics.

It is necessary to observe bed rest when all signs of opening of the cervix before childbirth are observed in a woman in the early stages of bearing a child. The gynecologist recommends complete calm. Any load should be limited.

Conservative treatment methods involve the use of a Meyer ring. The product is made of plastic. Goal: To control the baby's pressure on the cervix. The manipulation is suitable for women in labor with a small opening at a gestational age of 28 weeks or more. Thanks to it, the baby's weight is evenly distributed. This method is used as an auxiliary method.

At an earlier stage, in the absence of infectious diseases, surgical intervention is prescribed. The goal is to place sutures on the cervix so that dilation does not occur until after birth. No discomfort is felt during surgery. Anesthesia is administered in advance. The suture material is removed before labor begins, when the amniotic sac is opened.

Both types of treatment for the disease involve the prescription of antibacterial drugs. They are needed to exclude birth and prevent an infectious process. To enhance effectiveness, antispasmodics are prescribed. Reduce hypertension with tocolytic agents. Hormonal medications are prescribed if an opening is observed due to a malfunction of the endocrine system.

Stimulation of dilatation during labor

With a mature cervix, labor begins at 38 weeks and ends with the birth of a baby. Sometimes doctors stimulate the process. Indications are premature, late labor. The onset can be spontaneous, weakly occurring, with an unexpected stop.

How to open the uterus before childbirth:

1. by administering medications;
2. use amniotomy;
3. manually.

The obstetrician notes the weakness of the process, stimulates it, if the reproductive organ stops contracting, contractions are not enough to fully open. The doctor uses medications when 12 hours have passed after the water has broken, and the birth process has not begun. Such stimulation is carried out carefully under the supervision of medical staff. The absence of an allergic reaction to drugs is checked prematurely.

Signs of the need to stimulate uterine dilatation during labor:

• hypertension;
• gestosis;
• early release of water;
• stretchiness;
• weak contractions, complete absence;
• the reproductive organ does not open;
• heart failure;
• placental abruption;
• late toxicosis.

The obstetrician, based on the health status of the mother in labor, makes a decision on stimulation. If symptoms of premature cervical dilatation appear during pregnancy in the third trimester, the doctor will recommend that the woman in labor go to the clinic for a couple of weeks. Medical staff will monitor the condition of the woman and baby. If necessary, uses the surgical method.

The method of amniotomy is widely known. The idea is to pierce the bubble. The main indication for manipulation is suddenly stopped dilatation, which has already occurred by 2 cm. Piercing will speed up labor. The amniotic fluid will recede and the pressure on the pelvic bones will decrease. The method is considered safe and absolutely painless.

Another method of stimulation is to manually dilate the cervix. Special tools are often used - reamers. A prominent representative is an inflatable balloon filled with liquid. He acts on the neck, achieving an opening. When using the method, there is a danger of the bubble bursting. Therefore, it is carried out in case of emergency.

Straightening the cervix before childbirth occurs on the eve of the process. If during the examination the gynecologist discovers that this has not happened, the procedure is performed manually. Sometimes accompanied by severe pain. Manipulation is necessary to facilitate the child's exit.

Signs of dilatation begin unnoticed in many cases. Then a nagging pain sensation appears, the mucous membrane and blood plug come away. The main indicator of approaching labor is uterine contractions. If such symptoms become apparent in the middle of pregnancy, tell your gynecologist. There was a threat of premature birth of the baby.