What does a loose cervix mean? Short cervix during pregnancy: what to do. To make an accurate diagnosis, ultrasound is prescribed

Tumor diseases are nothing more than the response of the female body to numerous nonspecific pathogenic environmental influences. Inflammatory processes, which often precede cancer and create conditions for its occurrence and development, play a major role in the occurrence of cancer of the female genital area. Inflammatory diseases and ulcers of the cervix create favorable conditions for the development of cancer.

Erosion (ulcer) of the cervix is a defect in its mucous membrane. Most often, erosion occurs in chronic inflammatory diseases accompanied by leucorrhoea. Under the influence of the inflammatory process, the whiter surface layers of the cervix are exfoliated, the cervix is “exposed” and becomes loose. As a result, an ulcer forms on the cervix. Thus, any disease of the genital organs, accompanied by leucorrhoea, can lead to the formation of cervical erosion. Cervical erosion is not an independent disease, but is only a manifestation of one or another painful condition of the reproductive system or the entire body of a woman.

A disease similar to erosion is inversion of the cervical mucosa. Eversion of the mucous membrane (ectropion) occurs due to tears in the cervix that occur during childbirth. In this case, the mucous membrane of the cervical canal is exposed, and it is easily exposed to adverse effects from the vagina and its secretions.

Cervical cancer can arise from the so-called “leukoplakia” (white plaque), which is an area of thickening of the cervix.

Sometimes the basis for the development of the cancer process can be loose, lush growths of the mucous membrane of the cervical canal. These growths, called polyps, can be single or multiple, spreading beyond the cervix, deep into the uterine cavity. In these cases, we are no longer talking about polyps, but about polyposis. Excessive growth of the uterine lining, which sometimes occurs in old age, can also contribute to the development of uterine cancer.

Malignant neoplasms of the ovaries also most often occur against the background of inflammatory and other female diseases.

Finally, it should be remembered that with a long course, benign tumors can acquire the properties of malignant ones, i.e., degenerate and become malignant. Cases of malignant degeneration of harmless ovarian cysts are often observed. Cancer occurs in patients with uterine fibroids approximately ten times more often than in other women. The frequency of coincidence between fibroids and uterine cancer makes us take this disease very seriously.

Cancer occurs on the basis of the above and other painful changes in the woman’s reproductive system, but not always, but only in the presence of certain, not yet fully understood conditions. Consequently, these diseases, although called “precancerous”, do not necessarily and do not always lead to the development of cancer. However, the fact that in the presence of such diseases, tumors occur more often than in their absence should not only alert, but also encourage timely and radical treatment of precancerous diseases.

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Causes of cervicitis

Causes of cervical inflammation can be very diverse. They lie in specific and nonspecific pathogens.

The most common causes of such inflammation are specific infections. These include: trichomonas, mycoplasma, syphilis, chlamydia, gonococci and herpes.

All these pathogens enter the female genital area directly during sexual intercourse.

Less common factors that provoke cervicitis are nonspecific conditionally pathogenic microflora.

These microflora include staphylococci, streptococci, fungi of the genus Candida, and E. coli. Such conditionally pathogenic microflora is present in the body of every woman; such organisms begin to actively develop only in favorable conditions for them, when the protective functions of the body are reduced.

Reasons that can cause pathological processes in the female genital area also include abortion, miscarriage, curettage, which can also injure the cervix and cause pathological changes in its mucous membrane.

The rarest factors that can provoke cervicitis include allergic reactions to latex, various spermicides and all kinds of intimate hygiene products. But such causes are very rare, and only in a very advanced stage can they cause cervicitis.

If detected untimely and at an advanced stage, such cervicitis can transform into chronic inflammation of the cervix. And it is already much less treatable.

Therefore, it is extremely important to carefully monitor your health, consult a doctor on time and undergo a medical examination even without any complaints in the sexual sphere.

Symptoms of cervicitis

Symptoms and signs of inflammation can be both pronounced and hidden.

Signs of uterine inflammation the following:

Painful sensations in the lower abdomen. Such pains are predominantly aching and pulling in nature. They are similar to period pain. The severity of such pain depends on the individual characteristics of the female body, because everyone has a different pain threshold, and on the severity of the disease.
Discharge mixed with pus or mucus. Such discharge can also be strong or barely noticeable.
Pain when urinating.
Discomfort and pain during sexual intercourse.

Such signs of the disease can be detected by the woman herself. When examined by a doctor, an experienced doctor will visually determine the following: signs of uterine inflammation:

Redness of the cervix.
Loose cervix.
Swelling of the mucous membrane of the cervical canal.
Small ulcers and hemorrhages of the organ mucosa.

The severity of the symptoms of this disease also completely depends on the pathogen that provoked the disease. This is how the disease caused by gonococci develops most violently and clearly.

In this case, all of the above symptoms will be very pronounced, and it is simply unrealistic not to notice the pathological process in the female body.

There will be pain and discharge and cervical hyperemia. Gonococci are the cause of a loose cervix.

But if the disease is caused by chlamydia, then the symptoms will not be so pronounced: they will be weak, or the disease may be completely asymptomatic.

Trichomonas manifest themselves in the form of small ulcers and hemorrhages on the mucous membrane of the cervical canal.

If the pathology is caused by a herpetic virus, then upon examination a bright cervical hyperemia with many ulcers and mucosal hemorrhages.

Diagnostic methods

This problem can be diagnosed only by examination by a doctor and after all the necessary tests and manipulations.

First, you will need to be examined by a gynecologist, who can often visually see this problem.

But in order for the treatment of such a disease to be as effective as possible, it is necessary first of all to identify the cause of the disease. After all, only after eliminating the cause is it possible to completely cure the disease.

After a visual examination using gynecological speculum, an experienced doctor will definitely prescribe additional tests: smear microscopy, bacterial culture, PCR.

Cytogram of inflammation will accurately show the causative agent of the disease , and accordingly the treatment will be more accurate. A cytogram refers to the taking and analysis of a scraping from the cervical canal.

In this case, the contents of the canal mucosa are taken and examined in detail.

The cytogram will accurately show the contents of the taken smear, detect pathogenic microflora, determine the presence or absence of inflammatory secretions, cancer cells, show the number of leukocytes, erythrocytes and other blood cells (if any), and even accurately show the correspondence of the epithelium to the age characteristics of the woman.

You should prepare for the cytogram. To do this, it is necessary not to do any douching for 2-3 days, not to use suppositories, creams, or suppositories. A few days before the scheduled test, you should abstain from sexual intercourse. Also, a few days before the study, you must stop taking hormonal contraceptives.

It is best to conduct this study in the middle of the cycle, on days 14-15.

Treatment of cervicitis

To know, how to treat cervical inflammation, it is necessary to accurately determine the causative agent of the disease. Depending on the cause of cervicitis, treatment consists of taking antibacterial or antiviral drugs.

If the disease provoked by infections, then treatment with sumamed, monomycin, maxaquin, erythromycin and other antibacterial drugs would be appropriate.

If the disease provoked by fungi genus Candida, then antibacterial therapy is not prescribed at all; it would be appropriate to take antifungal drugs such as Diflucan and its analogues.

Very often, with this disease, doctors prescribe suppositories for cervical inflammation called terzhinan. This is a complex preparation of local action. Chlorophyllipt, silver nitrate, and dimexide are also used for topical use. The vagina is treated with such solutions.

The most difficult to treat are inflammatory processes of viral etiology. Typically, such problems are caused by the genital herpes virus. Such treatment will be the longest and will require the use of antiviral drugs, immunostimulating agents and the use of immunoglobulin.

Inflammatory processes of this nature can be provoked and human papillomavirus. In this case, cytostatics and interferons are useful for treatment.

If the disease has already become chronic, then drug treatment may no longer give positive results.

In this case, the use of modern surgical techniques will be required. These include: laser therapy, cryotherapy, diathermocoagulation.

A prerequisite for effective treatment is the restoration of normal vaginal microflora, regardless of the causative agent of the disease.

Under no circumstances should you use traditional medicine to eliminate the disease yourself. In this case, they will not have any positive impact on this problem.

It is also important to remember that such a problem is much easier and faster to eliminate at the initial stage, when it has not yet become an advanced chronic form.

Prevention of cervicitis

It is easier to prevent any disease than to cure it later. To prevent cervicitis, you should first of all regularly undergo a preventive examination see a doctor, avoid casual sexual contact, use contraceptives, and do not ignore basic hygiene procedures.

Video: How to treat cervical inflammation

To summarize all of the above, it is worth noting that inflammation can have completely different etiologies and can be completely asymptomatic or very violent. Prevention and treatment of such a disease depends entirely on the pathogen that provoked it; a treatment regimen and the necessary medications are prescribed exclusively by a specialist, after a series of studies.

doktora.guru

What are the causes of a loose cervix during pregnancy?

In the early stages, the cervix can be variable; both a dense surface and a softer one are allowed. But over time, as the fetus develops, the reproductive organ must become hard so that the baby develops normally and is kept inside the womb without fear of premature birth.

A loose cervix during pregnancy means that the pharynx is not tight enough and is not able to hold the baby in the cavity, and there is a risk of miscarriage and infection.

If before the 15th week of gestation the uterus has not become dense, then diagnostic measures are prescribed to determine the causes of this situation, which may be the following:

weakened cavity muscles as a result of previous births;
surgical interventions and abortions, due to which adhesions are formed;
congenital pathology;
thyroid diseases;
hormonal imbalance - lack of progesterone or excess of androgens.

One of the most common causes of soft pharynx is isthmic-cervical insufficiency, when muscle tone is so weakened that there is a need for surgical intervention to preserve pregnancy.

Diagnosis and symptoms of uterine laxity

Already during the first diagnostic examination, the doctor assesses the condition of the cervix, after which an ultrasound examination is performed, which can determine the length of the pharynx. It is by this parameter that the risks for pregnancy are mainly determined, since most of the time the pathology is asymptomatic and the woman herself will not be able to notice any signs.

Normally, from the second trimester, when the baby begins to actively grow, the cervix should gradually become firmer and more elastic in order to hold the fetus. If an ultrasound reveals a shortened cervical size, less than 2 cm, then this becomes a direct threat of miscarriage in the early stages or premature birth in later stages.

A short and soft cervix is considered normal only before the onset of labor, in order to simplify the process of natural delivery.

When assessing the condition of the reproductive organs during pregnancy, specialists collect a complete medical history to determine the increased risk. Multiple abortions, previous forceps deliveries, or carrying more than one fetus are signs that require close monitoring.

Loose cervix - treatment methods

When choosing a treatment method, the reasons that caused the pathology are of particular importance. If hormonal deficiency is detected, then drug therapy is prescribed to normalize the production of hormones. Most often, medications are used to increase progesterone (progestogel, utrozhestan) in a hospital setting and at complete rest to reduce the risk of miscarriage.

A loose cervix during pregnancy from 20 to 30 weeks becomes the reason for the installation of a pessary. A specialized device that is installed on the pharynx and helps redistribute the weight of the growing fetus, and also becomes an obstacle to premature dilatation of the cervix.

In case of complications, surgical intervention is used by suturing and tightening the pharynx until 36-37 weeks of pregnancy. The operation is performed in no more than 20 minutes under general anesthesia, which allows you to carry a healthy baby for the entire 9-month period without the danger of premature labor.

When diagnosing a loose cervix, it is strongly recommended:

Refuse sexual activity, as this raises the tone and promotes greater opening of the pharynx.
Maintain a regimen of rest (at least 8 hours of sleep) and activity.
Try to spend as little time sitting as possible, so as not to create excessive stress on the pelvic area.
Eliminate bad habits and adjust your diet.

You can strengthen your abdominal muscles and ligaments with special Kegel exercises, which will reduce the risk of developing cervical laxity.

The best prevention of various pathologies during pregnancy is planning for conception. A woman should be tested for the presence of infectious processes and undergo comprehensive treatment for successful pregnancy and birth of a child.

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Causes

As for the causes, softening may be the result of pathological changes or be a normal phenomenon.

Pathological changes

Factors leading to changes in the consistency of the cervical region may be the following:

The use of medications without a doctor's prescription during pregnancy (papaverine, no-spa), which are often used to relieve nagging pain, but have a relaxing effect on the cervix.
Pathological birth, which was accompanied by deep tears and injuries, resulting in stitches.
Isthmic-cervical insufficiency is a pathological condition in which the cervical uterus shortens and softens prematurely. This syndrome can be caused by both mechanical and hormonal causes. Mechanical causes imply defects in the structure of the organ: the content of muscle and connective tissue is not proportional in favor of the latter. As a result, the cervix cannot withstand the pressure of the growing fetus. The causes of this condition are congenital defects in the structure of the organ. Hormonal factors that lead to ICI are an increase in the production of male sex hormones in the body of a pregnant woman. 17-OH-progesterone and DHEA sulfate increase. With this cause of ICI, labor may begin prematurely and urgently at 17 or more weeks of gestation. Mechanical causes often trigger labor at 30 weeks or more.
Inflammatory processes in the female genital area - endocervicitis. As a result, the likelihood of infertility also increases.
Neoplasms.
Congenital anomalies of the structure of the internal genital organs.
Multiple artificial abortions.

Ovulation period

Under the influence of a number of hormones that regulate a woman’s menstrual cycle, the cervix changes its consistency, the width of the cervical canal and the nature of the discharge. The main hormone that has a significant effect on the hardness or softness of cervical tissue is estradiol. Normally, by the middle of the cycle, its level in the blood increases to its maximum, reaching a peak at the moment of rupture of the follicle - the period of ovulation. The egg passes through the fallopian tube, where it can hypothetically meet a sperm. In order for sperm to freely penetrate into the uterine cavity, the cervix must become soft and the cervical canal wide.

The time for the release of the egg from the follicle and the softening of the cervix during the average menstrual cycle occurs on days 12 - 15. If the length of the cycle is not 28 - 32 days, but 33 - 45, then the cervix becomes soft on days 17 - 30.

Course of pregnancy

Often, a soft cervix is observed during pregnancy earlier than expected. This reaction of the body is considered natural only from the 36th week of gestation.

But often ignoring this fact leads to irreparable consequences. If such a reaction is observed during the formation and growth of the embryo, when pressure is placed on the lower part of the uterus, a course of treatment should be undertaken and this often happens in a hospital setting. If the muscle tone of the uterus is too strong, then the cervix may open, and this is always accompanied by its softening and shortening.

Such a reaction can be recorded from 20 to 30 weeks, occasionally in the first trimester. In a normal state, softening is noted already before childbirth.

First week after conception

The change in cervical density in the early stages is due to the formation of a more complex network of blood vessels that are responsible for feeding the uterus and baby in the womb. In addition, the corpus luteum of the ovaries does not yet produce progesterone strongly enough, a hormone that ensures the density of the cervical region. Over time, during a healthy pregnancy, the cervix becomes dense in consistency and also long. The cervical canal closes, and the mucous contents protect the amniotic membranes from the penetration of microorganisms. Sometimes an obstetrician-gynecologist during an examination determines a soft cervix during early pregnancy. This is a reason to prescribe progesterone drugs.

The period before delivery

A soft cervix before childbirth is considered to confirm the readiness of the female body for childbearing. It is at this point that the organ is no longer able to hold the mucus plug and becomes more susceptible to expulsion of the fetus. At this stage, the cervix is soft, short and opens gradually. Often, women notice stretching in the lumbar region and the gradual removal of the mucus plug. Such processes, as a rule, are observed from the end of the 37th week, but can also begin at the 39th week. If the cervical region does not dilate sufficiently, and labor has already begun, then additional stimulation is required.

Softening occurs due to a cascade of reactions that occur at the time of delivery. This process is very complex and begins in advance, covering changes both at the level of the fetoplacental system and at the level of the brain. Not everyone's neck becomes soft in due time. Often its softening and shortening occurs either too early or does not occur at all. Ultrasound and palpation are used to monitor the cervix. The gynecologist regularly examines the woman before childbirth, determining her readiness, and takes appropriate measures if any deviations are detected.

Symptoms

Softening of the cervical region may be accompanied by a number of clinically significant signs. In the 1st and 2nd trimester, the patient most often learns about a short and soft cervix at the next ultrasound screening. Since early pregnancy is often accompanied by nagging pain in the area of the uterus and ovaries, a woman may not think about the warning signs of isthmic-cervical insufficiency. Stretching of the uterine ligaments, intense work of the corpus luteum of the ovary, and concomitant inflammatory pathology of the pelvic organs can cause pain. But changes in the aspect of softening of the cervical region are also accompanied by nagging pain. A pregnant woman cannot differentiate these sensations on her own. Therefore, regular visits to your obstetrician should be mandatory.

The main symptoms of pathological premature softening are mild nagging pain in the lumbar region, hypertonicity of the uterus (a feeling of petrification in the lower abdomen) and increased discharge from the genital tract.

Consequences and possible complications

Based on the pathology that accompanies the softening of the cervix, certain consequences will be noted. Basically, this process is natural and physiological. But if it becomes pathological during gestation, then the consequence in this case may be a miscarriage. In non-pregnant women, a constantly soft cervix is a sign of diseases of various origins that can lead to a violation of its consistency. Chronic inflammatory processes and neoplasms localized in the cervical region change its structure.

Since a soft cervix is not always normal, it is important to monitor your health both during pregnancy and in everyday life.

In order to know about the condition of the organ, you should undergo cervicometry using ultrasound and palpation of the cervix on a chair. The most serious complication of a soft cervix is premature birth. The amniotic sac prolapses into the area of the softened cervical region, which can burst with any sudden movement. In addition, vaginal bacteria can easily penetrate the amniotic membranes and cause intrauterine infection of the fetus.

Timely diagnosis and treatment are the key to successful delivery on time.

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What is the uterus and cervix?

The uterus is a smooth muscle unpaired hollow organ that can expand many times during pregnancy for favorable gestation. The cervix is the lower segmental part of the uterus, one side opens into the uterus, the other into the vagina. Thus, we can say that this is a kind of “gate”.
Normally, the uterus is smooth, hard, and pale pink in color. Before the onset of menstruation, it loosens, softens and opens slightly, which means the body is ready for fertilization and implantation of the embryo. If pregnancy does not occur, menstruation occurs and the uterus returns to its previous state.

Looseness of the cervix normally occurs during pregnancy, in the early stages and in the last weeks, closer to childbirth. This is a physiologically normal phenomenon. But if the cervix softens mid-pregnancy, it can lead to miscarriage or premature birth. Why is this happening?

There are several main factors leading to loosening of the cervix:

The most common cause is cervical insufficiency of the cervix (decreased muscle tone). Actually, this pathology provokes spontaneous miscarriages and premature births. This deficiency is determined by several types:

Functional type:

Organic type:

The main indicators of cervical insufficiency are looseness of the cervix and its premature dilatation during pregnancy. But in nulliparous women, its diagnosis is very difficult, because it is asymptomatic. Other signs include:

During pregnancy, the uterus undergoes significant changes. In the first days after conception, thanks to hormones, the uterus softens to better secure the embryo in the uterine cavity and provide adequate nutrition. Then, during the first month, the uterus returns to its normal structure. It will continue to change throughout pregnancy, but looseness should normally appear in the last days before delivery.

At the same time, the cervix expands slightly, the tone goes away, and it shortens. This is considered normal and prepares the body for childbirth and facilitates the birth itself. Such phenomena do not require treatment.

But if this happens in the middle of pregnancy, then it requires treatment, otherwise the risk of labor starting prematurely increases.

In a normal pregnancy, the cervix will be firm, long and well closed. If the cervix is insufficient, it loosens and the pharynx opens. If, during examination, the membranes of the amniotic sac are visible in the mirrors, the cervix is shortened to two centimeters, then the diagnosis is confirmed.

Initially, hormonal therapy is prescribed for two weeks. If after this, upon re-examination, improvements are noticeable, the threat of miscarriage is significantly reduced, then treatment is continued. Additional medical supervision is required throughout pregnancy.

There are other treatment methods if hormonal therapy is ineffective.

A pessary (ring) is an additional measure; it is placed on the cervix. Thus, it performs a bandage function - it supports the neck and does not allow it to open. Requires constant monitoring by a doctor; while wearing a pessary, it is necessary to regularly undergo ultrasound and undergo flora tests. It is removed towards the end of pregnancy, but if bleeding occurs or premature labor begins, it is removed earlier.

If the pessary is ineffective, a surgical measure comes to the aid of the loose cervix - suturing. The operation is performed in a hospital under local anesthesia. Indications for suturing are:

It is important to select anesthesia as accurately and carefully as possible, because it should not harm the baby. Sutures are removed a couple of weeks before the expected date of birth, but in some cases this is done earlier: premature contractions, the onset or complete breaking of waters (with a long absence of labor there is a risk of hypoxia and infection of the fetus), bleeding.

The surgical treatment method has virtually no complications, but still has contraindications:

Before pregnancy occurs, pathology can be seen in the presence of scar changes or other defects on the cervix. In other cases, diagnosis is possible only after the first miscarriage.

Women with cervical insufficiency have a high risk of miscarriage. For this reason, infertility is often diagnosed, so after discovering such a diagnosis, it is necessary to immediately begin treatment.

Why is there a loose uterus after childbirth?

The postpartum recovery procedure may not always be without complications. Looseness of the uterus after childbirth is one such phenomenon, which may be a symptom of subinvolution.

The first months of the postpartum period are the most important, it is at this time that involution occurs - restoration of organ functions, normalization of hormonal levels. However, it happens that the cervix is blocked by particles of membranes, placental debris or blood clots, or is bent due to weakening of the ligaments; Due to mechanical or viral damage, the uterus cannot shrink to its natural size. This condition is called subinvolution.

Symptoms of the disease are an enlarged, loose uterus and heavy brown bleeding that does not stop.

Sometimes the disease is accompanied by elevated body temperature.

Causes and treatment

Subinvolution is recognized in two types - infectious in nature and true. Infectious occurs due to inflammatory processes after childbirth (against the background of pyelonephritis and anemia of pregnant women), as a result of retention of the remnants of the placenta or membranes in the uterine cavity, as well as due to infection during childbirth.
True subinvolution occurs due to excessive stretching of the uterus due to polyhydramnios, a large fetus or carrying twins, with too fast or very long delivery. It can also occur after a cesarean section, against the background of cervical fibroids or adenomyosis.

To make an accurate diagnosis, ultrasound is prescribed

Treatment depends on the type of subinvolution and the presence of inflammatory processes. Treatment is mainly medicinal, but in some cases vacuum cleaning of the uterus or massage of the uterus and ovaries may be prescribed.

Other pathologies of the cervix after childbirth.

Scar on the cervix after childbirth

Scars are formations of connective cells on the damaged mucous membrane of the cervix, or scars. After childbirth or as a result of surgery, they can occur on the cervix. One of the main provoking factors is difficult childbirth. Their danger lies in the possibility of infection as a result of retention of the remains of the placenta or fetal membranes separated after childbirth on them.
In this case, curettage of the uterine cavity will be required; lack of treatment can lead to blood poisoning.

Alarming symptoms that are a reason to consult a doctor are:

Treatment of the disease can be therapeutic (restoring hormonal levels, relieving inflammation, boosting immunity) and surgical.

Eversion of the cervical mucosa is called ectropion. It occurs when the uterus receives severe trauma due to the birth of a large fetus, malpresentation of the fetus, hardness of the cervical tissue as a result of incorrect sutures after ruptures or after a cesarean section.

If severe trauma to the uterus occurs, and all layers are affected, including the muscular layer of the cervix, scarring subsequently occurs, as a result of which the tissue is not sufficiently supplied with nutrition. The cervical mucosa, as a result of a gap in the vagina, is damaged by the acidic vaginal environment, which can result in infections and reproductive dysfunction.

There are no specific manifestations of the disease; it is diagnosed during examination by a gynecologist (open cervical mucosa, cloudy mucus discharge, scar changes on the cervix causing deformation). To confirm the diagnosis, colposcopy and cell examination (cytology) are prescribed to confirm the benignity of the process.

Inversion of the cervix can provoke a disruption of the physiological state of the cervical canal, the development of an inflammatory process, reproductive dysfunction and some other pathologies.

The essence of treatment is to correct the structure of the cervix by such methods as diathermocoagulation and diathermopuncture, plastic surgery and reconstruction, and conization of the cervix.

Whatever questions about the state of your reproductive system bother you, a consultation with a gynecologist is always necessary. By following all the recommendations, you can maintain your health and prevent the development of many diseases.

Video: cervical maturity. Preparing for childbirth

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Cervix during pregnancy

Conventionally, the cervix can be called a tube connecting the uterus and vagina. As women age, this “tube” changes. For those who have not yet given birth, the cervix has a cylindrical shape, it is smooth and wide. But in women who have given birth, the cervix becomes loose, round or even trapezoidal. The length of the uterus is 3-4 cm, and the width is about 2.5 cm.

The cervix has two parts: lower (vaginal) and upper (supravaginal). Inside it is the cervical canal. During the examination, the gynecologist just sees the vaginal part and the opening leading to the external os (canal).

Before pregnancy, the outside of the cervix is pink, shiny, uniform, smooth and strong, but inside it is velvety, loose and bright pink. It is this internal part that is responsible for the production of mucus, which fills the cervical canal inside. Thanks to this dam of mucus, an obstacle is created for sperm - they cannot penetrate inside before ovulation. But during ovulation, the external os opens slightly, mucus disappears (or becomes minimal), and the cervix does its best to help sperm penetrate the uterus.

With the onset of pregnancy, the cervix also changes. It swells and becomes red-blue. The color change is due to intense blood circulation. Throughout pregnancy, the cervix “matures.” This process is necessary for normal childbirth. Over 9 months, the cervix becomes thicker, denser and moves slightly towards the center of the pelvis.

Cervix during early pregnancy

The cervix in early pregnancy is the indicator that best indicates the ongoing process.

If everything is fine with the baby, then the cervix is slightly deviated, and the cervical canal is tightly closed and impassable for the finger.

But if there is a threat of miscarriage, then the tissue of the cervix is loose, and the internal os is slightly open, so there is a possibility of a finger getting inside. In this case, the woman must be hospitalized in order to do everything possible to save the child.

What is noteworthy is that most miscarriages in such cases occur due to an infection that enters the woman’s body through an open internal pharynx.

Cervix during late pregnancy

A doctor, examining a pregnant woman before childbirth, determines the readiness of the body by looking at the cervix. Before childbirth, the cervix becomes soft, its length becomes half as large, and the internal os itself begins to expand. The internal segments of the cervix smooth out, becoming like a continuation of each other.

Before the baby is born, the length of the cervix decreases and the cervix itself opens, allowing the baby to pass through.

The cervix dilates directly during contractions. When dilatation is 4 cm, labor slows down and subsequently dilates to 1 cm per hour. If dilatation occurs faster or slower, then the process itself can cause anxiety - rapid or protracted labor is possible, and a caesarean section is quite possible.

Cervix during pregnancy by week

Throughout pregnancy, timely diagnosis can help a woman carry and give birth to a child. The gynecologist must examine the cervix 4 times before birth. There are certain deadlines for this - week 20, week 28, week 32 and week 36. This, of course, is the case if the pregnancy is proceeding normally. But, if necessary, doctors can perform this procedure much more often.

Cervix: length during pregnancy

The cervix, like its length, is directly dependent on the duration of pregnancy:

from 10 to 14 weeks of pregnancy - size from 35 to 36 mm;
from 15 to 19 weeks – size from 38 to 39 mm;
from 20 to 24 weeks – 40 mm;
from 25 to 29 weeks – 41 mm;
from week 29 – reduction begins;
from 30 to 34 weeks – 37 mm;
from 35 to 40 weeks – 29 mm.

At approximately 36 weeks, the cervix begins to actively prepare for childbirth and its mission - to help the baby be born.

What is noteworthy is that in those women who have previously given birth, the length of the cervix will increase faster. For example, by week 13, the size of the cervix should be between 36 and 37 mm.

Cervix during pregnancy: what is normal

To determine the maturity of the cervix, there is a special scale developed by gynecologists and obstetricians.

Consistency. If the cervix is tight, 0 points are given. If it is slightly softened, but quite dense near the throat, then 1 point is given. If the neck is soft enough, then 2 points are given.
Length. If the length of the neck is more than 20 mm, 0 points are given. If the length is from 10 to 20 mm, then 1 point is given. If the length is less than 10 mm, then 2 points are given.
Location. If the cervix is located posteriorly relative to the pelvic axis, then 0 points are given. If the cervix is located anteriorly relative to the pelvic axis, then 1 point is given. If the cervix is located in the middle relative to the wire axis of the pelvis, then 2 points are given.
Patency. If the external pharynx is tightly closed and the finger does not pass through or the tip passes through with difficulty, then 0 points are given. If the pharynx is slightly open, but there is a slight seal, although the cervical canal may allow a finger to pass through, then 1 point is given. If the neck is smoothed more than 20 mm, but there is a possibility of penetration of more than 1 finger, then 2 points are given.

Pregnancy in the cervix

Sometimes, in very rare cases, the egg does not implant in the uterus, but descends into the cervix. Thus, one of the types of ectopic pregnancy occurs - cervical. This is a very rare pathology; among all ectopic pregnancies it ranks last and accounts for about 0.01% of cases of all other anomalies.

Doctors diagnose either a cervical pregnancy or a cervical isthmus pregnancy (if the embryo emerges from the cervix).

The cervix is not the place that is intended for bearing a child. Maximum, fetal development can be observed here up to 5 months - after which the elasticity of the cervix stops. A miscarriage occurs with large loss of blood. Deaths after such miscarriages are also common.

Pregnancy in the cervix: causes

Most often, such an abnormal pregnancy is possible if there are some problems - obstacles to the development of a normal state. Basically, this is a pathology of the uterus, as a result of which the egg cannot enter the uterus and “migrates” to the cervix, where the embryo attaches to the walls of the canal. Basically, the causes of cervical pregnancy are:

An abortion that was recently performed.
Caesarean section less than three years after.
Uterine fibroids.
Adhesions in the uterus (Asherman's syndrome).
Pregnancy through IVF.
Uterine abnormalities – congenital or acquired after surgery, trauma, etc.

Pregnancy in the cervix: symptoms and diagnosis

Cervical pregnancy is insidious because it is difficult to recognize. The symptoms of this ectopic pregnancy are quite vague: a state of “pregnancy”, spotting (from “smearing” to heavy bleeding), frequent urge to urinate (or any symptoms of bladder dysfunction). In principle, a woman does not feel anything extraordinary.

The diagnosis can be made by a doctor after mandatory laboratory and instrumental examination.

During a routine examination, the doctor may become suspicious if he sees an enlarged cervix. But if the pregnancy is cervical-isthmus, then the cervix may be of normal size.
The body of the uterus is not the size it should be at a particular stage of pregnancy.
The uterus is smaller in size than the cervix.
The cervix has a clear deviation.
The level of hCG in the blood is sharply reduced and does not correspond to the period of pregnancy.
An ultrasound shows the absence of an embryo in the uterus, an enlargement of the cervical canal, or an embryo that is visible in the lumen where the cervix is located.
An MRI shows a formation that has grown into the cervix.

Pregnancy in the cervix: treatment and consequences

Cervical pregnancy is a very serious pathology; currently only two types of treatment have been developed - radical (removal of the uterus) and organ-preserving.

The development of pregnancy in the cervix is fraught with severe bleeding, which can become a threat to the woman’s life, therefore, the sooner treatment is carried out, the better.

The simplest treatment method is hysterectomy. Doctors remove the entire uterus and give the woman a blood transfusion. However, this is not an option for many women who want to have children. In addition, the mortality rate after such operations is almost 50%.

Today there are three more organ-preserving techniques - conservative, surgical and minimally invasive surgical.

With conservative treatment, a number of measures are taken that reduce the supply of blood to the uterus, and also introduce toxic chemotherapy drugs for the embryo, due to which cell division and fetal development are inhibited.
During surgical treatment, sutures are placed on the cervix, then hysteroscopic resection and blockage of the arteries are performed (to make the work less dangerous), after which the laser destroys the place where the fertilized egg grows into the cervix and removes the elements.
In minimally invasive surgical treatment, the arteries are clipped (temporarily), then the fertilized egg is removed using vacuum aspiration and the cervix is tamponed with a Foley catheter.

It is worth noting that the most effective method is still radical, since with organ-preserving methods various complications are possible - from bleeding to progressive pregnancy in the cervix.

The consequences of this pathology depend on when the pregnancy was detected in the cervix, as well as what treatment method was used.

The sooner doctors detect cervical pregnancy, the better - there is a greater chance of treatment with a favorable prognosis. But if bleeding occurs or the period is quite impressive, then the prognosis may be very unfavorable, so doctors remove the uterus.

It is very important to choose a competent doctor who understands modern treatment methods - then there is a high probability of preserving the causative organ, and in the future - having children.

Short cervix during pregnancy

Another dangerous pathology that occurs during pregnancy is a short cervix. This physiological feature of the female body can provoke miscarriage or premature birth. This pathology is detected during an examination by a woman’s gynecologist, as well as during an ultrasound.

Why is a short cervix dangerous during pregnancy?

One end of the cervix opens the uterine cavity, and the other opens the entrance to the vagina, which is why it is very important that this organ copes with holding the child inside the woman for a certain time.

Sometimes women's cervixes are naturally short - 20 mm or less. Most likely, in this case we are talking about cervical insufficiency, so there is a high risk of miscarriage. Sometimes the cervix is shortened as a result of previous pregnancies, after abortions or curettage: due to scars, it simply loses the ability to stretch.

The short cervix, bearing the weight of the baby, can open at any moment. In addition, it, being deformed, does not always provide reliable protection against infections. And during childbirth there is a risk of cervical rupture. That is why, if a doctor identifies such a pathology, the pregnant woman is under his constant supervision.

Short cervix during pregnancy: what to do

If doctors diagnose a pregnant woman with a short cervix, they advise the woman to rest completely. If there are any hormonal disorders, then there is a high probability that doctors will prescribe medications to correct the condition. If the case is critical, then stitches may be placed on the uterus - temporarily, until birth. This procedure is performed strictly under anesthesia.
Doctors often prescribe an obstetric pessary for a short cervix - this is a ring that helps hold the cervix and prevents it from opening prematurely. Thanks to the obstetric pessary, the fetus will not exert such strong pressure on the cervix - the load will be slightly redistributed. By the way, doctors often recommend wearing a pessary for various other reasons that can lead to an involuntary miscarriage. The pessary is very elastic: it does not injure tissue and does not cause discomfort (although at first it is somewhat unusual to wear it).
Sometimes women refuse various additional measures and simply carry a child with a short cervix. Sometimes, indeed, both pregnancy and childbirth proceed quite normally, without complications. But such cases are the exception rather than the norm. Still, it is better to listen to the doctor’s recommendations so as not to pay too high a price.

Cervical erosion during pregnancy

Often a normal pregnancy is unexpectedly complicated by a disease such as cervical erosion. It is possible, of course, that it was there even before pregnancy, but there is a risk that erosion formed during it.

What is cervical erosion

Cervical erosion is a very common disease that occurs at any age. Erosion itself is a defect that occurs on the mucous membrane due to various external influences. For example, after an injury, inflammation, hormonal imbalance, oral contraceptives, etc. Often erosion is a consequence of infectious diseases such as gonorrhea, chlamydia, ureplasmosis, trichomoniasis, etc. Erosion is often a consequence of difficult pregnancy and childbirth, excess weight, and even improper douching.

What is noteworthy is that approximately 70% of women have experienced a disease such as cervical erosion.

Erosion can be true or pseudo (the second name is ectopia). True erosion is a very rare disease, so concepts are often substituted and ordinary ectopia is passed off as erosion. Basically, “erosion” means slight redness on the cervix, but true erosion is much more serious.

Signs of cervical erosion during pregnancy

Erosion can be detected during a routine examination by a gynecologist in the chair. In order for the diagnosis to be accurate, the doctor will take a scraping. Recently, women who are not pregnant are being referred for a colposcopic examination - it will allow a careful examination of the vagina and walls of the cervix.
But even before going to the doctor, a woman may feel that something is not right with her body. Signs of erosion are:

discharge - mixed with blood, especially abundant after sexual intercourse, douching or other mechanical impact on the cervix;
pain - during sexual intercourse.

But these symptoms are rare. If erosion is just beginning, then it may not manifest itself at all for a long time, and the disease will proceed without symptoms.

Treatment of cervical erosion during pregnancy

Today, experts do not advise young women who have not yet given birth to cauterize erosion, since after such a procedure a scar will form that will interfere with the dilation of the cervix during childbirth. Due to the scar, the cervix can tear and generally cause severe pain when dilated.

Non-pregnant women are advised to undergo laser coagulation - this is a safe and reliable modern method, which in all cases has proven itself to be positive. But still, doctors do not treat cervical erosion during pregnancy. Experts are sure that this is best done after childbirth.

Only if the extent of damage to the cervix causes alarm or its pathological changes are noticeable to the naked eye, then attempts are possible to revive the position and condition - in this case, treatment is selected individually.

Erosion does not affect the baby in any way, just as it does not have any effect on the pregnancy itself.

It will be necessary to cure the disease after your baby is born. By the way, sometimes cervical erosion after pregnancy can go away on its own - without treatment. But you shouldn’t hope for hope; be sure to consult a specialist.

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During pregnancy, the cervix should never be softened. It becomes soft and loose only towards the end of pregnancy. This indicates the body is preparing for childbirth. At earlier stages, the soft neck, gradually opening, smoothes out and loses its ability to hold the fetus. In this case, the amniotic sac partially passes into the cervix, which can lead to infection of its membranes, leakage of water and ultimately to a late miscarriage. That is why regular monitoring of the condition of this organ is very important. Softening of the cervix is a serious reason for hospitalization in a hospital, where the pregnant woman will be offered various treatment methods.

Drug treatment

If during the next examination the doctor discovered only softening of the cervix, this does not mean at all that the woman will not be able to carry the pregnancy to term. With such a change, a woman needs to spend as much time as possible in bed, not overexert herself and avoid nervous overload. In the case when uterine hypertonicity is added to a loose cervix, the observing gynecologist will most likely refer the woman for hospitalization in a hospital, where appropriate drug treatment will be carried out, namely: intravenous administration of various medications, taking pills, intramuscular. This calms the uterus and, in some cases, strengthens the cervix.

Installation of a pessary

Most often, the softness of the cervix is accompanied by its shortening. With this pathology, doctors say that the patient has cervical incompetence, which is fraught with late miscarriages at a period of 20 to 30 weeks. If a short and soft cervix is detected, the gynecologist may suggest placing an obstetric pessary. Simply put, a pessary is a special ring that secures the cervix, preventing it from opening prematurely, while reducing the pressure of the fetus on the cervix. This removes the threat of premature birth.

Installation of a pessary is a painless and quick procedure. It is usually removed at the end of pregnancy, after 37-38 weeks and always in the maternity hospital, since removing the pessary can provoke labor. The use of this simple device in most cases allows a woman to carry her pregnancy to term and give birth to a healthy baby.

Stitching the neck

Another way to preserve the desired pregnancy with isthmic-cervical insufficiency (as this pathology is correctly called) is a surgical operation to tighten the cervix with special sutures. The manipulation is carried out exclusively under anesthesia in a hospital setting. The favorable time for suturing when ICI occurs is 14-20 weeks. Before the operation, a comprehensive examination of the pregnant woman and preparation of the genital tract and uterus are required. Of course, like any surgical intervention, suturing the cervix can lead to complications or may not bring the desired result, but most often, with regular monitoring and control by a gynecologist, the prognosis for the birth of a full-term baby is quite favorable.

Every woman wants to be healthy, but women's health in the genital area is perhaps the most vulnerable place. According to statistics, various inflammatory processes in the cervix occur in every third woman of childbearing age.

This is facilitated by various infections and a woman’s lack of attention to her health, and simply ignoring a routine medical examination, because often such inflammatory processes are asymptomatic and can only be detected during an examination by a doctor.

Inflammatory processes in the cervix can be triggered by various reasons and occur in different forms. But all such pathological processes are united by one thing called "cervicitis".

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Causes of cervicitis

Causes of cervical inflammation can be very diverse. They lie in specific and nonspecific pathogens.

The most common causes of such inflammation are specific infections. These include: trichomonas, mycoplasma, chlamydia, gonococci and herpes.

All these pathogens enter the female genital area directly during sexual intercourse.

Less common factors that provoke cervicitis are nonspecific conditionally pathogenic microflora.

If detected untimely and at an advanced stage, such cervicitis can transform into chronic inflammation of the cervix. And it is already much less treatable.

Therefore, it is extremely important to carefully monitor your health, consult a doctor on time and undergo a medical examination even without any complaints in the sexual sphere.

Symptoms of cervicitis

Symptoms and signs of inflammation can be both pronounced and hidden.

If in doubt, consult a doctor

Signs of uterine inflammation the following:

Painful sensations in the lower abdomen. Such pains are predominantly aching and pulling in nature. They are similar to period pain. The severity of such pain depends on the individual characteristics of the female body, because everyone has a different pain threshold, and on the severity of the disease.
Discharge mixed with pus or mucus. Such discharge can also be strong or barely noticeable.
Pain when urinating.
Discomfort and pain during sexual intercourse.

Such signs of the disease can be detected by the woman herself. When examined by a doctor, an experienced doctor will visually determine the following: signs of uterine inflammation:

Redness of the cervix.
Loose cervix.
Swelling of the mucous membrane of the cervical canal.
Small ulcers and hemorrhages of the organ mucosa.

Important! Chronic inflammation of the cervix is characterized by less pronounced swelling. Also, the cervix is hyperemic. The discharge becomes cloudy in color, cylindrical tissues grow, pseudo-erosions form in the cervix, cysts appear at the site of the disease, and the cervical canal becomes denser.

The severity of the symptoms of this disease also completely depends on the pathogen that provoked the disease. This is how the disease caused by gonococci develops most violently and clearly.

In this case, all of the above symptoms will be very pronounced, and it is simply unrealistic not to notice the pathological process in the female body.

There will be pain and discharge and cervical hyperemia. Gonococci are the cause of a loose cervix.

But if the disease is caused by chlamydia, then the symptoms will not be so pronounced: they will be weak, or the disease may be completely asymptomatic.

They manifest themselves in the form of small ulcers and hemorrhages on the mucous membrane of the cervical canal.

If the pathology is caused by a herpetic virus, then upon examination a bright cervical hyperemia with many ulcers and mucosal hemorrhages.

Diagnostic methods

This problem can be diagnosed only by examination by a doctor and after all the necessary tests and manipulations.

First, you will need to be examined by a gynecologist, who can often visually see this problem.

After a visual examination using gynecological speculum, an experienced doctor will definitely prescribe additional tests: smear microscopy, bacterial culture, PCR.

In this case, the contents of the canal mucosa are taken and examined in detail.

The cytogram will accurately show the contents of the taken smear, detect pathogenic microflora, determine the presence or absence of inflammatory secretions, cancer cells, show the number of red blood cells and other blood cells (if any), and even accurately show the correspondence of the epithelium to the age characteristics of the woman.

It is best to conduct this study in the middle of the cycle, on days 14-15.

Attention! This study will accurately determine not only cervicitis, but also dysplastic cervical diseases, cancer and precancerous forms.

Treatment of cervicitis

If the disease provoked by infections, then treatment with sumamed, monomycin, maxaquin, erythromycin and other antibacterial drugs would be appropriate.

If the disease provoked by fungi genus Candida, then antibacterial therapy is not prescribed at all; it would be appropriate to take antifungal drugs such as Diflucan and its analogues.

Important! Self-medication for this problem is strictly prohibited. Only a doctor can select the necessary medications and develop a treatment regimen.

Inflammatory processes of this nature can be provoked and human papillomavirus. In this case, cytostatics and interferons are useful for treatment.

If the disease has already become chronic, then drug treatment may no longer give positive results.

In this case, the use of modern surgical techniques will be required. These include: laser therapy, cryotherapy, diathermocoagulation.

A prerequisite for effective treatment is the restoration of normal vaginal microflora, regardless of the causative agent of the disease.

Under no circumstances should you use traditional medicine to eliminate the disease yourself. In this case, they will not have any positive impact on this problem.

It is also important to remember that such a problem is much easier and faster to eliminate at the initial stage, when it has not yet become an advanced chronic form.

Prevention of cervicitis

Video: How to treat cervical inflammation

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loose uterus

Found (44 posts)

gynecologist November 24, 2009 / Nastya / Saratov

Back I had my last sexual intercourse, then I drank Escapelle. My stomach and chest hurt. I went to the doctor and said that uterus loose looks like she’s pregnant, and there’s a mass on the right side, she sent me for an intravaginal ultrasound - they said that she’s pregnant...

Surely every woman has heard the phrase “loose uterus,” which scares young and inexperienced girls. There's really nothing wrong with this. The uterus can become loose only in two cases: during the menstrual cycle or pregnancy.

Loose uterus and menstrual cycle

The menstrual cycle is the period of time from the start of one menstruation to the start of the next. A few days after the end of menstruation, the period of ovulation begins, during which it is very easy to fertilize an egg. It is during this period that the inner lining of the uterus becomes loose, as this contributes to the comfortable placement of the fetus inside it.

Loose uterus and pregnancy

Pregnancy is established through a detailed interview of the woman, a thorough examination, and also based on the results of certain tests. There is probably no need to talk about what pregnancy is, and we can go straight to the topic that interests us: a loose uterus during pregnancy.

During this period, a woman changes not only externally, certain changes also occur inside her body. In particular, this applies to the uterus, which increases in size, changes shape, becomes soft and loose. As noted above, this is necessary in order to provide the fetus with more comfortable conditions during its development.

Thus, we can conclude that the uterus is loose - this is a completely normal phenomenon during ovulation and pregnancy. Although sometimes looseness of the most important female genital organ can be a sign of fibroids. However, this happens quite rarely.