Gynecology

The state of the internal and external gullet of the uterus during pregnancy: what does their opening or closing mean?

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The waiting period of the child makes numerous changes to the body of a woman. One of these are oscillatory and periodic enlargements of the cervix of the cervix. The normal state of this part of the female body looks like a pale pink, friable tissue, after hormonal changes due to conception, it acquires a bluish tint associated with the increased blood flow of this area. The appearance of the cervix is ​​a very informative indicator for the gynecologist during the interesting position of the pregnant. The functionality of the inner throat is aimed at protecting the healthy development of the baby from infection from the outside. The overall course of the baby's waiting period can be assessed by the location, density and color of the muscle tissue, as well as by the normal indicators of the ductal flow.

If any changes are detected, such as softening of the mucous membranes or channel opening, the doctor usually prescribes diagnostic procedures and subsequent treatment in case of urgent need. According to generally accepted medical conditions, examination of the cervix is ​​performed at certain times, corresponding to approximately 20, 28, 32 and 36 weeks. If more frequent inspection procedures are required, then there are some problems, even if not significant, that force you to listen to the doctor's recommendations and to fulfill all his appointments. The most dangerous time to open the uterus is the first trimester, when the fetus is still very small and the possibility of miscarriage is quite high. Inadequate closure of the lower part of the cervix is ​​not always accompanied by hormonal changes inherent in pregnancy, sometimes the cause may be congenital pathological disorders of the uterine structure, causing isthmic-cervical insufficiency.

Symptoms preceding the opening of the isthmus

Signs of expansion of the lower part of the cervix differ in their manifestations, depending on the duration of pregnancy. Very often, this process is not accompanied by any pain or any other signals, which is extremely dangerous because it increases the risk of losing the fetus at times. Sometimes in the first trimester, pains in the lower abdomen of a cramping character may appear, informing about the increased tone of the uterus. Inadequate closure of the pharynx due to isthmic-cervical insufficiency (ICN) is characterized by periodic, but intense pain syndrome in the vaginal area.

With the ICN, the isthmus, which holds the fetus inside the uterine cavity, softens and relaxes so much that it loses its functional ability under the weight of the amniotic fluid. Clarification of the presence of this type of failure is carried out by a transvaginal ultrasound diagnosis method. Since the way to measure the duration of the uterine cervix, which should be in the normal range of 2-2.5 cm, is not entirely effective.

Istmico-cervical insufficiency, as the most dangerous herald of the possible opening of the internal orifice of the cervix. In addition to congenital pathology of the uterine passages, the ICN has two types of origin: functional, which happens with hormonal changes, in particular the increase in male androgens, and post-traumatic. The latter type develops after unsuccessful or frequent interruptions of pregnancy, as well as due to birth injuries and ruptures. In the early stages of the phenomenon of this diagnosis increases the risk of miscarriage is no less than in the middle or at the end of the period. At the beginning of the way of waiting for the baby, the risk of losing the fetus comes down to its small size and weakness of the muscles of the isthmus. But, starting from the second trimester and until the end of the entire pregnancy, cervical insufficiency is able to provoke miscarriage in another way. Through partial dilation of the cervix, infection of the amniotic fluid may occur with the development of the inflammatory process, which will inevitably lead to the threat of interruption or damage to the formation of certain functions or organs in the baby itself.

Possible methods of prevention and treatment with the threat of spontaneous abortion due to the disclosure of internal pharynx.

Prevention and treatment

Of the preventive precautions, the main ones are those that preclude an increase in uterine muscle tone:

  • Sexual rest with the exception of sexual relations until the end of the entire waiting period of the baby.
  • An anti-caffeinated diet with limited chocolate intake.
  • Restriction of stay in warm and stuffy rooms, as well as adherence to sunbathing.
  • Exception of overheating of the whole body in saunas, steam rooms and even hot baths.

From medical procedures, due to the inappropriateness of preventive measures, common:

  • Surgical intervention. If the diagnosis is established with absolute accuracy and is indeed the risk of abortion, the only way out is to hem the isthmus in order to avoid further stretching due to softening. Stitches are applied with non-absorbable material for a period of one and a half months until the end of the term, or more precisely, until 38 weeks are reached. Unfortunately, in some cases, this way of preserving the fetus may not work due to various reasons: from mother’s diseases to the pathology of pregnancy.
  • Install ring pessary. Mechanical impact, keeping the opening of the pharynx due to the strengthening on the cervix of a ring structure made of plastic or silicone, which has the name "Meyer's ring". The treatment period lasts from 20 to 38 weeks of pregnancy. The disadvantage of this method is the organic rejection of the details of the female body and an increased risk of infection of the fetus due to the foreignness of the material.
  • Drug treatment, expressed in intravenous-drip injections, is prescribed in the form of hormonal therapy, as well as medicines with a concentration of magnesium, vitamins and antispasmodic drugs.

Description of the internal os of the uterus during pregnancy

The uterus is connected with the vagina by the cervix, the inside of which is called the cervical canal. This narrow canal has two openings: one - before entering the uterus, the second - when leaving the vagina. Hole, which serves as a transition from the cervix directly into the genital organ, called the internal throat.

The functions of the extreme space of the cervical canal are to protect the uterus from the penetration of pathogenic microorganisms into it, retain the fetus in the uterine cavity, and protect the fetal bladder from infection. With the onset of pregnancy, the canal ring located at the entrance to the uterus acquires density, and the exit to the cervix is ​​completely fenced off.

Closer to the time of delivery, the cervix begins to soften, the cervical canal shortens, and the pharynx gradually opens. Normally, this process occurs at 36-38 week.

Outdoor pharynx: what is it?

The external pharynx is a hole located between the vagina and the cervix. It is the entrance to the cervical canal from the vagina. In the zone of the external pharynx, cells of different epithelia, cylindrical and flat, are in close contact.

In the normal state, this combination provides the aperture with the ability to stretch and recover. However, in violation of internal processes, this place becomes the epicenter of cell degeneration into a malignant tumor.

The external pharynx is palpable during a gynecological examination. In nulliparous women, it has the form of a closed ring. After giving birth, the hole takes the form of a flattened slot. The outer, or outer pharynx should be closed.

During pregnancy, its expansion begins during the preparation of the cervix for the birth process. According to its diameter, doctors determine the readiness of the uterus for childbirth. The most intensive opening of the external entrance to the cervical canal begins after an increase in the lumen of the internal os due to the pressure of the fetus on the cervix.

What should be normal pharynx during pregnancy?

Mucus forms between the vagina and the uterus, which creates additional protection for the uterus against the penetration of pathogenic microflora. Normally, both entrances to the cervical canal should be closed up to 36 weeks. The diameter of the outer and inner throat can reach 2-4 mm (after numerous deliveries, 6 mm is allowed.). The condition of the uterine lumen is checked during ultrasound at 11-14, 20-22, 32-36 weeks.

The external slit examines the gynecologist at 20, 28, 32, and 36 weeks. After 36 weeks, the cervix softens. In women who have not given birth, the passage to the cervical canal is about 0.5 cm open, and those who have given birth have a hole that opens up to about 1 finger. Full opening is diagnosed after reaching the external opening of a diameter of 10 cm.

What is dangerous disclosure of the throat?

The need to constantly monitor the state of the cervical openings is caused by the fact that the opening of the cervix often occurs without clear symptoms. A woman may experience slight discomfort and periodic contractions of the uterus. However, only a doctor is able to establish that this is connected with the opening channel.

Reasons for opening the throat:

  • natural preparation of the birth canal for the birth of the baby,
  • high levels of male hormones in the body,
  • increased pressure on the cervix during multiple pregnancies,
  • cervical insufficiency,
  • congenital abnormalities of the genital organs,
  • injury of the cervical canal due to abortions or gynecological operations,
  • progression of cervical erosion,
  • low levels of pregnancy hormone.

Disclosure of cervical openings in the last weeks of pregnancy indicates the imminent onset of labor. This is a normal process that does not pose a danger to the woman and the fetus. However, if the process starts well before the expected date of delivery, there is a risk of miscarriage or premature birth.

If the doctor diagnoses an increase in space when leaving the vagina, the expectant mother is sent for an ultrasound. With a normal internal opening, there is a high probability of a favorable outcome of pregnancy without the use of radical measures.

Treatment of throat opening

Therapy for cervical dilatation is aimed at slowing down the process of expanding the opening and preserving pregnancy. The treatment regimen depends on the severity of the process and the gestation period at which the pathology is revealed. A woman is sent to a hospital where one of the treatment methods is used:

  • medicamentous
  • overlay support structure
  • surgical.

Drug treatment involves hormonal drugs, antispasmodics and vitamins. The most popular hormonal drugs in pregnancy are Utrozhestan and Duphaston. When identifying the threat of abortion, the doctor prescribes an increased dose of medication.

The minimum time for taking a large dose is 7-14 days. After the expiration of this time, ultrasound is performed. If the cervix does not shorten and the opening process has stopped, the doctor may reduce the dose of the drug. In most cases, hormonal therapy continues until the last month of pregnancy. Sometimes hormones are needed right up to the birth.

Antispasmodic drugs are used to reduce the sensitivity of the uterus and cervix. The tension of the uterus relieve spasmalgon, No-shpa, papaverine. Medicines prescribed in the form of injections, droppers, tablets and suppositories. Drugs are canceled when uterine tone is eliminated. Vitamin complexes are used as maintenance therapy.

Identification of pathology leads to the fact that the woman begins to experience nervous tension. To eliminate stress, it is recommended to drink sedatives.

Drug therapy is appropriate if a partial opening of the external pharynx is diagnosed. Pathology of the internal opening and a significant increase in the external require the use of a special design or suturing the isthmus of the cervical canal. Features of the techniques are described in the table.

  • treatment of the vagina with dysbacteriosis warning drugs,
  • hormonal drugs
  • the rapid spread of infection not detected before surgery
  • material allergy
  • increased uterine tone,
  • immune rejection of foreign tissues,
  • cervical damage if labor begins before the suture is removed
  • treatment of the vagina with antiseptic agents for 7 days,
  • strict bed rest for the first 5 days after surgery,
  • use of antispasmodic drugs.

Regardless of the method of treatment chosen, it should be remembered that the inner and outer lumen cannot completely close. If the lumen is open, it is impossible to return it back to its original position. However, the use of therapy helps to avoid the situation when the hole opens completely before the fetus becomes viable.

Preventive measures

To predict all possible complications during pregnancy is impossible. In order to reduce the risk of premature onset of the labor process, it is necessary:

  • Planning a pregnancy with a gynecologist. A woman should undergo a full examination, cure gynecological pathologies and give up bad habits.
  • Avoid abortions. Eliminating unwanted pregnancies involves interfering with the natural physiological process. As a result of abortion, hormones are disturbed and the genital organs are injured. The risk of miscarriage increases when you first try to carry a child over the age of 25 years.
  • Time to become a medical account. Early registration allows timely identification and elimination of pregnancy pathologies.
  • Maintain a normal weight. Excessive weight when carrying a baby leads to an increase in the load on all organs and systems and a change in the hormonal balance.
  • During pregnancy, refuse to visit saunas.
  • Avoid stress.
  • To adhere to the schedule of planned visits to the gynecologist and recommendations for the ultrasound.
  • In identifying the threat of abortion, clearly follow the instructions of the attending physician.

If during the first pregnancy the woman found ICN, then with repeated gestation there may be a threat of miscarriage. Those who have been diagnosed with this diagnosis are recommended to use the pessary. When carrying out it is necessary to completely abandon sexual intimacy and reduce physical exertion.

What is the cervix?

This is a kind of connecting tube between the uterus and the vagina about 3-4 cm long, and about 2.5 cm in diameter. At the cervix, there are two parts: the lower and upper. The lower part is called the vaginal, because it goes into the cavity of the vagina, and the upper part - the supravaginal, because it is located above the vagina. Inside the cervix passes the cervical canal, which opens into the uterus with an internal throat. Outside, the surface of the cervix has a pinkish hue, it is smooth and shiny, durable, and from the inside - bright pink, velvety and loose.

Cervix after conception

During pregnancy, a number of changes occur in this organ. For example, a short time after fertilization, its color changes: it becomes bluish. The reason for this is an extensive vascular grid and its blood supply. At the same time cervical glands dilate and become more branched.

At 9 months of pregnancy, the doctor notes the softening of the tissues of the cervix and its "maturation". Such changes in the body of a pregnant woman indicate readiness for the birth of a child. Immediately before childbirth, the cervix is ​​shortened (to 10-15 mm) and is located in the center of the pelvis. According to the opening of the cervical canal, an obstetrician-gynecologist determines the approach of labor, which begins with the expansion of the internal pharynx and contractions.

Cervical rate during pregnancy

For 9 months, the woman is forced to visit the gynecologist often. In the best option, that is, with a healthy pregnancy without complications, at least 9-12 times. If there are health problems or the risk of miscarriage, then this number may be several times greater.

On the first examination, the doctor finds the cervix and determines its shape, size, consistency, location. In normal pregnancy, the cervix is ​​dense to the touch and tilted back, while the channel is not passable for the finger. If there is a threat of spontaneous miscarriage, the doctor will determine this by a shortened and softened cervix, and the channel opens.

Periodic visits to the gynecologist will allow time to recognize the pathology or disease and take the necessary measures. During examinations, the doctor takes tests: a smear on the flora (this analysis will help determine the inflammatory process, detect some types of infection (fungal, candidiasis, gonorrhea, trichomoniasis, bacterial vaginosis) and cytological examination (thus studying the structural features of the cell surface and the cervical canal, which makes it possible to identify various oncological diseases at the earliest stages).

As a rule, if at first a woman has no cervical pathology, a planned study of the condition of this organ is carried out at 20, 28, 32, 36 weeks of gestation. Если же отмечаются какие-либо нарушения, то обследования проводят чаще. Некоторые изменения состояния шейки матки, а также характер выделений могут свидетельствовать о возможной угрозе прерывания беременности. Принятые вовремя меры позволяют сохранить беременность.

Опишем наиболее распространенные заболевания шейки матки, которые могут существенно повлиять как на течение, так и исход беременности:

Истмико-цервикальная недостаточность во время беременности

This is a pathological condition of the cervix in which the muscles in the area of ​​the isthmus of the uterus is not reduced. At the same time, the cervix opens before time, which causes the impossibility of holding the fetus. Recall that in a healthy pregnancy, the cervix is ​​tightly closed. Having no support, the fetus gradually descends, ancestral activity develops and miscarriage occurs. For isthmic-cervical insufficiency, late miscarriages occurring between 20 and 30 weeks of gestation are most relevant. In some women, premature cervical dilatation may be accompanied by stabbing pain in the vagina, while in others it may be asymptomatic.

Most often, the ICN develops due to underdevelopment of the uterus and hormonal disruptions, but also among the causes of its occurrence are the following:

  • Congenital disorders of the structure of the neck with a deficit of connective tissue fibers and a relative increase in the proportion of smooth muscle tissue.
  • Congenital cervical hypoplasia.
  • Trauma of the isthmus and cervix during abortions, delivery of large fruit, the imposition of obstetric forceps.

Cervical endocervicitis

Often this disease - inflammation of the cervical canal - causes spontaneous abortions and premature births. In this case, an increased amount of mucus is secreted from the cervical canal, the site of inflammation is scarlet. As a rule, the causes of endocervicitis are sexually transmitted infections, streptococcus, staphylococcus, E. coli, enterococcus and other similar diseases. The most characteristic symptoms of this disease are copious discharge with an unpleasant odor.

Cervical erosion during pregnancy

Erosion implies a pathological condition in which sores form on the cervix, that is, damage to the integrity of the outer surface of this organ is observed. Inflammatory diseases of the cervix, most often caused by HPV, hormonal disorders, injuries from the use of barrier and chemical contraceptives, can provoke erosion. The wound itself in a few days is delayed, but the problem is that it does not overgrow with the cells that cover the outer surface of the cervix, but with others lining the internal mucosa of the cervix. During pregnancy, erosion does not touch, and treatment is left for the postpartum period.

The cervix during pregnancy is an important organ, both anatomically and functionally. Remember that it contributes to the process of fertilization, prevents the infection in the uterus and appendages, helps to "carry" the fetus, participates in childbirth. That is why monitoring the state of the cervix while carrying a baby is simply necessary.

Especially forberemennost.net - Ksenia Dakhno

What is a uterine mouth?

Uterine pharynx is the upper and lower cervical openings. The upper opening leading to the uterus is called the internal uterine throat, the lower opening leading to the vagina is called the external uterine throat. The latter can be palpated manually. If a woman has not yet had a single pregnancy, then the uterine mouth has a cross-oval shape. After pregnancy - the shape of the transverse slit.

Gestation during pregnancy and childbirth

During pregnancy, both the inner and outer uterus are closed. This prevents the entry of pathogenic microbes into the uterus, which can lead to the development of infection. With the onset of the labor process, contractions intensify, the uterus opens and the uterine throat changes: it shortens and becomes soft. Then the internal uterine pharynx opens. Next comes the opening of the outer throat. When it expands to about 10 cm, the so-called exile period begins.

Uterine pharynx and natural family planning

So, the uterine mouth plays an important role during pregnancy and childbirth. If the pregnancy has not yet arrived, but is planned, the uterine shed will help determine the fertile period. During the cycle, the position, elasticity and opening of the pharynx change. The study of uterine throat is similar to the method of studying cervical mucus, when the discharge is examined to determine the best days to conceive. However, each of the two methods, used separately, does not have high reliability. It is advisable to use them in combination with the temperature method. More information about this can be found in the articles “Temperature Method” and “Symptothermal Method”.

How does the uterine mouth

After menstruation, the uterine pharynx is closed and protrudes far into the vagina, which makes it easier to probe. It feels like a cherry or a nose tip cartilage. As ovulation approaches, the uterus mouth becomes softer and its opening expands. At the same time, he changes his position and moves back 2–3 cm - during this period it is difficult to probe. In this state, it feels more like an earlobe or a lip. In general, it can be assumed that the days favorable for conception, come when the mother sack is the softest and most wide open.

The chances of conceiving during this period are especially great, since sperm can easily penetrate the uterus. After 1-2 days after ovulation, the uterus mouth begins to close again and becomes harder.

How to investigate the uterus?

It is better to start the study immediately after menstrual bleeding, when the uterus is easy to feel. To ensure that the results were as successful as possible, it is worth conducting the survey under the same conditions. Here are some things to consider:

  • examine the uterine mouth every day,
  • before the procedure, be sure to wash your hands with soap,
  • the bladder must be empty
  • use the same finger as much as possible and ensure that it is clean,
  • it is desirable to use the same position, for example, by raising one foot on the side of the bath or lying down with one raised leg,
  • if you can not feel the uterine pharynx, you can try to move the uterus lower, pressing on the lower abdomen,
  • Records should be made of probing the pharynx to simplify follow-up examinations. For this you can, for example, use the cycle calendar on the My Child website.

At the beginning, such studies can, of course, cause some personal rejection, and it will take at least 2 cycles before the woman succeeds in interpreting the changes of uterine pharynx correctly. But as soon as the process gets better, studies of the uterine throat in combination with the temperature method can be a good help in natural family planning.

Other articles on the topic: "Uterine pharynx"

The length, condition of the internal os uterus. We understand what and how

The length, condition of the internal os uterus. We understand what and how

Not all women know thoroughly, but also to remember their anatomy. Especially when it does not concern them during the natural course of life. However, with the onset of such a beautiful and long-awaited nine-month pore, called pregnancy, issues related to female anatomy become more relevant, each time causing more and more interest. And the value of this interest is directly proportional to the number of visits to the doctor, followed by passing tests and passing ultrasound and other mandatory examinations.

Where is it

Such a concept as the inner throat of the uterus, often appears in the records of the observations of the gynecologist and the results of ultrasound. And worried and dubious future moms are worried about the lack of understanding of the situation, frantically searching for answers to questions on the vast expanses of the Internet.

The uterus, a hollow (empty, free inside) organ consisting of muscle tissue, which gives it the ability to contract at the onset of menstruation and childbirth, pushing the fetus. Its lower part, located at the bottom of the pelvis, is attached directly to the vagina. Between the uterus and the vagina there is a tubular "passage", whose length is about three to four centimeters and approximately two and a half centimeters in diameter. This “passage” is called the cervix. The cervix is ​​divided into two parts: the vaginal - the one that is connected to the vagina and the supravaginal, which is connected above its border, directly to the uterus. Inside the cervix itself is the cervical canal, which goes into the uterine cavity. On the border of the uterus and cervical canal is the inner throat of the uterus. In normal condition, the internal pharynx is closed. It opens only in two cases: during menstruation and childbirth. Sometimes there is a congenital anomaly of the internal os, when it is constantly open - an “unnatural” discovery. Also, this phenomenon can be abortions.

Dimensions and condition during pregnancy

In principle, upon the occurrence of pregnancy, the most important and crucial task is assigned to the internal pharynx: a protective one that covers the fetus from external influences.

During inspections, his location, condition, and density are taken into account. Normally, his condition is checked at the twentieth, twenty-eighth, thirty-second and thirty-sixth weeks.

The dimensions characterizing the internal opening of the uterus, in particular its diameter, is a very important and necessary indicator for early detection of cervical weakness and timely making the right decisions that can affect the positive outcome of pregnancy.

On average, the size of the width of the inner throat, starting with the tenth and ending thirty-sixth week, do not undergo any significant changes.

Protrusion of the membranes and cerclage

However, sometimes there are some protrusions of the membranes - a slightly dilated cervical canal. If this happens, which is detected by ultrasound, the inner pharynx of the uterus does not have to be changed or ajar. Such a kind of "hernia" can be formed in its normal state. So, with the appearance of such a picture, regardless of the state of the internal uterine pharynx, a procedure is presented that represents suturing the cervix in order to prevent its premature disclosure and delivery. Even with the increase in the diameter of the pharynx higher than six millimeters, there are already grounds for gynecological correction.

Such a mini-operation is called a cerclage. Usually it is carried out strictly on urgent testimony, in the period from the sixteenth to the twenty second week. With the beginning of labor activity, which occurred on time, such stitches are removed very simply and do not pose any danger and problems for the woman, both during pregnancy and after it.

Changes in the structure and width of the cervix

Interestingly, the structure and width of the cervix changes as the term of labor approaches. If at the beginning of pregnancy it was a cylinder, then by the thirty-first week it takes the form of a cone. Moreover, the size of its diameter at the level of the internal pharynx is larger than in the middle part. And this picture persists until the end of pregnancy.

With the onset of the third trimester, the length from the placenta to the internal os, with a normal pregnancy, should be more than six centimeters. If the figures do not correspond to and much less, then this may indicate a too low attachment of the placenta, which does not allow the inner sores to open fully. And if the placenta has blocked the inner throat of the uterus, then this indicates its presentation.

Mandatory inspections

In any case, all designated examinations and procedures should be attended. You should not be afraid or invent various outcomes of events, having seen completely unfamiliar numbers and symbols in the exchange card. Ask everything from your doctor and only from him. On the web resources you are unlikely to find the answers to your questions. They can give you only an obstetrician-gynecologist.

The state of the internal os uterus during pregnancy

Hello Tatiana! Please explain the situation: an ultrasound was performed at 18 weeks of pregnancy. The development of the fetus is normal, only the conclusion of the ultrasound scanner was alarmed: "Minor dilatation of the internal os". The protocol says: "Internal pharynx: cervical length 59 mm (total length), CK dilated to 7 mm, to a depth of 21-22 mm, a closed portion of the cervix 34.5 mm." The doctor-uzist said to observe physical and sexual peace. The gynecologist observing my pregnancy did not pay attention to the conclusion about the expansion of the internal os. Still, at 10 weeks a colposcopy of the cervix took place and a cervical polyp was found. Can it expand because of it? And I’m worried, I’ve already read a lot about ITSN and how it threatens. Tell me, what are my next steps? I am also worried about tingling in the vagina.

  • Added by:
  • Pathology and abnormalities

The cervix has the important function of keeping the fetus in the uterus. Up to 37 weeks she is normal in the closed state, and after this period begins to be prepared for childbirth. In addition, a closed cervical () channel to some extent prevents the penetration of infection to the fetus.

Cervical Length and ConsistencyNormally, during the entire pregnancy, the neck is dense in consistency, its average length is 3-4 cm (it may be slightly shorter in multipar women).

These are the characteristics that make it possible to perform the main function? retention of the fetus. After 37 weeks (the period from which the pregnancy is considered full-term), structural changes begin to occur with the neck: it softens, shortens, occupies a central position, begins to open slightly. These changes are necessary in order to form a single channel with the body of the uterus. During childbirth (during the first period), it gradually opens up to 10-12 cm. And then (in the postpartum period) it gradually returns to a near-pregnant state (the outer shed of the cervix becomes slit-like, and in those who have not given birth, it is spot).

Measurement of the cervix can be done in two ways:

  1. When an obstetrician-gynecologist determines all the main characteristics (length, density, position relative to the axis of the pelvis, the condition of the external os,). It is carried out at each examination on the gynecological chair to assess the dynamics of changes.
  2. Ultrasound examination (ultrasound): you can determine the length, condition of the internal and external pharynx, as well as the cervical canal itself (which is very important when there is a threat of premature birth).

Pathology and abnormalities

Information The most common pathology is a short cervix during pregnancy - isthmic-cervical insufficiency (ICN).

With ultrasound, the ICN is taken as the neck length less than 25 mm. Another criterion is the funnel-shaped expansion of the internal os (which normally closed).

The causes of ICN are cervical trauma in previous births, after abortions, and after cervical treatment (). In this case, the neck can not perform its functions, there is a threat of premature birth. It can also lead to habitual miscarriage. Diagnostics is based on ultrasound data (cervicometry is performed - measurement of the cervix and assessment of the condition of the internal throat). When shortened to 25 mm or less, the suture is performed on the neck, or the unloading obstetric pessary is set.

Additionally The opposite problem is cervical immaturity in full-term pregnancy. It is caused by a violation of the formation of a generic dominant (for example, with fear of childbirth), as well as anatomical features, or after interventions on the neck (it becomes poorly extensible).

The degree of maturity of the cervix is ​​scored according to a number of signs, which is presented in the table.

Being in search of information on how to conceive a girl, I also learned about that will help in planning my son. I hope someone will find this useful. read more

Cervix during pregnancy

The cervix is ​​a kind of muscle ring that ends the uterus and joins the vagina. Its length is about a third of the entire length of the uterus, it has a small hole - the uterus opening (cervical canal) through which the menstrual flow comes out.

Sperm cells for fertilization of the egg in the fallopian tubes penetrate the uterus also through this opening. The pharynx of the uterus is covered with a mucus plug, which is pushed out during orgasm. In women who have not given birth, the shape of the cervix is ​​different from those who have given birth. In those who have given birth, it is round or has the shape of a truncated cone, while for those who have not given birth it is flat, wide and cylindrical. After an abortion, the shape of the cervix also changes, so it is not possible to fool the doctor. Determine the shape of the cervix, its consistency, size, condition of the external opening, the throat edge, the degree of opening of the throat, the degree of maturity can be with vaginal examination. Then usually carry out inspection with a mirror.

Maturity of the cervix is ​​determined by a special scale:

1. Cervical consistency: 1 point - Softened, but 2 points compacted in the internal pharynx - Soft 3. Location of the cervix relative to the wire axis of the pelvis: 0 points - located in the back 0 points - Outer shed is closed, the end of the finger passes 1 point - The cervical canal misses 1 finger, but the seal in the internal pharynx gropes for 2 points - It misses more than the 1st finger, with the smoothed neck more than 2 cm All women know how their sexual system works. At least approximately have an idea of ​​the functions of the uterus, vagina and ovaries. But they know little about the cervix. Этот женский половой орган имеет большое значение при зачатии, в период беременности и при родах. Только внешне осмотрев шейку матки доктор легко сможет определить делала женщина аборт или нет, рожала ли она, через сколько у нее наступят месячные.

Шейка матки во время овуляции

В период овуляции шейка матки становится более мягкой, влажной и эластичной, потому что в цервикальном канале разжижается слизь. Выделяется слизь в больших количествах, а это служит помощью сперматозоидам при передвижении к яйцеклетке. The opening of the cervical canal opens and the cervix itself rises upward. As soon as ovulation is completed, the cervix descends, it becomes hard, and the external pharynx closes. Cervix and pregnancy During the entire pregnancy of a woman, the cervix changes significantly. When pregnancy occurs, the color of the cervix becomes bluish, its glands dilate and become much branched. In the early stages of pregnancy, bleeding and widening of the internal os is a very dangerous sign, abortion is most likely not to be avoided. By the end of pregnancy, the cervix matures and softens, this indicates the readiness of the body for the birth of a child. Immediately before the birth of a child, the neck is in the middle of the small pelvis, its length is 10-15 mm, its canal opens to 5-10 mm. The cervical canal passes into the lower segment smoothly. Expansion of the internal canal and colicy pains speak about the onset of labor activity. The neck during childbirth expands to 10 centimeters in diameter. This allows the child to pass through the birth canal. It happens that during the progress of the cervix is ​​torn. This can occur for various reasons - weak labor, rapid delivery, large fetus, surgery on the neck, ruptures during previous births. If a rupture occurs, the doctor will suture. If you do not notice the gap or poorly suture it, then in the next pregnancy problems arise - miscarriage or premature birth.

short neck, 23 weeks. Pregnancy and childbirth

Hello. I have a period of 23 weeks, recently put a pessary. Data from ultrasound to its installation: 23 mm, mouth closed - 32 mm, mouth closed - 26 mm, V-shaped opening (the last two are made with an interval of less than a day, the difference is likely due to different devices and doctors). After installing the ultrasound (did the same where 26 mm before it was) showed 20 mm and a U-shaped opening of 7 mm. Control next week - they said, the main thing is to observe the dynamics. Prescribed candles for sanitation + Utrozhestan and.

In this case, I was implanted both times and released until 38 weeks.

Well, be careful there and lie more - they said. medication did not add anything else :)

68th day in the hospital. Medikolga's blog on 7ya.ru

I wrote this on October 3rd, because I just wanted to express myself somehow. Now I am sure that this can support more than one girl. Today is the 68th day I am in the hospital. Fortunately not in a row :-). This is the third time. and ends the third week. And when they write out is still unknown. Today, on examination, the doctor said that if I strongly ask, then maybe next week they will let me go home to rest. Doctors are afraid to leave me unattended, and before giving birth almost another two months.

low placenta recommendations. Pregnancy and childbirth

Good day! set low placentation at 20-21 weeks, 20mm. The ultrasound doctor said without limit in every sense, will rise. I know what rises on average (with the older child there was even a presentation). The doctor in the LCD is almost hysterical, urgently in the hospital. Now, has something changed in practice? Yes, there is no tone, etc. I wrote a waiver, but the "cockroach" settled down. What do you think?

Pregnancy after cervical treatment

Previously, it was believed that such procedures as loop electroconization of the cervix, cryotherapy and other methods of treating precancerous conditions of the cervix, lead to problems with the possibility of becoming pregnant in the future. American researchers at the head of Allison Naleway (Allison Naleway) proved that the treatment of precancerous diseases of the cervix does not harm childbearing and future pregnancy. For 12 years, researchers have monitored the condition of about 100,000 women, some of whom have undergone.

Uzi in 15 weeks. good and not so good. Pregnancy and childbirth

The girls visited the first ultrasound! The term was increased by 2 weeks, total 16 week began. As I was afraid not to put it into words, because there is almost no belly, but everything is fine with the baby. KTR-88,8. TVP-2.2 mm. , HR - 147 beats. They gave me a picture of myself constantly. Of the not so good: hypertonus of the posterior wall of the uterus, the chorion is low on the back wall, the lower edge reaches the internal pharynx. And the main thing is the neck. The length is 40.0 mm, the width “C” of the channel is 0.1 cm. The doctor did not focus on this, only the direction was given.

ICN :(. Pregnancy and childbirth

Girls who have a positive experience? In the internet, nothing good. The doctor watching seems calmly to the result of the ultrasound has reacted. But today at the day hospital they said that I had to be put in the maternity hospital: (Medication was prescribed for the time being: pills, candles, injections, droppers, physio. I try to stay positive. But I want to know that this is not a sentence!

I report. Pregnancy and childbirth

Um .. sales ne no where to start. I am glad that we are developing in time, the BPR is 52mm, OCh 165mm, DB 37mm (do not ask what it would like to know, but it is written that it corresponds to the date) Weight 450g, HR 142 beats / min, rhythmic. With placenta identity, everything is normal. It is bad that the head is very low, a great threat, the neck is shortened to 30 mm, the internal pharynx is not visualized due to the low location of the head ..

about the disclosure. Pregnancy and childbirth

explain to me, pliz. they say opening up so many fingers or so many see this one and the same thing. 2 fingers and 2 cm. I arrived in rd with 2 fingers, and after 5-6 hours of labor there were only 4 cm. It's like. and more - how to help the disclosure. Well, it is clear that it is better to walk than lie. and there are some other ways?

My placenta closes completely forehead

What to do? yesterday she was on ultrasound she said, the baby is developing well, but the placenta completely closed the front shed, that is, if it is for a long time, it will be a presentation. Now said to be watched. And what can not change anything? And she can then move as it should? and in general what does it mean that I cannot have sex now? And if on a long term there will be a presentation of what? Caesarean? Tell that. Please, who did this end what? 13 weeks to us.

Opened by the cervix. Pregnancy and childbirth

Hello! Maybe, who knows, tell me what is fraught with. My sister is about 25 weeks old. Uzi showed the opening of the cervix by 0.8 cm. As far as I understood from the side of the uterus, it is still closed outside. They lay down to save. At the moment, forbidden to walk, just lie down. I asked whether to sew. She was told that no, allegedly stitches impose up to 17 weeks. Tell me what they are doing in this case, I have no information.

ultrasound for a short cervix. Pregnancy and childbirth

I'm going to Art Med tomorrow, I can't wait until April 12th. I had to hang on to Shvets, no one had more free time. I wrote yesterday-the day before yesterday about the short neck (1.5cm). What should I say to the doctor and how will he look in reality is it short? and how is it going with me? What tomorrow's ultrasound will give me, otherwise I’m as usual a brake, I’ve been reading for a day now it became scary. In short, how to look at the short neck? although I'm going for just an ultrasound, but at the moment the main thing is not to give birth.

Two questions. Including about the neck .. Pregnancy and childbirth

1. And do kids move more as they get longer? More often? Stronger? That is, how is it felt? I just to know. It was my day ago that they slept (I wrote a poster here), but today they’ve been dabbling for a whole day, not much, but obviously they’re not sleeping. 2. About the neck. So far I have everything in order with her. But still somewhat frightening experience of girls, who suddenly happened to open. The stump is clear that as long as everything is normal, the doctors will not do anything. But I still lead an active lifestyle (as long as nothing interferes).

Symptoms of cervical dilatation. Pregnancy and childbirth

Tell me, what are the symptoms when opening the cervix (not before childbirth, but during pregnancy). And then, because of this symphysitis, it starts to hurt me everywhere there periodically, I don’t know whether this vagina or the bones are there, it’s all there. In short, the cockroaches began to swarm in my head in full :)

We were told at the courses, although, of course, everything is very individual, but there is something to be defined. If there is a tingling sensation with a needle in the depths, in the place where, according to your calculations, the neck is now, this may well mean that it is slowly preparing and softer for opening. It’s as if they poke a needle there, not painfully, but rather, unexpectedly. Once and there it was.

If all this is simultaneously accompanied by a divergence of the pelvic bones (lower back, thighs ache), then this, from experience (not statistics, I mean!), Most likely means that the whole process started there, and the uterus is also preparing.

Well, in childbirth is easy. As a rule, the disclosure of 7-8 cm corresponds to the frequency of contractions of 1.5 minutes with an interval of 3-5 minutes.

cervical length. Pregnancy and childbirth

Girls. Tell me, are there any rules for this? I have 23 weeks, did an ultrasound: there is no tone, the inner pharynx is closed, the neck is 32 mm. Maria MM writes that the neck is a bit short. And who remembers, at this period who as it was? I have problems with male hormones, I drink dexamethasone. Perhaps these things are related. Maria Maria also writes that you need to follow the neck. How is it? Do often ultrasound, or look at the chair? On the armchair the same length is not visible, only the disclosure (pah pah pah, God forbid) can see?

Destroy the myths about pregnancy, childbirth and children. Part 3

About childbirth Myth number 5. Childbirth is the biggest pain that can only be and lasts up to 24 hours! There are many myths about genera, but they all usually talk about how it is impossible to hurt, how hard it is to survive, and how we, women, have not been lucky in this life. I must say that my birth was not so smooth and calm as pregnancy. But even so, I can refute this myth! So, in order ... It all started on April 5 somewhere around 8 in the morning. Husband left on.

Why do children of the first days of life die? One of the most.

All 9 months you have a baby growing under your heart, which is surrounded not only by your love and caress, but also by reliable protection from amniotic membranes and amniotic fluid. The fetal bladder forms a sealed tank with a sterile environment, thanks to which the child is protected from infection. Normally, rupture of the fetal membranes and rupture of amniotic fluid occurs before delivery (when the cervix is ​​fully opened) or directly during the birth process. If the integrity of the bubble has been broken before, it is.

11. Does the doctor always, with the examination, with certainty make a diagnosis of premature discharge of water?
With a massive break a diagnosis is not difficult. But, unfortunately, in almost half of the cases, doctors even at leading clinics doubt the diagnosis, if they rely only on examination data and old research methods.

12. Is it possible to diagnose premature outpouring of waters using ultrasound?
Ultrasound examination makes it possible to say whether a woman has oligohydramnios or not. But the cause of oligohydramnios can be not only the rupture of fetal membranes, but also impaired renal function of the fetus and other conditions. On the other hand, there are cases when a small rupture of the membranes occurs against the backdrop of polyhydramnios, for example, in the pathology of a pregnant kidney. Ultrasound is an important method of monitoring the condition of a woman who has had a premature rupture of the membranes, but does not answer the question of whether the membranes are intact.

13. Is it possible to determine the leakage of water using litmus paper?
Indeed, there is such a method for determining the amniotic fluid, based on the determination of the acidity of the vaginal environment. It is called the nitrazine test or amniotest. Normally, the vaginal fluid is acidic and the amniotic fluid is neutral. Therefore, the penetration of the amniotic fluid into the vagina leads to a decrease in the acidity of the vaginal environment. But, unfortunately, the acidity of the vaginal environment is reduced in other conditions, such as infection, ingestion of urine, semen. Therefore, unfortunately, the test based on determining the acidity of the vagina gives a lot of both false positive and false negative results.

14. In many antenatal clinics take a smear on the water, how accurate is this method of diagnosis of premature discharge of water?
Vaginal discharge, containing fetal waters, when applied to a glass slide and dried, forms a pattern resembling fern leaves (fern phenomenon). Unfortunately, the test also gives a lot of inaccurate results. In addition, in many medical institutions, laboratories work only during the day and on weekdays.
15. What are the modern methods of diagnosis of premature rupture of the membranes?
Modern methods of diagnosis of premature rupture of the fetal membranes are based on the identification of specific proteins, of which there are many in the amniotic fluid and are normally not found in the vaginal fluid and other body fluids. For the detection of these substances develop a system of antibodies, which is applied to the test strip. The principle of operation of such tests resembles a pregnancy test. The most accurate test is a protein detection test called placental alpha microglobulin. The commercial name is Amnishour (AmniSure®).

16. What is the accuracy of the Amnishur test?
The accuracy of the test Amnishur is 98.7%.

17. Can a woman put Amnishur test on her own?
Yes, unlike all other research methods, the test of Amnyshur does not require examination in mirrors and a woman can put it at home. All that is needed for the formulation of the test is included in the set. This is a tampon, which is inserted into the vagina to a depth of 5-7 cm and held there for 1 minute, a test tube with a solvent in which the tampon is washed for 1 minute and then the test strip, which is inserted into the test tube, is ejected. The result is read after 10 minutes. In the case of a positive result, as in the pregnancy test, 2 strips appear. With a negative result - one bar.

18. What to do if the test result is positive?
If the test was positive, you must call an ambulance or go to the maternity hospital if the gestation period is more than 28 weeks and to the gynecological department of the hospital if the pregnancy is less than 28 weeks. The sooner the treatment is started, the more chances to avoid complications.

19. What if the test is negative?
If the test is negative, you can stay at home, but at the next visit to the doctor, you need to tell about the troubled symptoms.

20. If more than 12 hours have passed from the moment of the supposed rupture of the membranes, is it possible to put the test?
No, if more than 12 hours have passed since the supposed rupture and the signs of water have stopped, then the test may show an incorrect result.

Questions and answers about premature amniotic fluid leakage

1. How often does premature rupture of membranes occur?
A true premature rupture of the membranes occurs in approximately every tenth pregnant woman. However, almost every fourth woman experiences certain symptoms that can be confused with premature rupture of the membranes. This physiological enhancement of vaginal secretion, and a small incontinence in the later stages of pregnancy and abundant discharge during infection of the genital tract.

2. How does premature rupture of membranes manifest?
If a massive rupture of fetal membranes has occurred, then it cannot be confused with anything: a large amount of transparent, odorless and colorless liquid is immediately released. However, if the gap is small, it is still called by doctors as a subclinical or high lateral gap, then it is very difficult to make a diagnosis.

3. What is the danger of premature rupture of the membranes?
There are 3 types of complications that may result from premature rupture of membranes. The most frequent and severe complication is the development of an ascending infection, up to sepsis of the newborn. In premature pregnancies, premature rupture of the membranes can lead to premature birth with all the consequences of the birth of a premature baby. With a massive discharge of water, mechanical injury to the fetus, loss of the umbilical cord, placental abruption are possible.

4. Who is more likely to rupture the membranes?
Risk factors for premature rupture of the membranes are genital infection, overstretching of the membranes as a result of polyhydramnios or multiple pregnancies, abdominal trauma, incomplete closure of the uterine mouth. An important risk factor is premature rupture of membranes during a previous pregnancy. However, almost every 3rd woman has a rupture of membranes in the absence of any significant risk factors.

5. How fast is labor activity in case of premature rupture of the membranes?
This is largely determined by the duration of pregnancy. In full-term pregnancy in half of women, spontaneous labor occurs within 12 hours and more than 90% within 48 hours. In case of a premature pregnancy, it is possible to keep the pregnancy for a week or longer if the infection does not join.

6. Can a small amount of amniotic fluid normally stand out?
Normally, the membranes are sealed and there is no even the slightest penetration of amniotic fluid into the vagina. За подтекание околоплодных вод женщины часто принимают усилившуюся влагалищную секрецию или небольшое неудержание мочи.

7. Правда ли, что в случае преждевременного излития вод беременность прерывают независимо от срока?
Premature rupture of the membranes is indeed a very dangerous complication of pregnancy, but with timely diagnosis, hospitalization, and early treatment, premature pregnancies can often be prolonged unless an infection occurs. With full-term pregnancy and close to full-term, as a rule, stimulate the onset of labor. Modern methods of diagnosis and treatment, in this case, make it possible to smoothly prepare a woman for childbirth.
8. If there was a premature rupture of the membranes, but the mucus plug did not come off, does it protect against infection?
The mucus plug does protect against infection, but when the fetal membranes rupture, one plug of mucosal protection is not enough. If treatment is not started within 24 hours from the moment of rupture, serious infectious complications may occur.

9. Is it true, the waters are divided into front and rear and the discharge of the front waters is not dangerous, it is often found in the norm?
Fruit water is really divided into front and rear, but no matter where the gap occurred, it is the gateway for infection.

10. What precedes the break?
By itself, the rupture of the membranes occurs painlessly and without any precursors.

What are the tests for leakage of amniotic fluid.

Source [reference-1] Traditional methods Inspection in mirrors Technique: Visual determination of the leakage of amniotic fluid in the posterior vaginal fornix. When conducting a study, a woman is asked to cough. Accuracy: Subjective Disadvantages: The examination requires an inspection in the mirrors. Urine, semen and other fluids can be easily confused with amniotic fluid. Nitrazine (pH) (all existing tests of various manufacturers, gaskets and litmus papers that react to leakage.

My miracle is pregnancy. A diary. 26. Day of birth.

39 weeks. Birth Day - continued. 4:45 pm I make out. Kapets damn, I went nuts. I have fights, and here damn sit answer the questions, now the system ... they don’t think at all with their head. They also asked, “Well, how are they now, are there any fights?”, I say, yes, yes, there are already such decent fights. And to me: “well, today you will give birth before 23:00”. I say "I hope, I want today, well, a maximum of 22 to 3 o'clock at night." Surprised, began to ask why. Well, I quickly explained that the stars are well located. Surprised, probably.

My miracle is pregnancy. A diary. 27. Day of birth.

39 weeks. Birth Day - a successful conclusion! And so I began to feel pressure in the lower back, but I was afraid to call the doctor, because I thought that I was confusing something. But when the pressure began to intensify and push in the ass, the husband quickly ran after the doctor. She came, felt, said that she already felt the head (with a haircut), but my opening was only 8 cm and the neck was torn. And I was already specifically started to grieve. Damn, what is this relief when it already begins to hurt. I did not care that the neck is torn.

Double joy. Multiple pregnancy

. In addition, they often have such severe complications as gestosis (increased pressure, edema and protein in the urine), pre-eclampsia (high pressure) and eclampsia (extremely high pressure, damaging the brain and internal organs). You should always control the pressure and weight. One of the serious complications is the threat of miscarriage, as a double or triple load on the uterus can lead to an earlier disclosure of uterine throat. Sometimes the doctor may suggest special devices or suturing the cervix, allowing you to safely convey the pregnancy up to 36 weeks. So the doctor can offer hospitalization with a relaxing uterus and special medicinal procedures that allow you to bring the pregnancy to the right time, you should not refuse the hospital & m.

A small discovery. Pregnancy and childbirth

The girls, for 32 weeks, took a smear today and groped for a slight disclosure, although the doctor said that the multiparous is the norm - but I still get flustered. Has anyone been told yet about disclosing at the same time? The last ultrasound was at 28 weeks: 5 mm in the mouth, 2 mm cervical canal, and the length of the meter. 41 mm. I read the Internet about norms - I'm losing my mind, because I do not understand anything ((((

Weakness of labor. Childbirth, complicated condition.

. Diagnosis of a weak labor activity The diagnosis "labor weakness" is set by the obstetrician, the leading childbirth, based on the nature of contractions, the dynamics of cervical dilatation. The presence of this pathology is indicated by a decrease in the rate of disclosure of uterine throat. So, if it is normal, from the beginning of a regular labor to the opening of the uterine mouth, it lasts 3–4 cm on average for 6 hours, then with the development of the weakness of the labor, this period lengthens to 8 hours or more. During childbirth, the doctor examines the woman in labor at regular intervals. If for a certain period cervical dilatation is not enough, then they also speak of a weakness of labor activity. The tactics of further management of childbirth after diagnosis.

Why do you need oxytocin? All about childbirth

. The primary weakness of labor activity develops from the very beginning of labor, and the secondary - after a period of prolonged good labor activity. Weakness of labor activity is diagnosed according to the slowed-down dynamics of uterine opening opening (less than 1-1.2 cm per hour) and due to the absence of fetal movement along the birth canal when the size of the mother and fetus is in proportion. Prolonged immobile standing of the fetus in the pelvic cavity can lead to compression of the soft tissues of the mother, followed by the appearance of her urogenital or intestinal-genital fistulas and adverse effects on the fetal head, up to a violation of cerebral circulation.
. With particular care decide on the appointment of oxytocin in multiple pregnancies and uterine myoma. Oxytocin is used with extreme caution, and in the presence of signs of hypoxia in the fetus - insufficient oxygen supply, as with the use of oxytocin, contractions become more frequent and longer, and during contractions the blood supply to the placenta is significantly impaired. For the prevention of complications from the use of oxytocin strictly follow the dosage.

If someone reads this.

My wife has a womb after childbirth, the uterus is enlarged, a week has passed and the doctor (in train) has written us to administer oxytocin intramuta 2 times.

We can get rid of it, it can somehow affect the child, since milk is ours from the breast of the matreteri.

The beginning of the hard work. All about childbirth

On the nature of labor pains and behavior during the first stage of labor. What most often scares a young woman preparing for the first time to become a mother? The answer suggests itself - contractions.
. The birth canal is preparing to “release” the child from the womb. Intrauterine pressure during contractions increases as the uterus itself is reduced in volume. Ultimately, this leads to the rupture of the fetal bladder and the outpouring of part of the amniotic fluid. If this coincides with the full opening of the uterine throat, they speak of timely discharge of water, but if the uterine throat has not opened up sufficiently at the time of rupture of the membranes of membranes, this discharge is called early. The first, preparatory, childbirth period takes, on average, 12 hours, if the woman gives birth for the first time, and 2-4 hours less for those whose birth is not the first. At the beginning of the second period of childbirth (the expulsion period) to.

Secret language What do doctors say during childbirth? All about childbirth

. Each sign is estimated from 0 to 2 points. Rating: 0-2 - immature neck, 3-4 - not mature enough, 5-6 - mature. The opening of the cervix, the doctor determines during vaginal examination. The amount of disclosure of uterine throat is measured in centimeters. Full opening corresponds to 10 cm. Sometimes you can hear the expression "opening the cervix with 2-3 fingers." Indeed, the old obstetricians measured the opening in the fingers. One obstetric finger is conventionally equal to 1.5-2 cm. However, the thickness of the fingers is different for everyone, so the measurement in centimeters is more accurate and objective. During the vaginal examination, the doctor also makes a conclusion on the state of the fetal bladder and amniotic fluid. Then the woman can hear the terms.

Gap or puncture. All about childbirth

. The lower pole of the bladder takes root in the internal uterine throat and helps the cervix open. The opening of the cervix in primiparous and multiparous occurs in different ways. In primiparous, the inner uterine mouth first opens, the cervix is ​​smoothed and thinned, and then the outer uterine mouth opens. In multiparous external uterine pharynx is ajar at the end of pregnancy. During labor, the opening of the internal and external os, and the smoothing of the cervix occur simultaneously. The degree of cervical dilatation is determined in centimeters during vaginal examination. Cervical dilatation of 11-12 cm, in which the edges cannot be determined, is considered complete. The first stage of labor is characterized by occurrence.
. In multiparous external uterine pharynx is ajar at the end of pregnancy. During labor, the opening of the internal and external os, and the smoothing of the cervix occur simultaneously. The degree of cervical dilatation is determined in centimeters during vaginal examination. Cervical dilatation of 11-12 cm, in which the edges cannot be determined, is considered complete. The first period of labor is characterized by the occurrence of regular contractions and the advancement of the presenting part of the fetus (the part that first passes through the birth canal, and before the birth is addressed to the cervix) through the birth canal. Most often the presenting part of the fetus is its head. In normal childbirth, water1 leaves by itself. Usually fetal poo.

'' Go for a breakthrough ''. Why open the bladder? All about childbirth

. Late amyomyia Sometimes, despite the full disclosure of uterine throat, the fetal bladder remains intact and the period of exile flows at the front waters that have not departed. The reasons for this pathology can be the following: excessive density of the membranes prevents their timely opening under the pressure of intrauterine pressure, excessive elasticity of the membranes leads to the fact that the fetal bladder becomes thinner and fills a significant part of the vagina, and sometimes comes out of the vagina outward, with a "flat" n.
. Normally, the opening of the fetal bladder occurs when cervical dilatation is more than 6 cm. Lyudmila Petrova, Obstetrician-gynecologist of the highest qualification category, head of the maternity ward of maternity hospital N 16, St. Petersburg Article provided by the magazine "Pregnancy. From conception to birth" N 03 2007.

About the puncture of the bubble. Pregnancy and childbirth

In general, I’m sitting at home with the pribolemshi flu))) I read all sorts of reviews about childbirth, and now I finally got a tip about a doctor who is now being watched. the girl writes that she came with a raid of 5 cm and immediately pierced a bubble with her - I am sitting here and wondering - is that necessary? or what would hurry all over do? is this also some kind of stimulation or am i misunderstanding something? is it normal with such a disclosure to pierce the bubble?

Signs, symptoms and manifestations of CI during pregnancy: how dangerous is the opening of the internal cervix of the cervix, how it is treated

During pregnancy, a woman becomes the most vulnerable, as her body works for two. If there are several fruits, then the load increases. In this regard, it can develop ICS - a dangerous pathology that leads to the loss of a baby. How to determine the onset of the disease and avoid negative consequences, learn from our article.

In addition to the positive aspects, childbearing has a lot of negative risks and threats to the health of the woman and the baby. One of the dangerous pathologies is cervical insufficiency. What is it? What are the symptoms and treatment?

What is cervical insufficiency (ICN)?

Cervical insufficiency is a pathology of the cervix, consisting in the inability of the body to hold the fetus. As a result, a spontaneous miscarriage or premature birth occurs. A distinctive feature is the absence of symptoms, and pathology can only be detected by ultrasound and not before the second trimester.

There are two types of ICN:

  1. Traumatic - caused due to injuries of the cervix.
  2. Functional - the spectrum of causes is wider, most often the lack of progesterone or on the background of hyperandrogenism.

The disease proceeds without clear symptoms.

Rare manifestations of pathology:

  • slight bleeding,
  • pulling pains in the abdomen,
  • pressure in the upper uterus,
  • a feeling of tearing the vagina from the inside.

The uterine sphincter keeps the uterus in good shape, and during the period of carrying a child, it controls that the opening does not happen before the prescribed time. When the ICN process is violated.

  • with abortion, fetal operations in history,
  • having internal breaks
  • undergoing operative labor when applying obstetric forceps or pelvic presentation,
  • after surgery on the cervix.

These procedures violate the muscle fibers, lowering the overall tone.

It also occurs when the anomalous structure of the reproductive organs of a woman. Congenital cervical insufficiency is rare, can be diagnosed even in a non-pregnant patient, in this case, cervical dilatation is observed during ovulation of more than 0.8 cm.

Other reasons:

  • with increased levels of male hormones in the body (hyperandrogeny),
  • polyhydric water - there is an additional pressure on the cervical canal and it cannot cope,
  • large fruit,
  • in patients aged 30, the risk of ICN increases,
  • conception with IVF,
  • observed in patients who are engaged in hard physical work during pregnancy.

CI does not bother a mother in the first trimester. In the second, between the ages of 16-24 weeks, small bleeding may occur, sometimes pulling the lower abdomen. The child is actively developing, increasing and gaining weight. As a result, the cervical canal is under a strong load, and since the muscle fibers are destroyed and do not have the necessary tone, the fetus is lost.

In advanced cases of cervical insufficiency, a surgical method is used - stitches are applied. For this, the internal pharynx is narrowed down with the help of silk threads.

How dangerous is it if the inner or outer throat is open

When ICN observed the opening of the internal or external pharynx. This represents a threat to the life of the fetus.

In the first trimester, it is not possible to reveal the ICN, because the embryo is small and does not affect the uterus. As it grows, the load will increase, and a premature opening of the pharynx occurs. Sometimes, cervical insufficiency begins to develop from week 11 according to the following scheme:

  1. There is an opening of the inner throat.
  2. Opening of the external pharynx.
  3. Prolapse of the membranes in the vagina.
  4. Violation of their integrity.
  5. Fetal death

Starting from the second trimester, the ICN is actively developing, increasing the risk of miscarriage. This happens more often between the ages of 18-24 weeks. At the end of the term, pathology causes premature birth with a high risk to the life of the child.

To correctly diagnose cervical insufficiency, a complex of procedures is necessary: ​​gynecological examination and ultrasound monitoring.

It is not necessary to take tests for the diagnosis of ICN, since it is only possible to determine the state of the cervix by ultrasound. For a gynecological examination, the doctor makes a presumptive diagnosis.

To determine the pathology, an ultrasound examination with a vaginal sensor is necessary (this method is more efficient). In the process of examination, the specialist assesses the condition of the cervix, the length and the presence of an opening of the internal os. When the ICN, the organ has a V-shaped appearance. To confirm the diagnosis, the patient is asked to cough or the doctor puts pressure on the uterus to increase the load and check the work of the organ.

Normal lengths of the cervical canal: up to 6 months of pregnancy - 3.5-4.5 cm, at later 3-3.5 cm.

Births at ICN are rapidly, as the uterine sphincter does not perform its function. Women with this diagnosis are sent to the hospital in advance, where they stop taking the drugs or the doctor removes the pessary or stitches. Delivery occurs naturally, if there are no indicators for cesarean section.

Cervical insufficiency is a serious pathology that threatens the life of a child. A woman may have a spontaneous miscarriage or premature birth. Even with the right treatment, there is a risk:

  • Pessary installation requires careful and regular reorganization so that germs and bacteria do not get into the internal organs and to the child,
  • suturing - surgery, which has some contraindications.

The main danger of ICN is the absence of symptoms. A miscarriage often occurs, and only after this a pathology is diagnosed due to an X-ray of the fallopian tubes.

Pregnancy is one of the most important and exciting periods in a woman’s life. The waiting period for the birth of a new life is filled not only with joyful emotions, but also with concern for the life of the future baby. Modern medicine has made great strides forward and today it is possible to establish various pathologies in the early stages. However, future moms still have questions related to this period. В частности, женщин часто беспокоит вопрос нормы раскрытия внутреннего зева при беременности. Для ответа на этот вопрос нужно понять, как устроен женский организм.

Раскрытие внутреннего зева во время беременности при нормальном течении

При физиологичном течении шейка матки начинает готовиться к родам, начиная с 32-34 недель. During this period, it becomes softer around the edges, more often it comes in tone, which leads to softening and thinning of its lower part. The part from above, on the contrary, becomes more dense. These changes lead to the fact that the child begins to gradually fall and its weight to provoke its further disclosure. This process is quite slow and takes about a month, increasing a few days before delivery.

The following symptoms are the harbingers of childbirth:

  • the bottom of the uterus begins to fall. It takes about 3 weeks directly to the contractions themselves. This process is a consequence of the fact that the fetus is pressed against the pelvis. A woman can notice this by the fact that she has become easier to breathe,
  • the head of the child puts pressure on the bladder and intestines, which leads to more frequent visits to the toilet and the occurrence of constipation,
  • the uterus becomes more sensitive and reacts by becoming firmer with the slightest irritation (sudden movements of a woman or fetus, when touched to the stomach),
  • the woman feels the preparatory contractions, which are felt less and shorter than the real ones,
  • the neck becomes plastic and soft.

Vaginal examination of the cervix is ​​routinely performed at weeks 20, 28, 32, and 36. If there are any problems, then inspection is performed more often. Opening of the internal pharynx at 36-38 weeks of pregnancy normally indicates completion of preparation for childbirth. At the moment, there has already been a partial replacement of muscle tissue on the connective tissue, which is able to stretch to a greater extent during labor. The doctor sees this by the fact that the cervix has become more loose and shortening it leads to a gaping cervical canal. If a woman is preparing to become a mother for the first time, then the external pharynx allows only a fingertip to enter, for multiparous, one finger. The neck begins to unfold from the inner throat. If the birth is first, then the channel in its form resembles a truncated cone with a base at the top. Further, the pressure of the fetus contributes to the stretching and the external os. With repeated birth, this process is easier and takes less time, due to the fact that the outer jaws are already open for 1 finger. In this case, the outer and inner mouth open almost simultaneously.

Sometimes this process begins well before the right time of delivery. For example, if the birth is still far away, and the doctor talks about opening the neck by 17 mm, and the internal os, by 6-7 mm, then it is a question of pathology. Early exposure is most dangerous in the first trimester. The causes of this pathology are:

  • cervical insufficiency,
  • pre-pregnancy abortions and miscarriages,
  • cervical injuries,
  • erosion,
  • progesterone deficiency.

Treatment of internal pharyngeal opening during pregnancy

First of all, a pregnant woman should ensure peace of mind by eliminating physical and emotional stress. Comply with bed rest.

There are 2 ways to stop disclosure:

  1. Surgical (circlage when opening the internal pharynx). It consists in suturing the neck. The operation is performed under general anesthesia. For its implementation the following conditions are necessary:
  • integrity of the fetal membranes,
  • up to 28 weeks
  • absence of infectious processes.

When do the prolapse of the membranes of pregnancy during pregnancy, twins, features and consequences.

Use of a pessary for multiple pregnancies, prevention of preterm labor.

Opening of the internal pharynx after suturing occurs normally after they are removed for a period of 37 weeks.

  1. Installation pessary. It is considered a less traumatic way than surgery. Rather effective and safe method which can be applied on any term of pregnancy. If a woman is at risk, installing an obstetric pessary at 15-16 weeks increases the result of the method to 97%. The principle of its work is that it squeezes the neck, preventing it from opening further. Also, there is a decrease in fetal pressure on the unstable cervix. The redistribution of pressure leads to the closure of the cervix by the central opening of the pessary, the formation and unloading of the cervix. All this leads to the preservation of the child.

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The state of the internal and external gullet of the uterus during pregnancy: what does their opening or closing mean?

Often during examination or ultrasound, a pregnant woman hears about the closed uterine pharynx or its opening. As a rule, the gynecologist voiced the condition of the external os, and an ultrasound scan describes the internal os. What do these concepts mean? What do they matter during pregnancy? What is the opening of the inner throat?

How to give birth to a healthy baby with ICN?

In addition to the positive aspects, childbearing has a lot of negative risks and threats to the health of the woman and the baby. One of the dangerous pathologies is cervical insufficiency. What is it? What are the symptoms and treatment?

Manifestations and dynamics during pregnancy

CI does not bother a mother in the first trimester. In the second, between the ages of 16-24 weeks, small bleeding may occur, sometimes pulling the lower abdomen. The child is actively developing, increasing and gaining weight. As a result, the cervical canal is under a strong load, and since the muscle fibers are destroyed and do not have the necessary tone, the fetus is lost.

In advanced cases of cervical insufficiency, a surgical method is used - stitches are applied. For this, the internal pharynx is narrowed down with the help of silk threads.

In the early stages

In the first trimester, it is not possible to reveal the ICN, because the embryo is small and does not affect the uterus. As it grows, the load will increase, and premature opening of the pharynx occurs. Sometimes, cervical insufficiency begins to develop from week 11 according to the following scheme:

  1. There is an opening of the inner throat.
  2. Opening of the external pharynx.
  3. Prolapse of the membranes in the vagina.
  4. Violation of their integrity.
  5. Fetal death

On late terms

Starting from the second trimester, the ICN is actively developing, increasing the risk of miscarriage. This happens more often between the ages of 18-24 weeks. At the end of the term, pathology causes premature birth with a high risk to the life of the child.

How is the diagnosis made?

To correctly diagnose cervical insufficiency, a complex of procedures is necessary: ​​gynecological examination and ultrasound monitoring.

It is not necessary to take tests for the diagnosis of ICN, since it is only possible to determine the state of the cervix by ultrasound. For a gynecological examination, the doctor makes a presumptive diagnosis.

Ultrasound Examination

To determine the pathology, an ultrasound examination with a vaginal sensor is necessary (this method is more efficient). In the process of examination, the specialist assesses the condition of the cervix, the length and the presence of the opening of the internal zyv. When the ICN, the organ has a V-shaped appearance. To confirm the diagnosis, the patient is asked to cough or the doctor puts pressure on the uterus to increase the load and check the work of the organ.

Normal lengths of the cervical canal: up to 6 months of pregnancy - 3.5-4.5 cm, at later 3-3.5 cm.

How are birth

Births at ICN are rapidly, as the uterine sphincter does not perform its function. Women with this diagnosis are sent to the hospital in advance, where they stop taking the drugs or the doctor removes the pessary or stitches. Delivery occurs naturally, if there are no indicators for cesarean section.

Cervical insufficiency is a serious pathology that threatens the life of a child. A woman may have a spontaneous miscarriage or premature birth. Even with the right treatment, there is a risk:

  • Pessary installation requires careful and regular reorganization so that germs and bacteria do not get into the internal organs and to the child,
  • suturing - surgery, which has some contraindications.

The main danger of ICN is the absence of symptoms. A miscarriage often occurs, and only after this a pathology is diagnosed due to an X-ray of the fallopian tubes.

Cervical dilatation earlier

Sometimes this process begins well before the right time of delivery. For example, if the birth is still far away, and the doctor talks about opening the neck by 17 mm, and the internal os, by 6-7 mm, then it is a question of pathology. Early exposure is most dangerous in the first trimester. The causes of this pathology are:

  • cervical insufficiency,
  • pre-pregnancy abortions and miscarriages,
  • cervical injuries,
  • erosion,
  • progesterone deficiency.

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