What is the dangerous shortened cervix during early pregnancy and how is it corrected medically, quickly, conservatively?
Often during pregnancy, when a short cervix is detected in the early weeks, the doctor may register the patient for the risk of miscarriage and prescribe a specific treatment. As a rule, a small cervix is rarely a congenital anomaly, often a change in its size is a consequence of aggressive intervention: hysteroscopy, abortion, curettage.
What is a short cervix
The length of the lower segment of the uterus is of great importance when carrying a child, so gynecologists pay special attention to this issue even when planning a pregnancy. The length of the normal uterine cervix should be from 3.5 to 4 cm, if it is less than 2.5 cm, then the body is considered short. During childbirth, the neck of the cervix should be tightly closed, which does not allow the fetus to appear prematurely. A condition where the organ is short and involves premature disclosure is called isthmic-cervical insufficiency - it threatens the expectant mother with preterm labor.
A shortened cervix is a serious pathology that is almost asymptomatic, i.e. in most cases, girls do not even realize that there is a serious problem. Short organ threatens with complications, especially for women in position. Only a gynecologist is able to determine the presence of a problem during a vaginal examination, but an accurate diagnosis will be made only by a specialist who performed the ultrasound examination.
Symptoms of cervical shortening
A woman for a long time can not feel health problems, because a shortened neck does not manifest in any way. As a rule, the gynecologist establishes the diagnosis during the examination or during ultrasound examination. Only in 20% of cases the pathology has symptoms that are actively beginning to manifest at a period of 15 weeks. It is no coincidence, because At this time, the fetus grows in size, gaining weight, while pressing harder on the muscular sphincter of the pharynx. The shortened cervix during pregnancy has the following signs:
- mucosal bloody or watery discharge from the vagina,
- slight lower abdominal pain
- feeling of pressure, tearing in the vagina.
For any adverse symptoms, a woman should visit a doctor who will help determine the root cause of the problem. It is difficult to identify pathology on your own - for this purpose you will need targeted research using ultrasound. The earlier the specialist diagnoses the ailment, the faster the therapeutic measures will be taken. Early treatment with medication will help preserve the pregnancy.
Causes of shortening
Small uterine cervix - a dangerous pathology that has a negative impact on the normal childbearing. The aggravating circumstances of such a condition can be a multiple pregnancy, a large fetus, high water. The pathogenesis of the processes determining the development of this disease depends on internal and external factors. Causes of cervical shortening during pregnancy can be the following:
- hormonal disorders,
- congenital pathologies of the structure of the uterus, which are caused by heredity (underdevelopment of the cervical canal, genital infantilism),
- deformation of the body
- hyperandrogenism (excessive production of male sex hormones - androgens),
- connective tissue dysplasia
- mechanical injuries from diagnostic curets, abortions, surgeries,
- organ rupture during past birth.
Complications and consequences
A shortened organ in normal life does not cause discomfort, has no pronounced symptoms. Only when a woman is expecting a child, a gynecologist can identify the problem during a medical examination. The consequences of the disease are serious. This concerns the threat of miscarriage or premature birth, because under the pressure of the baby, the neck begins to open and shorten more. To save pregnancy, it is important to diagnose the problem at an early stage in order to take steps to eliminate it. In addition, the following pathological effects may occur:
- infection of the fetus due to its vulnerability,
- rapid delivery, accompanied by ruptures of the vagina, perineum,
- the development of ICN (cervical insufficiency), this condition is accompanied by the inability of the uterus to hold the fetus.
Timely determination of the pathology will help the specialist to find effective ways to treat it. As a rule, the diagnosis of a shortened organ is carried out from the 11th week of pregnancy, when the patient is examined by a gynecologist and is registered. Suspected disease is the appearance of watery blood discharge and lower abdominal pain. At the same time, only complex diagnostics, which includes:
- mirror inspection (determines the state of the external pharynx),
- ketosteroids urine test,
- tocography to determine the presence of contractions and tone of the uterus,
- digital examination of the vagina (helps to assess the patency, length and condition of the organ),
- blood test for antibodies to hCG
- ultrasound procedure,
- examination of blood and smear for the presence of bacterial infections (chlamydia, gonorrhea, mycoplasmosis),
- determination of hormone levels in the blood of a pregnant woman (testosterone, estrogen, progesterone),
- a blood test for thyroid hormone levels,
- dynamic echography
- blood flow doplerometry,
- transvaginal echography
- cardiomonitoring (to determine the intrauterine state of the child).
Independently establish the diagnosis is almost impossible. The symptoms are so subtle that they can easily be ignored by the patient and the doctor. It is important to conduct a comprehensive examination, including palpation and gynecological examination. Differential diagnosis is used as a technique that aims to exclude possible diseases in the patient and to establish an accurate diagnosis. The success of such a check is determined by a thorough comprehensive examination.
Differential diagnosis with the threat of early labor is carried out with diseases of the abdominal organs: septic colitis, acute appendicitis, cystitis, diseases of the urinary tract. A dangerous condition is often differentiated with acute pyelonephritis, foodborne toxicoinfection, renal colic, the presence of fibroids. For the accuracy of the diagnosis may require the help of doctors of other specialties.
Can the cervix lengthen during pregnancy?
When carrying a baby, the neck can undergo various changes. Proceeding from the circumstances, it is then extended, then shortened. If the patient has been doing hard work all day, the neck will be shortened. Although after a good rest may be lengthened. The main thing is to visit the doctor in time and follow all the recommendations given by the gynecologist. A short neck during pregnancy is often corrected by surgery or conservative means.
Based on the week of pregnancy, the specialist chooses a specific method of treatment. Women who have a body length of 30 mm before the 20th week are at risk, they are under the close supervision of a gynecologist. With multiple babies up to 28 weeks, 36 mm is considered the norm, and 45 mm for nulliparous. If the length of the neck is 20 mm, surgical intervention is necessary. It is possible to extend the organ with the help of drugs, but they should be prescribed only by a gynecologist.
How to lengthen the cervix during pregnancy
Treatment of a short cervix requires strict control by a gynecologist, who will determine the most effective methods. If the patient has a slight change in the length of the uterus, then the specialist may prescribe treatment with medications that are aimed at lowering the tone. As a rule, for this purpose, the patient is shown intravenous administration of Magnesia and Ginipral. Hormonal therapy, surgical and conservative treatment can be prescribed to pregnant women with ICN. It depends on the threat of termination and the duration of pregnancy.
If during the examination the doctor found softening and hypertonicity of the uterus, he may prescribe medication. The most important recommendation for a patient with a short neck is to limit any physical exertion. If the appearance of the CI condition is caused by a lack of hormones, then a specialist can prescribe the use of such agents as Duphaston, Turinal, Microfollin, Dexamethasone. If the patient is threatened with preterm birth, the doctor will suggest that the pregnant woman should have stitches. In addition, as additional methods of treatment can be:
- Homeopathy. The doctor may prescribe auxiliary drugs Sulfur, Calcium carbonicum, Silicea.
- Herbal treatments. Broths of calendula, viburnum, St. John's wort, chamomile have a tonic effect on the woman's body. This therapy should be under the supervision of a physician.
- Bandage. With this tool you can ensure the correct location of the fetus and prevent its early lowering.
- Gynecological ring or obstetric pessary. It is applied for a period of 25 weeks or more, when a pregnant woman cannot use stitching to avoid infection of the fetus.
A hormonal failure during pregnancy can provoke the appearance of cervical insufficiency, which negatively affects the health of the mother and baby. The doctor in this state may prescribe medication, the action of which is aimed at reducing the activity of the uterus. The most popular is Utrozhestan, is available in the form of vaginal suppositories and capsules.
The dosage of the drug is selected individually, based on the symptoms and severity of the threat of interruption. Typically, the dose is 200 or 400 mg every 12 hours. When a vaginal drug is taken, it is absorbed faster and is better tolerated by the body. Natural progesterone Utrozhestan is contraindicated for varicose veins and liver diseases.
Surgical treatment is best carried out from the 13th to the 27th week. To prevent infection, it is better to intervene from the 7th to the 13th week. Indications for surgery may be premature labor, abortion, the rapid progression of pathology. In addition, when opening the throat, there is also a need for stitching. Surgery is carried out in several ways:
- narrowing of the cervix by strengthening the muscles along the side walls of the body,
- sewing the outer throat,
- mechanical narrowing of the inner throat of the uterus.
Often, with a shortened neck, a cerclage is done - an operation to apply temporary sutures. Held before the 28th week of pregnancy. The procedure helps prevent premature opening of the uterus. As a rule, brackets and stitches are removed when the amniotic fluid is discharged. Contraindications use of the operation:
- genetic, mental illness,
- kidney, heart, liver,
- malformations of the child,
- bleeding during pregnancy
Short cervix during labor
If a woman managed to bear the fetus during cervical insufficiency and the delivery was completed on time, this does not mean that complications were avoided. Short neck is reflected in the course of the entire period of delivery. Often childbirth pass quickly or rapidly. A woman who is preparing to become a mother for the first time can give birth in 4 hours, and multiparous in just 2. Such a rapid delivery is dangerous with complications, injuries and ruptures. Therefore, pathology requires timely treatment.
To avoid the appearance of such pathology as a shortened cervix, it is necessary to observe a number of preventive recommendations and rules:
- the use of reliable contraceptives to protect against unplanned pregnancy,
- regular visits to the gynecologist,
- maintaining a healthy sexual lifestyle
- proper pregnancy planning
- constant health monitoring
- for chronic diseases, colposcopy is necessary.
Short cervix during pregnancy - a reliable solution exists
The fact that the cervix is not of sufficient length, is unaware of most women. This serious pathology has an impact on women's health. Its symptoms are especially dangerous in the period of carrying a baby. The diagnosis is made known directly during pregnancy. To this end, a series of studies using ultrasound and medical equipment.
What should be the length of the cervix during pregnancy
Over the course of gestation, deviations in the length, consistency of the uterine cervix occur, and also the opening of the pharynx changes. In the early stages, the length should not be less than 35-40 mm (12-37 weeks). Shortening the cervix Only by the 38th week of gestation of the fetus should the cervix be shortened - this is considered normal. A significant change in length occurs shortly before the onset of labor - up to 15 - 10 mm.
During this period, the cervix occupies a central position in the pelvis. If there was a shortening of the cervix within 30 mm, then special attention must be paid. A woman whose length has decreased to 15-20 mm is better under constant observation in the hospital.
If the cervix is short, is it dangerous?
If such a diagnosis is made, then its consequences are very serious - a woman has a 50% risk of childbirth in the next 2 weeks. The threat of miscarriage, premature birth provoked shortened neck. In this state, it may not perform an important function - to keep the uterus along with the constantly increasing fetus.
The infection of a fetus as a result of the lack of full protection is a major threat. A pregnant woman is under the danger of rapid development of childbirth. The result of which often becomes ruptures of the vagina, cervix, perineum. Diagnosing the problem at an early stage of pregnancy allows you to correctly determine the method of treatment of pathology.
Causes of shortening
The reasons for which the uterine cervix undergoes a decrease are different. Often there are the following factors:
- Natural abnormality of the structure of the uterus (underdeveloped cervical canal, defects arising from the development of the uterus, the presence of genital infantilism).
- Hyperandrogenism (the presence of excess amounts of androgens - sex hormones, characteristic of men).
- The hormonal disorders that occurred during pregnancy (no symptoms). Damage resulting from previous childbirth.
- Injuries that occurred during surgical interventions, abortions.
- Pathology of the organ caused by connective tissue dysplasia.
Symptoms in the second trimester
Detection of pathological manifestations of the cervix is possible in the period of the second trimester using ultrasound or gynecological examination. Usually, a vaginal examination of pregnant women is rarely performed, but with a woman's complaints, it is necessary.
When carrying a fetus, a woman should be alerted with symptoms such as:
- The appearance of tingling pain in the vagina.
- The appearance of cramping pain in the lower abdomen, in the lower back.
- The presence of unusual secretions - thick mucus, bloody, watery secretions with a specific smell.
The appearance of the latter (liquid, with a characteristic odor) indicates that the flow of amniotic fluid occurs. The development of such symptoms is observed from 22 weeks. If any of these symptoms appear, you should immediately contact your gynecologist.
What threatens to reduce the length
Pathology threatens spontaneous miscarriage, premature birth. This is due to the pressure of the growing baby, and the neck may open prematurely. It provokes a weakening of the protection of the fetus from infections. If the birth arose in a timely manner, then this state of the organ causes a rapid flow of events. May be accompanied by ruptures not only of the cervix, but also the perineum.
The deformation of the uterine cervix is one of the signs of ICN (stivic-cervical insufficiency). In this condition, there is a risk of pregnancy failure due to physiological problems associated with the retention of the fetus within the uterus. The neck and isthmus are under the constant pressure of a developing baby.
If narrow and short
The most appropriate solution would be a systematic observation by a gynecologist, if it was found that the length of the neck was reduced. Be sure to observe peace, take care of yourself and follow the advice of a specialist. It is necessary to pay attention to the tone, which affects the early maturation of the cervix, affects the reduction of its length, disclosure.
Physical loads are limited. It is recommended to wear a bandage. If this pathology is detected, the woman will be offered corrective treatment. Tactics chosen by the doctor, it depends on the period, the causes of the violation. The most common mistake women make is the fear of going through procedures.
How to lengthen or treat
From the clinical picture and the term of gestation, the method of treating the pathology is chosen. It may be prophylactic, conservative or require surgery. If there is a need, the method used is adjusted.
If the critical length of the neck (30 mm) is fixed at week 20, then this is a reason to take a woman under mandatory control. In this situation, she will visit a gynecologist according to a special schedule. A non-surgical cerclage is assigned to extend the organ - supporting obstetric pessaries are used, which have different designs. The place of their installation is the cervix.
If by the end of the second trimester the cervix has become shorter - up to 20 mm, then surgical intervention is applied. For these purposes can:
- to strengthen the muscles of the walls using the mechanical method,
- to close the outer throat by stitching,
- narrow the inside of the throat using a mechanical option.
You can use the surgical method, starting from the 1st trimester. If you identify problems at an early stage (week 7), you can operate. A woman needs to be calmer, to reduce her activity, perhaps to use bed rest. Used medications to reduce the tone of the uterus.
Each of these 3 methods helps a pregnant woman give birth to a full-term baby.
Properly conducted treatment has a positive prognosis. This is facilitated by the use of effective methods that are aimed at reducing the tone, reliable retention of the fetus in the uterine cavity. The most common methods are the installation of an obstetric pessary, as well as suturing.
Of great importance is the timely start of therapy and strict adherence to all medical recommendations. Therapy makes it possible to eliminate the appearance of complications and prolong the pregnancy. Measures aimed at prolongation of pregnancy should be taken on time. This is possible only on condition that the woman necessarily visits all the necessary examinations. The diagnosis can be made using ultrasound, which is carried out at 15-17 weeks.
Shortening during cervical pregnancy is a common problem. It is important to follow all the recommendations of the doctor - to give up an excessively active life, wear a bandage. If necessary, undergo treatment. Then, with this diagnosis, the woman will be able to carry the baby and give birth to it alone. A completely healthy baby is born.
Causes of short cervix
Many women, especially during pregnancy, are frightened by making a diagnosis of a short cervix, in order to find out the cause of the symptoms that have appeared, they have to turn to specialists.
The reasons for the development of short cervix are many, among them can identify the most common and most studied:
- Defects of the hereditary apparatus, disorders arising during the period of prenatal development and the period of growth and puberty. This is usually manifested by anomalies of the structure, as well as congenital insufficiency of female sex hormones that are involved in the final formation of the organ. These are such pathologies as various forms of infantilism and underdevelopment of the cervical canal.
- Hormonal imbalance. Usually it occurs already in the period of pregnancy, which may manifest itself as a threat of spontaneous miscarriage. In most cases, it will be asymptomatic and the diagnosis is made to a woman only after an ultrasound examination. To this group can be attributed, and an overabundance of male sex hormones, androgens. There are a lot of factors that provoke their increased production.
- Traumatic effects on the cervix, most often mechanical. These include extensive surgery on the cervix, diagnostic curettage and abortion.
- Dysplasia of connective tissue. In this case, an increased level of relaxin will be observed.
Consequences of a short cervix during pregnancy
- Short cervix and, as a result, isthmic-cervical insufficiency, these are conditions that provoke the development of premature birth, as well as the threat of miscarriage and miscarriage.
- If there is leakage of amniotic fluid, there is a risk of infection of both amniotic fluid and fetus. In addition, placenta may occur. In the initial stages of pregnancy, a usually short, non-diagnosed and uncontrolled cervix leads to infection of the fetus, the development of congenital miscarriage or infertility.
- In later periods it is the development of preterm labor. Favorable outcome depends on the term of delivery. With a short period of time, this is a high risk of the birth of an unviable fetus.
What to do with a short cervix?
Actions for a short cervix:
- In 20 weeks. In this period, the risk of developing a non-viable fetus is very high. Up to 21 weeks, the loss of a child is considered a miscarriage. But already during this period, active growth and mass gain begin, so a short neck represents a greater threat. To eliminate it, the issue of surgery in conjunction with hormone therapy is resolved.
- In 30 weeks. At this time, a woman usually goes on maternity leave and her physical activity decreases and the state can be monitored. The fetus becomes viable, but nevertheless, in the event of a threat develops, preserving therapy is carried out to prolong pregnancy.
- In 32 weeks. This is the period of the last screening, when there is a final measurement of the cervix. Treatment and treatment will remain the same as before. After preliminary preparation, the child is born full-fledged and all his systems will be formed. In addition, the issue of the removal of stitches is resolved and delivery is possible depending on the clinical situation.
This is a pathological condition that is characterized by excessive excitation of muscle fibers in response to the action of provoking factors. In addition, the risk of developing a life-threatening condition increases.
Therefore, a woman in the diagnosis of her high tone and short cervix during pregnancy requires a prescription of treatment and possible hospitalization.
Treatment of short cervix with medical methods is currently quite common. In some cases, it is quite effective, and helps to avoid surgical interventions. The treatment for this pathology is long and requires regular use.
- Utrozhestan. It is used primarily for shortening of the cervix caused by hormonal imbalance, as well as their insufficiency. As a result, a reduction in contractile elements in the neck is formed. Mostly it is progesterone deficiency. There are several dosage forms of Utrozhestan, these are capsules and vaginal suppositories. The dosage and the choice of route of administration will depend on which symptoms are present, as well as the degree of their manifestation. The average dosage will be 200-400 mg, if administered twice a day. When detecting varicose veins, as well as liver diseases, the drug is not recommended to be used. The active ingredient is completely identical to the natural hormone progesterone. Therefore, with proper appointment and regular use of any contraindications does not occur. The advantage of intravaginal administration is a faster and more local effect. Can be appointed from the very beginning of diagnosis, and the introduction continues until 34 weeks of pregnancy. Those. He is able to protect the pregnancy of a woman until late.
- Duphaston. This is another analogue of natural progesterone. It is produced in the form of tablets for systemic use. The drug is now widely used in gynecological and obstetric practice. When taken, there is a low risk of side effects. Efficiency largely depends on the time of the beginning of the reception, so when used in the early stages of development of shortening, as well as low pregnancy, the likelihood of a positive effect is high. The course of treatment will be selected based on the pathological condition.
May be prescribed in the mode of pulse therapy with the development of an acute threat, as well as a supporting complex. The average dosage will be 10 mg when taken twice. Duphaston therapy continues throughout pregnancy up to 22 weeks.
- Magnesium sulfate is a common and yet inexpensive drug for the treatment of short cervix. The main purpose of its elimination due to the treatment with magnesia is to reduce the tone. As a result, a decrease in muscle tone occurs, as well as a decrease in pressure in the walls of blood vessels. There is a decrease in blood pressure and removal of pathologically formed amount of fluid. Efficacy will occur only after the intravenous or intramuscular route of administration. The limitation in admission is the first trimester and the immediately preceding labor. Twice the introduction of a 25% solution.
- Ginipral is a drug belonging to the class of selective tocolytics. Effective in the development of the threat of preterm labor, helps to eliminate the increase in the tone of the uterine wall, without interfering with the passage of oxygen through the placenta to the fetus.
It can be prescribed only after the onset of 16 weeks of pregnancy, depending on the severity of symptoms, the most optimal course is selected. You can not cancel Ginipral simultaneously.
Ginipral Utrozhestan Magnesium Sulphate Duphaston
- Bandage. This is a physical and non-pharmacological method of preserving pregnancy, which is necessary for reducing muscle tone, as well as reducing the pressure on the pathologically altered or prone to the development of cervical shortening. It is made of elastically textile materials, which ensure reliable retention of the organ with the fruit. Great importance is attached to its proper use, as in some cases the compression of the organ and parts of the fetus can occur. It provides long-term preservation outside the pelvic cavity, preventing the lowering, as well as the correct formation of the position. In addition, the intensity of stretch marks and increased exercise tolerance are reduced. To begin using the bandage should be from 18 weeks of pregnancy, when there will be an increase in the mass of the fetus. It should be dressed only in the prone position, before getting out of bed.
- Obstetric pessary. This is a vaginal ring that prevents premature cervical dilatation. It can be inserted from an obstetric period of 25 weeks, especially in cases where the stitching is ineffective or contraindicated. Especially in cases where there is a likelihood of injury to the membranes. The pessary is regularly treated and removed from 37 to 38 weeks.
Obstetric pessary Bandage for pregnant women
Surgical treatment is one of the necessary methods of treatment of the short cervix, as well as other factors for the development of the threat of premature birth. One of the appointments is the pronounced progress of this pathology.
During surgical treatment, the following effects are achieved:
- The onset of mechanical constriction in the field of internal throat.
- Complete elimination of its lumen.
- Strengthen the muscles in the pelvic floor and side walls, by narrowing the cervix.
In addition, indications in the conduct of suturing are cases of habitual miscarriage or anatomical defects in the organ. As well as a progressive change in its structure.
Surgical intervention is carried out in the period from 13 to 27 week. At a later date, it can be dangerous due to the high incidence of complications. If there is a risk of infection of the fetus, suturing is carried out from 7 weeks.
You can not carry out this procedure for increased excitability of the uterine wall, diseases of internal organs, mental and genetic nature, the development of bleeding and the identification of fetal malformation.
In most cases, it will be ambiguous, this is due to many factors. Primarily on the type of pathology, its severity, as well as the rate of progression.
In addition, the prognosis will depend on the effect of the chosen treatment and the woman’s approach to therapy and quality of life.
In the case of a positive effect from the therapy and the timely diagnosis of the condition, it is possible to bring the woman to the point where the birth becomes timely. Nevertheless, there is a high risk of childbirth ahead of time. In this case, great importance is attached to the preliminary prevention of respiratory distress syndrome in the fetus.
Prevention of cervical shortening is a particularly pressing issue, since in most cases, by eliminating such errors, it is possible to achieve a significant reduction in the number of women faced with a similar picture.
The downside of most drugs are side effects. Often drugs cause severe intoxication, subsequently causing complications of the kidneys and liver. To prevent the side effects of such drugs, we want to pay attention to special phytoampons. Read more here.
- Women planning a pregnancy should limit the number of sexual contacts without the use of protective equipment; for unprotected sex, sexually transmitted infections should be regularly examined for infections. In case of detection of such a disease, timely and complete treatment is required, with subsequent monitoring of the condition.
- In addition, with persistent or often recurrent inflammatory processes in the vagina, which may be associated with nonspecific pathogens, more thorough diagnosis and treatment should be carried out, performed in full with regular anti-relapse measures.
- Avoid prolonged intrauterine interventions. These include, first of all, abortion with penetration into the uterine cavity, as well as curettage for diagnostic purposes, including the cervical canal. To do this, you need to use reliable methods of contraception, avoiding later abortions and their complications.
- Avoid cervical diseases such as erosion and dysplasia, as well as cervicitis. In identifying such pathologies apply timely conservative treatment.
- An undertreated process or a previous surgical procedure can damage cells and impair their architectonics as well as functionality.
- Monitor the regularity of the menstrual cycle, as well as the state of the hormonal complex. If an imbalance is detected, immediate treatment is required.
- Constantly visit the obstetrician-gynecologist for the timely diagnosis and treatment of identified diseases.
Symptoms of a short cervix
The shortening of the cervix leads to the development of ICN - isthmic-cervical insufficiency. This condition leads to the fact that the fetus can not be held in the uterus. The cervical canal is revealed, which provokes a miscarriage or early onset of labor, or an accelerated delivery process. In addition, this feature of the structure reduces the degree of protection of the fetus from pathogens, because the barrier function is impaired.
Most often, the expectant mother does not know about shortening the cervix, since the pathology has no pronounced symptoms. The diagnosis is made during the examination and additional examination, including ultrasound and cervicometry. But in 20% of clinical situations, signs appear that indicate a problem. Their list includes:
- discharge of watery or bloody nature,
- slight pain in the lower abdomen.
Important! The presence of such symptoms is an urgent signal for an immediate appeal to a specialist! Early detection of a problem increases the effectiveness of corrective measures.
The first symptoms that appear when a short neck softens or starts to open a short neck are pain in the vagina of a piercing nature, to which the cramping pain syndrome is often connected in the lumbar region and lower abdomen. In addition, there may be a discharge of bloody nature, signaling the threat of miscarriage or early onset of the delivery process.
Independent determination of pathology is impossible, since instrumental techniques and medical examination are necessary for making this diagnosis.
Very short cervix
Shortening of the cervix may not cause discomfort to the woman, but this situation is pathological because the short cervical canal does not fix the closed state of the uterus properly. For this reason, when identifying a problem, a woman should be regularly monitored by specialists to monitor the condition.
The very short length of the cervix (less than two centimeters) is extremely dangerous because it provokes miscarriage or rapid delivery. For correction of the ICN, glucocorticoid drugs are prescribed to the woman, and, if necessary, temporary stitches are placed on the uterus. Another method of correction is the imposition of a pessary. Exercise should also be limited.
Any drugs are taken only after appointment by a specialist.
The list of necessary methods of instrumental diagnostics includes:
- transvaginal ultrasound,
- токография, которая реализуется с целью выявления тонуса матки и схваток,
- динамическая эхография, которая важна в случае угрозы невынашивания,
- Doppler blood flow (uteroplacental and fetal),
Cervical shortening during pregnancy
Shortening of the cervix is a dangerous condition, which requires strict dynamic observation and timely action when correction is necessary. The short length of the canal without gestation does not pose a threat to the woman, but during the gestation of the fetus it can be a provocateur of serious health problems for both the mother and the child.
What can cause a short cervix during pregnancy?
This pathological condition in the early stages creates a threat of miscarriage and miscarriage, and in the later stages - the rapid course of labor or their premature onset. Cropped cervix is not capable of holding the uterus with a growing baby. In addition, due to the small length of the cervical canal, the barrier function deteriorates and the risk of intrauterine infection of the child increases.
To prevent problems in the process of carrying it is necessary to regularly visit a doctor. Currently, there are effective ways to correct the CI and prevent the negative effects of this condition.
Childbirth and short cervix
In the case of negative dynamics, monitoring a woman with ICN requires hospitalization. Under the negative direction of the dynamics refers to a sharp decrease in the length and smoothing of the cervix. Also, hospitalization is appropriate if the woman has a history of early childbirth. On admission to the hospital, manifestations of preterm labor are eliminated and the patient is transferred to the pathology department for subsequent treatment.
If, for the possibility of carrying a woman, stitches were applied, then before delivery the doctor removes them. Since with a short cervical canal there is a high risk of rapid delivery, the woman should be under the constant supervision of specialists to prevent ruptures and other complications of the birth process.
Treatment of short cervix
In the case of minor changes of the cervix rather conservative therapeutic measures. The expectant mother is prescribed medication to relieve excessive uterine tone and return the cervix to an acceptable condition. To do this, intravenously administered drugs such as magnesia and ginipral.
In a number of clinical situations, prompt corrective measures may be required. Their list should include:
- Mechanical narrowing of the inner throat (the most acceptable method).
- Sewing the outer throat.
- Strengthening the muscular structures along the side walls of the cervix to narrow the canal.
Surgical intervention can be prescribed with a history of miscarriages and early births, with intensive progression of ICN. However, surgical correction may be contraindicated in pathological conditions of the cardiovascular system, liver, kidneys, hereditary and mental pathologies, uncorrected increased excitability of the uterine walls, bleeding, abnormal development of the child.
The operation can be carried out in the period from 13 to 27 weeks of carrying a child. To prevent ascending transmission, intervention can be done from week 7 to week 13. In the case of contraindications, conservative therapy is carried out, bed rest and medication reduction of the excitability of the uterus are recommended.
There are also non-surgical methods of state correction. They are distinguished by safety, non-invasiveness and ease of outpatient care. These include the installation of a pessary or Golgi rings. These methods of correction show the effectiveness in the case of low severity of manifestations of pathology. However, these techniques are appropriate and after surgical correction to reduce the pressure on the sewn neck.
Short cervix during pregnancy: how to recognize?
Normally, the length of the cervix is 3.5 cm, but if we are talking about its pathological condition, this figure drops to 2.5 cm or less. In shape, it resembles a cone. Its structure is represented by a third by strong muscle fibers, which securely fix the fetus in the genital organ during pregnancy.
If the shortened cervix in a woman is due to heredity, then this fact can be recognized long before the onset of pregnancy. Girls who regularly visit a gynecologist since puberty, as a rule, are aware of their diagnosis. In order to avoid complications, he is necessarily taken into account by the doctor at the planning stage of the conception by the patient.
If the woman came to the gynecologist already being in position, then the doctor will be able to establish the fact of a short cervix during a routine examination in a gynecological chair. As a rule, in these cases, the specialist additionally sends the patient to a transvaginal ultrasound examination, which will be able to confirm his assumption.
What is dangerous short neck during pregnancy?
The greatest danger of a short cervix during pregnancy lies in isthmic-cervical insufficiency (ICN), leading to the risk of miscarriage. If its length is less than 2.5 cm, then it will not be able to hold the fetus for a long time and premature disclosure of the uterine cavity will begin. Not detected in time pathology leads to loss of pregnancy.
During the birth itself, there is a high probability of their rapid occurrence and complications associated with it: injuries, tears, etc. Moreover, the shortened neck of the reproductive organ does not reliably protect the fetus from infection, since there is no complete barrier from pathogenic microflora penetrating from the outside.
Fortunately, this state is not an obstacle to motherhood. Even in the presence of isthmic-cervical insufficiency, it is possible to bear and give birth to a child if the necessary therapeutic and preventive measures are taken in time.
A short cervix during pregnancy can adversely affect the whole process of carrying a child. Aggravating factors such as large fetus, polyhydramnios and multiple fetuses aggravate this pathology. Read more about carrying a multiple pregnancy →
Causes of cervical shortening:
- congenital pathologies due to genetics: incomplete development of the cervical canal, abnormal structure of the uterus, sexual infantilism,
- hormonal abnormalities that occurred during pregnancy,
- acquired injuries of the cervix of the reproductive organ, obtained during childbirth, abortion or scraping,
- organ dysplasia.
For the first time, symptoms of a shortened cervix are felt from the 16th week of pregnancy. The fact is that from this moment on the fetus begins to gain weight faster, putting more pressure on the uterine mouth. The doctor may discover this during the next examination on the gynecological chair. Any complaints from the future mother are usually absent.
In rare cases, the symptoms of a short cervix during pregnancy are manifested by insignificant secretions mixed with blood or abundant mucous secretions from the genital tract, pains in the lower abdomen. If a woman has these signs, the doctor must refer her to an ultrasound scan. The first symptom of a miscarriage that has begun or the onset of preterm labor is bleeding at any time. More on the symptoms of miscarriage →