Position of the cervix. Cervix in different phases of the cycle and during pregnancy

The pleasant period of waiting for the baby can be overshadowed if pathologies in the development of the genital organs are discovered. During pregnancy, gynecologists must monitor the condition of the cervix. What transformations are happening to her at this time, how do new circumstances affect the development of the fetus and the process of childbirth?

Why does the cervix change during pregnancy?

The female body is designed in such a way that it creates conditions for bearing and giving birth to a child. The vagina and uterus are connected by the cervix - a muscular ring that affects the course of pregnancy and the process of childbirth. This part of the female genital organs has the following features:

when carrying an embryo, it protects the fertilized egg from falling out;
is an indicator of the normal course of pregnancy;
during contractions, the cervix opens, facilitating the passage of the fetus;
consists of the internal and external pharynx, connected by the cervical canal, the mucus inside of which prevents infections from entering.

After conception, under the influence of hormonal processes, the cervix begins to change. When a gynecologist examines the external pharynx, under normal conditions it looks smooth, elastic, and pale pink. The cervix has a length of 4 cm, a diameter of 2.5 cm. From the fourth week of pregnancy you can notice changes:

appearance;
sizes;
location;
consistency.

The gynecologist monitors the woman’s condition during regular follow-up examinations. The doctor must evaluate the situation with the genital organs, which have undergone changes since the first months of pregnancy. In order for the fetus to be properly nourished and formed, in a woman’s body:

hormonal levels are activated;
metabolic processes are accelerated;
vascular proliferation is observed;
blood circulation increases.

As a result of ongoing processes, the cervix undergoes changes in the early stages of pregnancy. During an external examination, a doctor may observe the following transformations:

the color of the mucous membrane becomes bluish;
instead of muscle fibers, connective tissue appears, which has an elastic collagen structure capable of stretching;
under the influence of progesterone, the cervix begins to lower;
the size of the cervical canal decreases.

Doctors conduct follow-up examinations at the beginning of the first trimester, at 20, 28, 32, 36 weeks. Depending on the stage of pregnancy, changes in characteristics affecting the condition of the cervix are observed. The determining factors for determining the normal course of pregnancy are the following indicators:

length;
consistency of mucus;
position;
permeability;
condition of the cervical canal.

Consistency

Under the influence of processes occurring in the pregnant woman’s body, changes in the female genital organs begin. Vasodilation and the influence of progesterone make the walls of the uterus, the endometrial layer that lines it and the mucous membranes of the cervix thick and loose. The work of the glands causes active production of thick, viscous mucus. In the cervical canal, the clot forms a plug, which solves the following problems:

maintains the balance of vaginal microflora;
prevents bacteria from entering the uterine cavity;
prevents the fertilized egg from slipping out;
creates conditions for the formation of an embryo.

The gynecologist must monitor the consistency throughout the entire period; in case of dangerous situations, the woman is hospitalized to save the child. A soft cervix during pregnancy is evidence of readiness for childbirth. Serious problems that threaten miscarriage cannot be ruled out. This can happen if the doctor discovers during examination:

slightly open internal pharynx, loose muscle tissue;
a dense, hard neck to the touch is evidence of hypertonicity, which may lead to fetal rejection.

Length

As the period increases, the cervix undergoes changes. Until the twentieth week of pregnancy, its length should remain constant. As the fetus grows, its pressure on the organ increases, and the size gradually decreases by 1-2 cm. This is necessary for the successful course of labor. The normal length of the cervix, depending on the period of pregnancy, should be as follows:

Patency and position

During pregnancy, the cervix changes its location. Gynecologists must monitor this clinical sign. If at the beginning of the term it is slightly raised, then in the last months it drops. The position of the cervix relative to the wire axis of the small pelvis plays an important role. The following situations are possible:

favorable case for childbirth - placement in the middle;
deviation to the side, bending forward are fraught with pregnancy pathologies that require monitoring.

An indicator of cervical maturity is the patency of the cervical canal, which is controlled by the gynecologist using a finger. The following options are not excluded:

In early pregnancy, access through the cervical canal is closed.
Before childbirth, a favorable situation is the passage of two fingers into the cervix.
A sign of immaturity is a closed external os; only the tip of a finger may enter the cervical canal.

Pathologies of the cervix during pregnancy

The appearance of unfavorable conditions for the fetus is detected in the early stages. Pathologies can lead to premature birth and spontaneous abortion. A short cervical length during pregnancy is sometimes dangerous. This condition is called isthmic-cervical insufficiency, in which the following consequences cannot be excluded:

due to increased pressure, uterine tone occurs, provoking fetal rejection;
there is a possibility of bleeding;
increased risk of miscarriage;
premature dilatation of the cervix occurs.

Gynecologists consider pathologies to include conditions of the genital organs that are dangerous to the fetus, which are determined in the first trimester. Increased uterine tone, creating the risk of interruption, requires the woman to be hospitalized and monitored by a doctor. Often the problem occurs for the following reasons:

The cervix is too high during pregnancy.
Her muscle tissue is very dense and hard.

At the beginning of pregnancy, gynecologists may detect the following pathological complications in a woman:

Endocervicitis. An infectious disease of the canal mucosa, accompanied by purulent discharge, can lead to infection of the fetus. Requires immediate treatment.
Erosion is the appearance of redness and ulceration on the surface of the mucous membranes. It is recommended to begin the treatment process after childbirth.

Causes

To give birth to a healthy child, it is important to carry out regular medical monitoring of women's health. This will help avoid the development of pathologies. The reasons for their appearance may be:

use of instruments during previous births that caused damage to the genitals;
hormonal imbalance;
multiple pregnancy;
low-lying placenta;
large fruit size;
performing abortions;
ruptures during childbirth;
gynecological curettage;
polyhydramnios.

Pathological conditions that are detected early can, in some cases, be corrected. They are often caused by the following reasons:

previous miscarriages;
adhesive process in the uterus;
hypertrophy of muscle tissue - elongated neck;
prolapse of the genital organs;
inflammatory diseases of the cervical canal;
pregnancy caused by IVF;
physiological characteristics of the development of the genital organs;
genetic predisposition;
stress;
uterine fibroids.

The causes of the development of diseases that interfere with the formation of the fetus and normal childbirth may be:

In case of erosion - trauma, previous inflammation, hormonal changes, consequences of infections, excess weight, taking oral contraceptives.
In the case of endocervicitis - promiscuity, pathologies of the genital organs, chemical burns of the mucous membrane, mechanical damage to tissue, disruption of the vaginal microflora.

Signs

Pathologies are often diagnosed during ultrasound at different stages of pregnancy. External signs may appear. A woman may complain of the following symptoms:

nagging pain in the lower abdomen;
a large amount of watery discharge;
the appearance of blood droplets in the mucus;
frequent urination;
tingling in the vaginal area;
formation of bloody discharge.

Diagnostics

To determine the condition of the reproductive organs, doctors perform a gynecological examination in a chair using a two-handed examination and special mirrors. Be sure to prescribe a vaginal smear test for the presence of fungus and sexually transmitted diseases. An ultrasound examination is performed using two methods. One of them - transabdominal - is performed through the anterior wall of the peritoneum in this way:

Before the procedure, be sure to fill the bladder to ensure better visualization.
The surface of the body in the lower abdomen is lubricated with a special gel.
They pass a sensor along it.

The transvaginal method of examination is performed through the vagina. This method provides accurate indicators of the condition of organs and the fetus. The procedure is carried out in the following sequence:

A condom is placed on a special sensor to prevent infection.
Lubricate its surface with gel for better penetration.
Insert into the vagina to a depth of approximately 10 cm.
The image is viewed on the monitor screen.

Cervicometry is performed using the transvaginal ultrasound method. This procedure is carried out several times while the child is waiting. It is definitely prescribed for multiple pregnancies and uterine development abnormalities. Cervicometry helps to establish:

exact neck length;
change in structure, shape;
shortening the size;
patency of the cervical canal.

Ultrasound is performed at various stages of pregnancy. The study helps assess a woman’s health status and identify the following features of organ development:

structural anomalies;
deformations;
the presence of cysts, neoplasms, polyps;
consistency and density;
expansion of the cervical canal;
position relative to the axis of the uterus;
signs of erosion;
tone.

Treatment of cervical pathologies during pregnancy

Treatment tactics depend on the diagnosis and the condition of the organ. If cervical shortening is established, several treatment methods are used for isthmic-cervical insufficiency. These include:

hormone therapy;
the use of drugs that relax the uterus;
prescribing antispasmodics to relieve hypertension;
installation of a pessary on the uterus - a special ring that prevents premature birth;
carrying out cerclage - sutures that are removed before the birth process begins.

Conservative therapy

When diagnosing isthmic-cervical insufficiency, the treatment regimen includes the use of several groups of drugs. If labor is approaching and the muscle tissue is not relaxed, hormonal therapy is prescribed. Prostaglandins are used in the form of suppositories, tablets, vaginal gels:

Prepidil is administered using a special syringe containing the drug. The gel is used at intervals of 6 hours up to a daily dose of 1.5 g.
Cytotec tablet is administered intravaginally. The maximum dosage is 25 mg over 24 hours.

All hormonal drugs are used under mandatory supervision by a gynecologist with periodic testing. The duration of therapy is determined by the doctor depending on the patient’s condition. To stabilize hormonal levels, the following drugs are prescribed:

Utrozhestan - vaginal suppositories, placed twice a day.
Duphaston tablets - take one three times a day.

To relax muscles before childbirth, antispasmodics are used - these are No-shpa, Papazol, which are taken one tablet 2 times a day. Doctors prescribe tocolytics for pregnant women - drugs that relieve muscle tone:

magnesium sulfate in the form of a dropper, the dosage and course of treatment are prescribed by the doctor;
Partusisten - taken orally, one tablet every 6 hours, the duration of therapy depends on the woman’s condition.

To open the cervical canal, a natural remedy is used - kelp sticks made from dried seaweed. They have a length of 7 cm and a diameter of 1 cm, and have the following properties:

due to high hygroscopicity, they increase in size, expanding the channel;
promote the production of prostaglandin, which promotes muscle relaxation.

Physical exercise

Gynecologists recommend performing special exercises to strengthen the muscles surrounding the cervical canal, with its shortened length. It is important not to do this without consulting your doctor, so as not to cause undesirable consequences. Number of repetitions – 10 times. To exclude uterine pathologies, it is useful to do the following exercise:

Stand with your right side to the back of the chair, grab it with your hands.
Take your left leg to the side, raise it to a comfortable position, and lower it.
Turn the other side.
Repeat for the right leg.

It is allowed to perform the complex while expecting a child and during the recovery period after childbirth. The following exercises will be useful:

Spread your legs wide. Sit down slowly and hold for 5 seconds. Perform springing movements with your legs. Take your time to get up.
Squat down, placing one leg to the side. While maintaining your balance with your arms extended forward, transfer the weight of your body from one leg to the other.

Surgical intervention

If the shortening is caused by hormonal reasons, and medications have not helped, surgery is prescribed. Surgical intervention in this case prevents premature birth, early dilatation, and rupture of membranes. Cerclage is performed - sutures are placed, which are removed after 36 weeks. The operation is performed in two ways:

narrowing the internal pharynx using circular stitching;
by applying a suture on the outer part.

The elongated state of the organ does not affect the course of pregnancy, but poses a danger before childbirth. The cervix may not open or the processes will proceed slowly. In this case, a caesarean section is prescribed. When diagnosing isthmic-cervical insufficiency, a woman can have an obstetric pessary installed on her uterus after 20 weeks, which is removed at the end of pregnancy. This helps prevent premature birth. A special plastic or silicone ring has the following effect:

reduces uterine pressure;
relieves the canal muscles.

Prevention

In order for the entire period of waiting for a baby to pass without problems, a woman should regularly visit a gynecologist, starting from planning conception. In order for the child to be born on time and healthy, it is necessary to adhere to certain rules. Prevention includes the following measures:

timely treatment of infectious and inflammatory processes of the reproductive organs;
smoking cessation;
maintaining normal weight;
exclusion of abortions;
pregnancy planning;
adherence to the diet recommended by the doctor.

If gynecologists at an early stage of pregnancy diagnose shortening of the cervical length, the woman needs to:

Avoid bending and lifting heavy objects.
Limit physical activity.
Rest during the day.
Get a good night's sleep.
Refuse to have sex before giving birth.
Avoid nervous tension.
When applying sutures or installing a pessary, follow the regimen prescribed by the doctor.
Take antispasmodics and sedatives.

Video

Healthy intrauterine development of a baby is impossible if the expectant mother has any pathologies of the female genital organs. During pregnancy, doctors regularly evaluate the condition of the cervix. It is especially important to carry out such diagnostics at the earliest stages of pregnancy.

Physiology

The cervix is a kind of entrance to the uterus. This organ is a continuation of the cervical canal. Normal cervical dimensions are very important. Deviations from the norm can lead to various pathologies occurring in a woman and her baby.

The location of the uterus and cervical canal is determined during an extended gynecological examination, which is carried out to the expectant mother on a chair.

The size of the cervix in most healthy women is from 3 to 4.5 cm. A change in this indicator is a very important clinical sign of the development of many pathologies.

Unstable hormonal levels cause the size of the cervix to change. This is especially clear in the second half of pregnancy.

If, when carrying a baby, a woman’s cervix is shortened in size, this is a manifestation of a pathology that requires correction.

State before ovulation

The cervix is adjacent to the vagina in its lower part. In non-pregnant women, this area is hard. Already in the first weeks of pregnancy it becomes loose and softens. The position of the vaginal part of the uterus before menstruation may change slightly. This condition is usually detected by a gynecologist during a gynecological examination.

During different periods of a woman's menstrual cycle, the cervix is different. In the period before ovulation, its hardness is maximum. The cervical canal is narrowed as much as possible. This condition is physiological.

Severe narrowing of the cervical canal is necessary at this stage of the female cycle in order to prevent conception.

During ovulation

During this period of the female cycle, the condition of the cervix changes. It becomes more loose and soft. If a gynecologist conducts an examination during such a period, he will also detect closure of the internal os of the uterus. Doctors call this condition symptom or sign of the pupil.

The cervix also rises slightly during this period. If the location of the reproductive organ is non-physiological, then this situation can lead to the woman experiencing adverse symptoms. Usually in this case, a nagging pain appears, and white discharge from the genital tract begins to appear.

During this period of the female cycle, the secretion of cervical mucus increases. It is necessary for successful conception to occur. It is thanks to this secretion that sperm can penetrate the uterus and the egg.

If the fusion of the sex cells of a man and a woman does not occur, then the next stage of the menstrual cycle begins.

After ovulation

During this period of the female cycle, the position of the cervix changes. This organ begins to shift downward. During a gynecological examination, the doctor determines that the cervix becomes dry and somewhat dense to the touch. The diameter of the cervical canal is insignificant.

This period is characterized by the fact that the cervix is not ready for sperm penetration. Changing hormonal levels contribute to the appearance of such changes. Female sex hormones affect epithelial cells, which leads to the development of their specific changes.

In early pregnancy

During a gynecological examination, the doctor evaluates several clinical indicators. It determines the location, tone, color, shape and density of the cervix.

In the first weeks of pregnancy, the color of the mucous membranes of this organ changes. This zone changes its color from pale pink to dark burgundy. The density of the cervix before a missed period is also different. All clinical indicators change as pregnancy progresses.

During a gynecological examination, doctors already in the first days of pregnancy detect congestion of blood vessels. The tone of the uterus also changes during this period.

If it is too pronounced, then this situation is already a manifestation of pathology - hypertonicity. In this case, more careful monitoring of the expectant mother is required throughout pregnancy.

Characteristic changes in the cervix begin to occur already in the first half of pregnancy. Even in the earliest periods from the moment of conception the density of the organ changes. The cervix becomes softer.

The lumen of this organ also changes. At first, the cervix is slightly open. As pregnancy progresses, the diameter of the cervical canal gradually decreases.

This physiological reaction is necessary to ensure that a woman does not experience premature birth.

The location of the uterus in the pelvis is a very important clinical sign. It may be tilted too far forward or to the side. In this case, the course of pregnancy may be pathological. In such a situation, a woman requires more careful monitoring throughout the entire period of bearing her baby.

In the early weeks of pregnancy, the cervical mucosa appears smooth. This is due to the large amount of cervical mucus produced by the epithelial cells of the cervical canal. Such a biological secretion is necessary in order to protect the pelvic organs and the developing baby from infection.

As pregnancy progresses, the mucous membranes of the cervix become looser. Typically, this situation develops by the third trimester of pregnancy. If the cervix becomes too soft or loose, the expectant mother may even need to be hospitalized in a hospital.

Many women try to palpate the cervix on their own. It is immediately worth noting that It's not worth doing this. It is impossible to identify signs of pregnancy using this method on your own. In this case, only the risk of secondary infection is high.

If a woman has a delay in menstruation after unprotected intercourse, then she should immediately seek advice from a gynecologist.

How to determine the condition of the cervix in the early stages?

To identify cervical pathologies, a gynecological examination is not always necessary. Usually the doctor conducts such studies only when indicated. More often, to monitor developing disorders, doctors resort to prescribing transvaginal ultrasound.

If a woman has a long cervix and no shortening, frequent gynecological examinations are not required. It should be noted that The appearance of cervical pathologies occurs in the very early stages of pregnancy.

It is no coincidence that several clinical examinations are performed during pregnancy. Until the 20th week, the cervix should be the same as before in the first days after conceiving the baby. No significant changes in this organ are observed. This is due to a gradual change in hormonal levels.

In this case, both pharynx of the cervix remain completely closed. The dimensions of this organ range from 4 to 4.5 cm. If in a woman this figure decreases to 2 cm, then in this case doctors talk about shortening.

Normally, the length of the uterus should be within normal limits. Only after 20 weeks does a slight physiological shortening of this organ begin to occur. This condition develops almost before the 28th week of pregnancy.

Subsequently, the size of the cervix continues to decrease. This situation is necessary for natural childbirth.

How do pathologies manifest themselves?

Doctors identify several risk groups, which include women with certain pathologies. In order to assess this risk, anamnesis is very important. If a woman had abortions, especially complicated ones, before conceiving a baby, then in this case more careful monitoring of her pregnancy is required.

The use of obstetric forceps and other auxiliary medical instruments during previous pregnancy contributes to the fact that the cervix may be damaged.

Hormonal imbalance only contributes to the fact that a woman's progesterone levels decrease significantly. In this situation, doctors, as a rule, prescribe special hormonal drugs to pregnant women.

Expectant mothers carrying twins or triplets also have a higher risk of developing various cervical pathologies. Such pathological conditions appear during multiple pregnancy already in its earliest stages.

Low placenta previa very often leads to the development of various pathologies of the cervix. Typically, this pathology develops towards the end of the first trimester of pregnancy.

The lack of full medical control over the development of this condition can contribute to the development of extremely dangerous pathologies for both the expectant mother and her baby.

Women in whom doctors have identified cervical erosion before or in the early stages of pregnancy are at increased risk for the development of various pathologies. In this case, careful monitoring and selection of monitoring tactics for the expectant mother is necessary.

The most important female organ during pregnancy is the uterus, where the fetus grows. At the same time, during gynecological examinations, close attention is paid to her cervix, which holds the fetus and, being tightly closed until the end of the term, prevents the penetration of infections. But sometimes the cervix during pregnancy, for various reasons, does not perform its functions, and in such cases there is a threat of miscarriage.

During pregnancy, the cervix holds the fetus and prevents infections

The cervix is a kind of tube connecting the uterus and vagina, with a diameter of about 2.5 centimeters and a length of 3-4 cm. Its lower part is the vaginal part, the upper part is the supravaginal part. The cervical canal is located inside the cervix; on the outside it is normally pink and smooth, on the inside it is loose and velvety to the touch.

During pregnancy, the cervix changes. The criteria for its normal state, determined at , are as follows:

dense to the touch;
bluish tint due to the proliferation of blood vessels;
increased in length and volume compared to the state before pregnancy;
slightly deviated relative to the pelvic axis;
with overgrown epithelium producing thick mucus;
closed, a finger does not fit into the canal.

The doctor can determine the threat of miscarriage by the loose structure and open cervical canal. If there are suspicions of deviations from the norm, the doctor will prescribe an ultrasound, which will determine the structure and condition of the cervical canal.

Length by week

One of the main criteria that the doctor pays attention to during the patient’s pregnancy is the length of the cervix. If it is less than the values necessary to hold the fetus until birth, there is a risk of miscarriage. Cervical shortening can be detected in two ways:

During a gynecological examination.
When performing a vaginal ultrasound, which is recommended to be done in several positions - standing, lying down, coughing.

Moreover, before pregnancy, it is possible to estimate the length of the cervix only if it decreases as a result of injury and is accompanied by gross, visible anatomical disorders. Reasons There are several reasons why the cervix may be shortened:

Congenital anatomical changes, deficiency of connective fibers, which is rare.
Hormonal changes, especially characteristic for the period of 15-28 weeks, when the fetus’s adrenal glands, which synthesize androgens, are activated.
Consequences of injuries to the muscle ring, operations, abortions, difficult births (for example, with a large fetus or in a breech presentation). During healing, scars form in damaged areas, which impair the ability of muscles to contract and stretch.

Normally, the length should change as the fetus grows and shorten before birth. Dimensions (in millimeters) and other criteria considered normal are shown in the table (in mm).

	10-15 weeks	15-20 weeks	20-25 weeks	25-30 weeks	30-35 weeks	35-37 weeks
First pregnancy	35,2	36,5	40,5	41	35,7	28
Repeated pregnancy	35,6	36,8	40	42,3	36,3	28,5

If an ultrasound examination reveals a shortened cervical cervix in combination with an enlarged pharynx, a diagnosis is made: isthmic-cervical insufficiency" However, it is worth keeping in mind that during the first pregnancy, it is very difficult to detect shortening in the early stages (up to twenty weeks), so an additional examination with a vaginal ultrasound is usually prescribed at 20-22 weeks.

Short cervix: what to do

First of all, a short neck is a reason for constant monitoring, so the number of visits to the gynecologist for women with this pathology is much higher.

According to statistics, it is this pathology that becomes the most common cause of miscarriages occurring in the 2nd trimester, and with habitual abortions it is detected in approximately 20% of cases.

The degree of development of isthmic-cervical insufficiency and, accordingly, the threat to pregnancy is determined by the sum of various criteria.

The scores obtained from the survey are summed up. If their sum is 5 or more, a correction is indicated.

The patient may be prescribed the following treatment methods:

Tocolytic therapy.

Drug treatment aimed at reducing uterine tone and muscle relaxation. To achieve this goal, the following drugs may be prescribed:

Droppers with magnesium sulfate.
Magne B6 up to six times a day.
Beta-agonists, for example, Partusisten.

Hormonal therapy.

Functional shortening of the uterus can occur with changes in hormonal levels, primarily with an increase in androgen levels and a lack of progesterone. The following drugs may be prescribed:

Progesterone up to 25 mg per day.
Utrozhestan orally or intravaginally twice a day until 27 weeks.
Duphaston tablet up to 3 times a day.

Important conditions for hormonal therapy are constant monitoring of hormone levels in the blood and gradual withdrawal of drugs, since abruptly stopping their use can provoke a miscarriage.

The suture is placed in the place where the anterior vaginal vault meets the cervix. This operation can be performed in several ways:

The external pharynx (posterior and anterior lips of the neck) is sutured. The disadvantage of this method is that a sutured cervix creates conditions for the development of infections in a confined space.
Narrowing of the internal pharynx by applying a circular suture. In this case, a hole remains for drainage, so this method is considered more favorable.

The operation is considered simple, but it is performed only in a hospital setting. The optimal period for the operation is 14-20 weeks, but in any case no later than 27 weeks, since later, with noticeable growth of the fetus, there is a high risk of postoperative complications. Anesthesia, as a rule, is administered epidurally and does not harm the health of the fetus. Stitches from the cervix are usually removed at 37 weeks in preparation for childbirth.

Placement of the pessary.

A pessary is a silicone or plastic ring that is placed to relieve the cervix and relieve pressure on the uterus. There are several types of obstetric pessaries; the choice is made depending on the nature of the birth, the diameter of the cervix and the size of the upper part of the vagina.

Installation of the ring is usually painless: the doctor lubricates it with silicone, inserts it into the vagina and places it on the uterus. The optimal timing of the procedure is after 20 weeks, and the pessary is removed at 37-38 weeks. If the ring is displaced, inflammation may develop, so to prevent complications, tests are scheduled every two weeks.

How does an obstetric pessary work?

Maturity indicators

At approximately 37 weeks, the cervix begins to change and prepare for childbirth. These changes are manifested by shortening, softening and smoothing, as well as by the fact that the cervix moves to a central position and begins to open. In gynecology, the term “degree of maturity” is used, which refers to the level of readiness for childbirth. The degree of maturity is expressed in points, which are determined according to the following criteria:

The points received are summed up and the result is evaluated:

Up to 3 points – the neck is immature.
4-6 points – the neck is ripening, not mature enough.
7-10 points – maturity.

If after 37 weeks the cervix does not enter a mature state, we are talking about a pathology opposite to isthmic-cervical insufficiency. It also requires correction, and in some cases, the choice of cesarean section as a method of delivery.

If during early pregnancy the doctor suspects a shortening of the uterus, a gentle regimen is recommended, which involves avoiding physical activity, lifting heavy objects, and exercising caution during sexual relations. At the same time, doctors advise avoiding strict bed rest, since it does not help maintain pregnancy, but can lead to the formation of blood clots.

Sources:

Baskakov P. N., Torsuev A. N., Tarkhan M. O., Tatarinov L. A. Correction of isthmic-cervical insufficiency with an obstetric unloading pessary // Protection of motherhood and childhood. — 2013. — No. 1
Obstetrics - National Guide. Ed. E.K. Ailamazyan, V.I. Kulakova, V.E. Radzinsky, G.M. Savelyeva. Moscow, 2009.

Pregnancy shows signs of the presence of a fertilized egg from the very beginning. The changes concern primarily the reproductive organs. Therefore, it is natural that in the early stages of pregnancy the cervix is made different than before. So the changes happening to her are one of the many symptoms of the event awaiting the woman.

Read in this article

Cervix: where is it?

Not all women will be able to explain, if necessary, what this segment of the reproductive system is, where it is located and what its significance is. This is logical; it is impossible to monitor the health or problems of the cervix on your own. Its examination and assessment is the responsibility of the examining gynecologist.

The cervix is the part of this organ visible during visual examination, which is transitional to the vagina and connects them to each other. It produces mucus at all stages of the menstrual cycle. The role of the cervix during pregnancy cannot be underestimated; it largely ensures that the fertilized egg is kept in its proper place. During examination, only its vaginal part can be detected, but this is often enough to assess the state of gynecological health. Upon examination, it looks like a round, protruding formation, covered with a mucous membrane and having a small hole in the middle.

The usual size of the organ is 4 cm in length and 2.5 in circumference, the consistency is hard, the pharynx is closed, it becomes slightly wider on critical days for the release of secretions.

Changes in the cervix in early pregnancy are quite noticeable to a specialist, which makes it possible to detect this condition. It is considered one of the important signs, along with the cessation of menstruation.

Signs of changes in the area of the uterus after conception

The uterus itself begins to change noticeably from about 4 weeks of pregnancy, when the grown fertilized egg causes protrusion of its wall, an increase in the size of the organ and asymmetry. A specialist can also detect this. What kind of cervix is in the early stages of pregnancy depends on the length of time from its beginning. But the increase in progesterone, which is observed immediately after fertilization of the egg, leads to the fact that the organ changes purely visually. This is easy to notice during a gynecological examination. An experienced doctor can accurately determine the period from the moment of conception.

During early pregnancy, the cervix acquires the following differences from its previous state:

The color of her mucous membrane becomes bluish, and before fertilization it was pink. Do not be afraid of these changes; they are caused by the proliferation of blood vessels and the activation of metabolic processes. This is necessary to improve blood supply in this area, since the formation of the membranes of the fetus and its nutrition require a large amount of oxygen;
Its position changes relative to the main part of the organ;
When palpated during examination, the tissues become different in consistency.

How the location of the vaginal part of the cervix changes

When the embryo appears, the reproductive organs adapt to it in such a way as to ensure normal development, comfort and protect it from possible dangers. This dictates the new position of the cervix in the early stages of pregnancy. It is not constant even before it, changing at different stages of the cycle. But in general, this part of the organ is located quite high relative to the vagina. This is especially noticeable during ovulation, when the body strives to facilitate the penetration of sperm into the female reproductive cell as much as possible.

The position of the cervix in early pregnancy becomes lower than usual. It lowers under the influence of progesterone, preventing the fertilized egg from slipping out. The course of the process depends on the level at which the cervix is located in the early stages of pregnancy, high or low.

If the cervix is high, this may mean increased tone of the organ itself, which creates a risk of interruption. Because of this circumstance, some women have to spend almost the entire period in a horizontal position. But the doctor will also take into account and evaluate other existing signs. Perhaps the high position of the cervix is a feature of a particular organism that does not threaten the fetus in any way.

Cervix consistency

The cervix feels quite soft to the touch during early pregnancy compared to its previous state. This is due to the dilation of its blood vessels, swelling and more active functioning of the glands. The indispensable companion of pregnancy, progesterone, also plays its role, making the uterus itself and the endometrium lining it also looser and thicker. But in comparison with the consistency of the walls of the organ, the cervix is denser. It is like a castle protecting the approaches to the fetus. That does not prevent her from being more mobile than before conception.

Many people are afraid that if the cervix feels soft to the touch during early pregnancy, it will not hold the fertilized egg. The fears are unfounded, since its channel narrows significantly, but the tissues normally still remain elastic and difficult to stretch for a certain time. The glands begin to more actively produce mucus, which becomes thicker and more viscous. A large clot of secretions called a plug forms in the cervical canal. It performs several functions at once:

does not allow foreign bacteria to enter the uterine cavity;
helps maintain the balance of microorganisms in the vagina;
creates comfortable conditions for the functioning of the reproductive organs.

If the cervix in the early stages of pregnancy feels too hard to the touch, this may indicate excessive tension on the organ itself, called. This condition threatens the rejection of the fertilized egg. It is unrealistic to independently assess the consistency of the cervix without being a specialist.

Therefore, you should not “wind up” yourself if it seems too soft or hard during self-examination. Regular visits to the gynecologist are a guarantee that the pathology will be detected before it is too late to correct it.

What is a short neck

Not many women experience pregnancy without any problems. And one of the most serious is the threat of interruption, which is caused by various reasons.

Fetal development and weight gain increase pressure on the cervix. In extreme cases, it shrinks in size and can no longer serve as full protection for the fetus. This condition of the cervix in the early stages of pregnancy is most often caused by hormonal reasons, but it can occur with injuries to the organ in the past, multiple pregnancy and polyhydramnios. This phenomenon is referred to as isthmic-cervical insufficiency and requires constant medical supervision and subsequent treatment. Symptoms of shortening of the cervix during pregnancy, detected by a specialist:

The consistency of its tissues is too soft;
Excessive mobility of this part of the organ;
Expanded lumen of the cervical canal.

In some women, these signs are mild, but in any case, she herself will not notice the problem, especially in the first weeks. It is important that the doctor has the opportunity to see the anomaly, both visually and using ultrasound. This requires timely registration and a lot of examinations.

Why is shortening the cervix dangerous?

In early pregnancy, shortening the cervix is dangerous because it increases the likelihood of miscarriage. Instead of a dense ring that protects the embryo from falling out of the cavity, isthmic-cervical insufficiency leads to the appearance of an element that provokes bleeding next to it. This part of the organ is unable to contain the increasing pressure, which leads to uterine tone. It becomes hard, tense, and its muscles can begin to actively clench and unclench at any moment, trying to reject the fertilized egg.

At an early stage, this is dangerous because the symptoms of cervical contraction during pregnancy are not always noticeable to the woman herself. Shortening of an organ area is also detected using transvaginal ultrasound, which is prescribed at different times. Some women experience:

The appearance of watery discharge. They are present in this state and are normal, but usually thick and not in such large quantities;
Mixing drops of blood into clear mucus;
Frequent need to urinate;
Nagging pain in the lower abdomen, lower back, unpleasant sensations in the form of tingling in the vagina.

Sometimes the short length of this part of the organ is congenital, in more common cases it is acquired. But in order not to provoke shortening of the cervix and not create a threat to the baby, a woman needs to take care of this even before pregnancy, that is:

In addition to a gynecological examination using speculum and two-handed examination, the doctor will refer the woman to undergo a microflora analysis. It is necessary to make sure that there are no sexually transmitted infections or fungi in the body that can harm the fetus. We are talking about the microflora of the vagina, but it directly affects the condition of the cervix.

Another cytology study examines the structure of the cells in this part of the organ. The cervix during pregnancy in the early stages is not at all immune from their degeneration into malignant ones. Two more problems that are sometimes discovered at the beginning:

Endocervicitis. Infectious inflammation of the cervix can lead to the penetration of bacteria into the organ cavity, infection of the fetus, weakening of muscles and, as a result, miscarriage. Therefore, treatment must be carried out immediately. The disease manifests itself in the fact that in the early stages of pregnancy, the infected cervix produces purulent discharge instead of mucous;
. Its formation can be caused by pregnancy or provoked by other reasons. But in any case, treatment is carried out after childbirth, and before it the condition of the epithelium is monitored. Erosion looks like redness or an ulcer on the surface of the mucosa.

In the early stages of pregnancy, a changed cervix is not only one of the symptoms of an “interesting position”. In addition to its protective functions for the fetus, it informs about possible problems that, if adequate measures are not taken, can lead to the worst. Therefore, women should not be afraid and avoid gynecological examination and intravaginal ultrasound, especially if there is a history of abortion, miscarriage, or premature birth.

Specialist help

Feel free to ask your questions and our staff specialist will help you figure it out!

Fertilization of an egg triggers numerous physiological processes in a woman’s body that are aimed at maintaining pregnancy. First of all, this affects the condition of the organs of the reproductive system. It is necessary to consider in more detail possible changes in the cervix after conception, which are the main diagnostic criterion in determining pregnancy.

The cervix is the lower segment of the organ that connects to the vagina. It contains glands that produce mucus throughout the menstrual cycle. When pregnancy occurs, the cervix ensures that the fetus is held in its proper place, preventing the development of spontaneous miscarriage.

Normally, the cervix is a small, rounded formation. Its size does not exceed 4 cm in length and 2.5 cm in circumference. As part of a medical examination, a gynecologist can evaluate only the vaginal segment of the organ. The cervix has a hard consistency, a closed pharynx, which opens slightly during menstrual bleeding to allow discharge. However, the development of pregnancy leads to changes in some characteristics of the organ.

After conception, the cervix becomes soft to the touch. This is due to an increase in the production of progesterone, a hormone that is a companion to pregnancy. It leads to vasodilation, which causes swelling of the endometrium of the uterus. However, the cervix does not lose its firmness and elasticity, which allows the fertilized egg to be preserved. At the beginning of pregnancy, she gains mobility. This is due to the softening of the tissue of the isthmus, which is the part of the uterus that connects the body and the cervix.

The appearance of an embryo in the uterus leads to the activation of glands, which actively produce a thicker and more viscous secretion. A large clot of mucus appears in the cervical canal, which is called a “plug”. It performs the following functions:

Protection of the uterine cavity from the penetration of infectious agents;
Maintaining the balance of vaginal microflora;
Creating optimal conditions for the functioning of the woman’s genital organs.

If after conception the consistency of the cervix remains hard, this indicates the development of hypertonicity of the organ. This pathological condition is characterized by increased tension in the uterus and can lead to rejection of the fertilized egg.

It is impossible to assess changes in the cervix yourself unless you are a specialist. Self-examinations can provoke the development of a vaginal infection and cervical injury. Therefore, only regular examinations by a gynecologist will allow pathology to be detected in time and corrected.

Changing Hue

Immediately after conception, processes begin to occur in a woman’s body that are aimed at maintaining the pregnancy. Usually the cervix is light pink, but during pregnancy it turns bluish-purple.

This is due to the rapid growth of the network of blood vessels in the organs of the reproductive system. The vessels fill with blood, which leads to their expansion and increases blood flow in the uterus. Increased blood supply to the genital organs also provokes swelling of the labia and vaginal walls.

Change of location

After fertilization, a gradual descent of the cervix occurs, its deviation towards the posterior wall. This arrangement reduces the likelihood of spontaneous miscarriage. The placement height is a diagnostic sign that helps the doctor determine how the pregnancy is developing.

A high position is an alarming signal that may indicate the development of hypertonicity. In such situations, doctors hospitalize the patient. After all, only a relaxed state of the uterus allows you to bear a child normally. Constant tension of muscle fibers in most cases provokes embryo rejection.

Sometimes the high location of the lower segment of the uterus is an individual feature of the female body. In such cases, only an intravaginal ultrasound examination of the organ will help determine the presence of a threat of spontaneous abortion.

With a high position of the cervix, women note the development of the following symptoms:

Watery discharge in large quantities;
Frequent urge to urinate;
The appearance of a nagging pain in the lower abdomen, in the lumbar region;
The appearance of blood streaks in mucous secretions.

Such symptoms should alert a pregnant woman and become a reason for urgent consultation with a specialist.

How is the organ examined after fertilization?

If pregnancy occurs, the woman should consult a gynecologist. The doctor will perform a gynecological examination using speculum and two-handed examination. Additionally, a study of the vaginal microflora will be required to ensure the absence of sexually transmitted infections that could threaten the fetus.

It is necessary to conduct cytology - a histological examination of cervical cells. This is necessary to prevent the development of cancer. The fact is that during pregnancy, a woman’s immunity is suppressed in order to prevent fetal rejection. This process can trigger the rapid growth of cancer cells that are in the body.

When pregnancy occurs, the development of the following diseases should be additionally excluded:

Endocervicitis. This is an infectious lesion of the cervix, which can provoke the penetration of bacteria into the uterine cavity, infection of the fetus, decreased tone of the organ and spontaneous abortion. Therefore, it is necessary to promptly determine the presence of infection and begin therapy;
Erosion (small ulcer on the uterine mucosa). The cause of the pathological formation may be pregnancy or infection. The disease requires constant monitoring by a specialist, but treatment is carried out only after delivery.

The listed changes in the cervix allow the gynecologist to draw a conclusion about the occurrence of pregnancy, its duration, and the development of threatening factors. You should not engage in self-diagnosis, because it can lead to the development of dangerous diseases and termination of pregnancy. Regular examinations with a doctor will allow you to monitor any changes in the process of bearing a child and stop pathologies in a timely manner.