The position of the cervix. The cervix in different phases of the cycle and during pregnancy

A pleasant waiting period for a baby can be overshadowed if pathologies of the development of the genital organs are found. During pregnancy, gynecologists must monitor the condition of the cervix. What transformations are taking place with 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 the conditions for bearing and giving birth to a child. The cervix connects the vagina with the uterus - a muscular ring that affects the course of pregnancy and the process of childbirth. This part of the female genital organs has features:

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

After conception, under the influence of hormonal processes, the cervix begins to change. When a gynecologist examines from the side of the external pharynx, then under normal conditions it looks smooth, elastic, pale pink in color. The cervix is 4 cm long and 2.5 cm in diameter. From the fourth week of pregnancy, changes can be seen:

appearance;
sizes;
location;
consistency.

The gynecologist monitors the condition of the woman during regular check-ups. The doctor necessarily assesses the situation with the genitals, in which changes occur from the first months of pregnancy. In order for the fetus to be properly nourished and formed, in the body of a woman:

the hormonal background is activated;
metabolic processes are boosted;
there is proliferation of blood vessels;
blood circulation is enhanced.

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

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

Doctors conduct control examinations at the beginning of the first trimester, at 20, 28, 32, 36 weeks. Depending on the gestational age, there are changes in the characteristics that affect the condition of the cervix. The determining factors for determining the normal course of pregnancy are the following indicators:

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

Consistency

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

maintains the balance of the microflora of the vagina;
does not allow bacteria to enter the uterine cavity;
prevents slipping of the fetal egg;
creates conditions for the formation of the embryo.

The gynecologist necessarily controls 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 are not excluded. This can happen if the doctor during the examination finds:

ajar internal pharynx, loose muscle tissue;
dense to the touch, hard neck - evidence of hypertonicity, in which fetal rejection is possible.

Length

With an increase in the term, the cervix undergoes changes. Until the twentieth week of pregnancy, its length should remain constant. With the growth of the fetus, its pressure on the organ increases, the size gradually decreases by 1-2 cm. This is necessary for the successful course of childbirth. The normal length of the cervix, depending on the period of pregnancy, should be as follows:

Permeability and position

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

a favorable case for childbirth - placement in the middle;
deviation to the side, tilt forward - are fraught with pathologies of pregnancy that require observation.

An indicator of the maturity of the cervix is the patency of the cervical canal, which is controlled by a gynecologist with 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 pharynx, it is possible that only the tip of a finger may enter the cervical canal.

Pathology 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, spontaneous abortion. The short length of the cervix during pregnancy is sometimes dangerous. This condition is called isthmic-cervical insufficiency, in which the following consequences do not exclude:

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

The pathologies of gynecologists include conditions of the genital organs that are dangerous for the fetus, which are determined in the first trimester. The increased tone of the uterus, which creates the danger of interruption, requires the hospitalization of the woman and the control of the doctor. Often the problem occurs for the following reasons:

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

At the beginning of the term, gynecologists can also detect such 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 - the appearance of redness, ulceration on the surface of the mucous membranes. The treatment process is recommended to start after childbirth.

Causes

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

use during previous births of instruments that led to damage to the genitals;
hormonal imbalance;
multiple pregnancy;
low placenta previa;
large size of the fetus;
abortion;
breaks during childbirth;
gynecological curettage;
polyhydramnios.

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

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

The reasons for the development of diseases that prevent the formation of the fetus and normal childbirth can be:

With erosion - trauma, inflammation, hormonal changes, the effects of infections, overweight, taking oral contraceptives.
In the case of endocervicitis - promiscuous sexual relations, pathologies of the genital organs, chemical burns of the mucous membrane, mechanical damage to tissues, violation of the vaginal microflora.

signs

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

pulling pains in the lower abdomen;
a large amount of watery discharge;
the appearance of droplets of blood in the mucus;
frequent urination;
tingling in the vaginal area;
formation of bleeding.

Diagnostics

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

Be sure to fill the bladder before the procedure to ensure better visualization.
The surface of the body in the lower abdomen is lubricated with a special gel.
Run a sensor through it.

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

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

Using the transvaginal ultrasound method, cervicometry is performed. This procedure is carried out during the waiting period of the child several times. It must be prescribed for multiple pregnancies, anomalies in the development of the uterus. Cervicometry helps to establish:

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

Ultrasounds are performed at various stages of pregnancy. The study helps to assess the state of health of a woman, to identify in her such features of the development of the body:

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 pathologies of the cervix during pregnancy

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

hormone therapy;
the use of drugs that relax the uterus;
the appointment of antispasmodics to relieve hypertonicity;
installation of a pessary on the uterus - a special ring that prevents premature birth;
cerclage - suturing, which is removed before the onset of the birth process.

Conservative therapy

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

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

All hormonal drugs are used with the obligatory control of a gynecologist with periodic tests. The duration of therapy is determined by the doctor depending on the condition of the patient. To stabilize the hormonal background, the following drugs are prescribed:

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

To relax the muscles before childbirth, antispasmodics are used - these are No-shpa, Papazol, which are taken on a 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 doctor prescribes the dosage and course of treatment;
Partusisten - taken orally, one tablet after 6 hours, the duration of therapy depends on the condition of the woman.

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, 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 the consent of the doctor, so as not to cause undesirable consequences. The number of repetitions is 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, lower it.
Turn the other side.
Repeat for the right leg.

It is allowed to perform the complex while waiting for the child and during the recovery period after childbirth. The following exercises will be helpful:

Spread your legs wide. Slowly sit down, linger for 5 seconds. Perform springy leg movements. Don't rush to get up.
Squat down with one leg out to the side. Maintaining balance with arms extended forward, transfer the weight of the body from one leg to the other.

Surgical intervention

If the shortening is caused by hormonal causes, and the drugs did not help, an operation is prescribed. Surgical intervention in this case prevents premature birth, early disclosure, rupture of the membranes. Cerclage is performed - suturing, which is removed after 36 weeks. The operation is performed in two ways:

narrowing of the internal pharynx with the help of circular stitching;
seam on the outside.

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

reduces uterine pressure;
unloads the muscles of the canal.

Prevention

In order for the entire period of waiting for the baby to pass without problems, a woman should regularly visit a gynecologist, starting with the planning of conception. In order for a child to be born on time and healthy, certain rules must be followed. Prevention includes the following activities:

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

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

Avoid bending, lifting weights.
Limit physical activity.
Rest during the day.
Organize a good night's sleep.
Refuse to give birth from sexual activity.
Avoid nervous tension.
When suturing, installing a pessary, follow the regimen prescribed by the doctor.
Take antispasmodics, sedatives.

Video

Healthy intrauterine development of the baby is impossible if the expectant mother has any pathology of the female genital organs. During pregnancy, doctors regularly evaluate the condition of the cervix. It is especially important to carry out such a diagnosis in the very early stages of bearing a baby.

Physiology

The cervix is a kind of entrance to the uterus. This organ is a continuation of the cervical canal. The normal size of the cervix is very important. Deviations from the norm can lead to the fact that a woman and her baby will have various pathologies.

The location of the uterus and cervical canal is determined during an extended gynecological examination, which is held by the expectant mother on the armchair.

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.

An unstable hormonal background contributes to the fact that the size of the cervix can change. This is especially clear in the second half of pregnancy.

If, when carrying a baby in a woman, doctors determine the shortening of the cervix, this is a manifestation of a pathology that requires correction.

Condition before ovulation

The cervix is adjacent in its lower part to the vagina. In non-pregnant women, this zone is solid. 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 somewhat. This condition is usually detected by a gynecologist during a gynecological examination.

In different periods of the menstrual cycle of a woman, 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.

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

At ovulation

During this period of the female cycle, the condition of the cervix changes. It becomes looser and softer. If the gynecologist conducts a study during such a period, he will also find the 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 genital organ is not physiological, then this situation can lead to the fact that the woman will have adverse symptoms. Usually in this case, a pulling soreness 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 essential for successful conception. It is thanks to this secret that spermatozoa can penetrate into the uterus and to the egg.

If the fusion of the germ 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 body begins to move down. 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 small.

This period is characterized by the cervix is not ready for sperm penetration. The changing hormonal background contributes to the appearance of such changes. Female sex hormones act on 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 maroon. The density of the cervix before the delay of menstruation is also different. All clinical indicators change with the course of pregnancy.

During a gynecological examination, doctors already in the first days of pregnancy reveal plethora 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 the 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 organ density changes. The cervix becomes softer.

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

This physiological reaction is necessary so that a woman does not have a premature birth.

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

In the initial weeks of pregnancy, the mucous membrane of the cervix looks smooth. This is due to the large amount of cervical mucus produced by the epithelial cells of the cervical canal. Such a biological secret is necessary in order to protect the pelvic organs and the developing baby from infection.

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

Many women try to palpate the cervix on their own. It should be noted right away that it's not worth doing it. 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 detect pathologies of the cervix, it is not always necessary to conduct a gynecological examination. Usually, the doctor conducts such studies only according to indications. 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 pathologies of the cervix occurs in the very early stages of pregnancy.

It is no coincidence that several clinical examinations are carried out during pregnancy. Until the 20th week, the cervix should be the same as before in the first days after the conception of the baby. Significant changes in this body are not observed. This is due to a gradual change in hormonal levels.

In this case, both cervical os remain completely closed. The dimensions of this organ in this case range from 4 to 4.5 cm. If in a woman this indicator drops to 2 cm, then in this case, doctors talk about shortening.

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

In the future, 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 such a risk, the anamnesis is very important. If a woman before the previous conception of a baby had abortions, especially complicated ones, then in this case more careful monitoring of her pregnancy is required.

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

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

Expectant mothers with twins or triplets also have a higher risk of developing various cervical pathologies. Such pathological conditions are manifested in multiple pregnancy already at its earliest stages.

Low placenta previa very often leads to the development of various pathologies of the cervix. Usually such a pathology is formed by 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 even before the onset 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 tactics for monitoring the expectant mother is necessary.

The most important female organ during pregnancy is the uterus, in which the fetus grows. At the same time, during gynecological examinations, close attention is paid to her neck, 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 the penetration of 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 section is the vaginal part, the upper one is supravaginal. Inside the neck is the cervical canal; outside it is normally pink and smooth, inside - loose, 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 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, the finger does not pass 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 determines the structure and condition of the cervical canal.

Length per 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 \u200b\u200bnecessary to hold the fetus until childbirth, there is a risk of miscarriage. The shortening of the neck can be detected in two ways:

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

At the same time, before pregnancy, it is possible to estimate the length of the cervix only if it decreases as a result of injuries and is accompanied by gross, visible anatomical disorders. reasons, along which the cervix can be shortened, several:

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

Normally, the length should change as the fetus grows and shorten before childbirth. 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 scan reveals a shortened cervix in combination with an expansion of the pharynx, the diagnosis is " isthmic-cervical insufficiency". However, it should be borne in mind that during the first pregnancy it is very difficult to catch a shortening in the early stages (up to twenty weeks), therefore, an additional examination with a vaginal ultrasound is usually prescribed for a period of 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 in women with this pathology is much greater.

According to statistics, it is this pathology that becomes the most common cause of miscarriages that occur in the 2nd trimester, and with habitual interruptions, it is found in about 20% of cases.

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

The scores obtained from the survey results are summarized. If their sum is 5 or more, a correction is shown.

The patient may be prescribed the following treatments:

Tocolytic therapy.

Drug treatment aimed at reducing the tone of the uterus and relaxing the muscles. To achieve this goal, the following drugs can be prescribed:

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

hormone therapy.

Functional shortening of the uterus can occur with changes in the hormonal background, primarily with an increase in the level of androgens 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.
Dufaston tablet up to 3 times a day.

Important conditions for hormone therapy are constant monitoring of the level of hormones in the blood and the gradual withdrawal of drugs, since a sharp cessation of their intake can provoke a miscarriage.

The suture is applied at the point where the anterior fornix of the vagina passes into the cervix. This operation can be performed in several ways:

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

The operation is considered simple, but it is carried out only in a hospital. The optimal time for the operation is 14-20 weeks, but in any case not later than 27 weeks, since later, with a 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 closed neck are usually removed at 37 weeks to prepare for childbirth.

Placement of a pessary.

A pessary is a silicone or plastic ring that is placed to unload the cervix and ease the pressure on it from the uterus. There are several types of obstetric pessaries; the choice is made depending on the number of births, 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 time for the procedure is after 20 weeks, and the pessary is removed at 37-38 weeks. When the ring is displaced, inflammation can develop, so testing is scheduled every two weeks to prevent complications.

How does an obstetric pessary work?

Maturity indicators

At about 37 weeks, the cervix begins to change and prepare for childbirth. These changes are manifested by shortening, softening and smoothing, as well as the fact that the neck moves into 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 obtained 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 become mature, it is a pathology opposite to isthmic-cervical insufficiency. It also requires correction, and in some cases, the choice of caesarean section as a method of delivery.

If, during early pregnancy, the doctor suspects a shortening of the uterus, a sparing regimen is recommended, which involves the rejection of physical exertion, heavy lifting, and caution during sexual intercourse. At the same time, doctors advise avoiding strict bed rest, since it does not contribute to the preservation of 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 Guidelines. Ed. E.K. Ailamazyan, V.I. Kulakova, V.E. Radzinsky, G.M. Savelyeva. Moscow, 2009.

Pregnancy shows signs of the presence of a fetal 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 becomes different than before. So the changes taking place with her are one of the many symptoms of an event awaiting a woman.

Read in this article

Cervix: where is it?

Not all women will be able to explain, if necessary, what kind of segment of the reproductive system it is, where it is located and what significance it has. This is logical, it is impossible to keep track of the health or dysfunction of the cervix on your own. Its examination and evaluation is the responsibility of the examining gynecologist.

The cervix is the part of this organ that is 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 gestation cannot be underestimated, it is it that largely ensures the retention of the fetal egg in its proper place. During examination, only its vaginal part can be detected, but this is enough to assess the state of gynecological health. On 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 firm, the pharynx is closed, it becomes slightly wider on critical days for the release of secretions.

A change in the cervix in early pregnancy is 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 uterus after conception

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

The cervix during early pregnancy acquires the following differences from the previous state:

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

How does the location of the vaginal part of the cervix change?

The reproductive organs, when an embryo appears, adapt to it in such a way as to ensure normal development, comfort and protect against possible dangers. This dictated the new position of the cervix in early pregnancy. It is impermanent and before it, it changes at different stages of the cycle. But in general, this part of the body is relatively high relative to the vagina. This is especially noticeable during ovulation, when the body seeks to facilitate the penetration of spermatozoa to the female reproductive cell as much as possible.

The location of the cervix in early pregnancy becomes lower than usual. It falls under the influence of progesterone, preventing the fetal egg from slipping out. The course of the process depends on the level of the cervix in early pregnancy, high or low.

If the cervix is high, this may mean an increased tone of the organ itself, which creates the danger of interruption. Some women, because of this circumstance, 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 neck is a feature of a particular organism that does not threaten the fetus in any way.

Neck consistency

The cervix to the touch during early pregnancy is quite soft compared to the previous state. This is due to the expansion of its vessels, swelling and more active work of the glands. Progesterone, an indispensable companion of pregnancy, 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 neck is denser. It is, as it were, a castle that guards the approaches to the fetus. That does not prevent her from being more mobile than before conception.

Many are afraid that if the cervix is soft to the touch during early pregnancy, it will not hold the fertilized egg. There are no grounds for fear, since its channel is significantly narrowed, and the tissues normally still remain elastic and difficult to stretch until a certain time. The glands begin to actively produce mucus, which becomes thicker and more viscous. A large clot of secretions forms in the cervical canal, called a plug. It performs several functions at once:

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

If the cervix in early pregnancy is too hard to the touch, this may signal excessive stress on the organ itself, called. This condition threatens the rejection of the fetal egg. It is unrealistic to assess the consistency of the cervix on your own, without being a specialist.

Therefore, you should not "wind" 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 get pregnant without any problems. And one of the most serious is the threat of interruption, which is caused by various reasons.

The development of the fetus and its weight gain increase the pressure on the cervix. In extreme cases, it shrinks in size and can no longer serve as a full-fledged protection for the fetus. This condition of the cervix in early pregnancy is most often caused by hormonal causes, but it happens with injuries received by the body 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:

Too soft texture of its tissues;
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 with the help of ultrasound. This requires timely registration and a lot of surveys.

What is the danger of shortening the neck

In early pregnancy, shortening the cervix is dangerous by increasing 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 body is not able to contain the increasing pressure, which leads to the tone of the uterus. She becomes hard, tense, her muscles at any moment can begin to actively contract and decompress, trying to reject the fetal 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 a section of an organ is also detected using transvaginal ultrasound, which is prescribed at different times. Some women experience:

Appearance of watery discharge. They are in this state and are normal, but usually thick and not in such a large amount;
Mixing blood drops to transparent mucus;
Increased need to urinate;
Pulling pain in the lower abdomen, lower back, discomfort 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 an acquisition. But in order not to provoke a shortening of the cervix herself and not pose a threat to the child, a woman needs to take care of this even before pregnancy, that is:

In addition to a gynecological examination using mirrors and a two-handed examination, the doctor will refer the woman for microflora analysis. It is necessary to make sure that there are no venereal infections and a fungus in the body that can harm the fetus. We are talking about the microflora of the vagina, but it affects the state of the cervix in the most direct way.

Another study on cytology studies the structure of the cells of 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 found 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 the muscles and, as a result, miscarriage. Therefore, treatment should be carried out immediately. The disease is manifested by the fact that in the early stages of pregnancy, the infected cervix produces purulent instead of mucous secretions;
. Its formation can be caused by pregnancy, and provoked by other reasons. But in any case, treatment is carried out after childbirth, and before them, the state of the epithelium is monitored. Erosion looks like redness or sore on the surface of the mucosa.

In the early stages of pregnancy, an altered cervix is not only one of the symptoms of an "interesting situation." In addition to the 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, and premature birth.

Help from a specialist

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

Fertilization of the egg starts numerous physiological processes in the body of a woman, which are aimed at maintaining pregnancy. First of all, this is reflected in the state 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 entire 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 only evaluate the vaginal segment of the organ. The cervix has a firm consistency, a closed pharynx, which opens slightly during menstrual bleeding to release secretions. However, the development of pregnancy leads to a change in some characteristics of the body.

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 of pregnancy. It leads to vasodilation, which causes swelling of the endometrium of the uterus. However, the neck does not lose its elasticity and elasticity, which allows you to save the ovum. At the beginning of pregnancy, she acquires mobility. This is due to the softening of the tissues of the isthmus, which is the part of the uterus that connects the body and the cervix.

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

Protection of the uterine cavity from the penetration of infectious agents;
Maintaining the balance of the microflora of the vagina;
Creating optimal conditions for the work of the female genital organs.

If after conception the consistency of the cervix remains firm, then this indicates the development of hypertonicity of the organ. This pathological condition is characterized by increased tension of the uterus, which can lead to rejection of the fetal egg.

It is impossible to evaluate changes in the cervix on your own if you are not a specialist. Self-exams can provoke the development of a vaginal infection, cervical injury. Therefore, only regular examinations by a gynecologist will allow timely detection of pathology and correct it.

Hue change

Immediately after conception, processes begin to occur in the body of a woman that are aimed at maintaining pregnancy. Usually the cervix has a light pink hue, but during the bearing of a child, it becomes a bluish-purple color.

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. Strengthening the blood supply to the genital organs also provokes swelling of the labia, the walls of the vagina.

Change of location

After fertilization, a gradual descent of the cervix occurs, its deviation towards the back wall. This arrangement reduces the likelihood of spontaneous miscarriage. Placement height is a diagnostic feature that helps the doctor determine how the pregnancy is progressing.

A high location 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 carry the child normally. The constant tension of muscle fibers in most cases provokes the rejection of the embryo.

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 location of the neck, women note the development of the following symptoms:

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

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

How is the organ examined after fertilization?

If pregnancy occurs, a woman should consult a gynecologist. The doctor will conduct a gynecological examination using mirrors and a two-handed examination. Additionally, a study of the microflora of the vagina will be required to make sure that there are no sexually transmitted infections that could threaten the fetus.

It is necessary to carry out cytology - a histological examination of the cervical cells. This is necessary to prevent the development of cancer. The fact is that during pregnancy, the woman's immunity is suppressed in order to prevent rejection of the fetus. 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, a decrease in the tone of the organ and spontaneous abortion. Therefore, it is necessary to determine the presence of infection in a timely manner, to begin therapy;
Erosion (a small sore 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 make a conclusion about the occurrence of pregnancy, its duration, the development of threatening factors. Do not engage in self-diagnosis, because it can lead to the development of dangerous diseases, abortion. Regular examinations with a doctor will allow you to track any changes in the process of bearing a child, and stop pathologies in time.