What are the risks of shortening the cervix during pregnancy? Short cervix: minor pathology or death sentence. Why the cervix opens prematurely and diagnosis of pathology

A short cervix is ​​a pathological condition in which its softening and decrease in length are detected. In a normal pregnancy, the cervix should be at least 4 cm long, this helps to keep the fetus in the uterine cavity.

If the cervix is ​​short according to ultrasound during pregnancy, then the woman needs to immediately solve this problem. This pathological condition can provoke the opening of the cervical canal, which leads to the premature birth of the baby.

Cervix during pregnancy

During the period of bearing a child, every pregnant woman undergoes a periodic examination in a gynecological chair, during which the doctor assesses the condition and degree of closure of the cervical canal.

If necessary, the doctor may prescribe additional examination methods to determine the degree of development of this pathological condition.

During pregnancy, the entire female body undergoes significant changes, especially the reproductive system. During this period, there is an increase in blood flow in the pelvic organs, as a result of which the epithelial tissue lining the cervical canal grows and begins to produce special mucus in larger quantities.

The muscle layer of the organ also changes, while the cervix increases in volume and size. All this is an obstacle to the penetration of infection into the uterine cavity to the fetus, and also contributes to a favorable course of pregnancy.

However, under the influence of certain factors, protective processes may fail. In this case, the cervical canal may begin to open and the cervix can no longer hold the fetus.

In this regard, women diagnosed with a short cervix are subject to enhanced monitoring and are at risk for miscarriage.

Why does the cervix shorten?

Signs of cervical shortening are most often detected when examining a pregnant woman between 15 and 20 weeks. Just at this time, the load on the structural parts of the perineum increases. This is due to increased fetal growth.

Shortening of the cervix during pregnancy can be provoked by the following predisposing factors:

• Genetic features of the structure of the female genitourinary organs: incorrect anatomy of the cervix and malformations of its development;
• Cervical injuries during previous childbirth, during artificial termination of pregnancy and other gynecological operations;
• Hormonal instability of the body - increased amount of male hormones in the blood (androgens);
• Increased content of relaxin in tissues present in the cervical wall.

All these factors can lead to premature opening of the cervical canal. This process is quite aggravated by multiple pregnancies, in which the pressure on the cervix more than doubles. Polyhydramnios and a large fetus predispose to the development of shortened cervical canal.

What is the danger of such a condition?

The main risks with a shortened cervix in length are associated with possible termination of pregnancy at various stages. This pathological condition can lead to the following consequences for the woman and child:

First.

Development of isthmic-cervical insufficiency (ICI). In this condition, the internal and external pharynx begins to open, which leads to the impossibility of holding the fetus in the womb. In the short term, this can lead to late miscarriage, and in the long term, it can lead to premature birth.

Second.

When the cervical canal is open, the risk of infection from the vagina entering the uterine cavity increases significantly. This can threaten intrauterine infection of the fetus, which, in the event of unfavorable concomitant conditions, can provoke its death.

Third.

It should also be noted that a short cervix during labor can contribute to its rapid progress. That is, the birth of a baby occurs in a short time.

In this case, regardless of the weight and size of the child, significant damage to the birth canal can occur: ruptures of the perineum and vagina, the occurrence of hematomas in the walls of the genital organs.

Since a short cervix poses a threat of miscarriage, the uterus, in turn, tries to prevent this process.

In this case, a woman experiences such an unpleasant condition as increased tone, when the pregnant woman feels periodic pain in the lower abdomen, accompanied by tension in the abdominal wall and a feeling of fossilization of the walls of the uterus.

Features of the pathological condition at different stages of pregnancy

A peculiarity of the female body is that the content of hormones at different stages of pregnancy changes significantly. This is necessary for the normal course of pregnancy and the safe entry of a woman into childbirth.

In this regard, cervical length indicators may vary at different periods. Let's consider what features shortening of the cervix has during the most significant periods during pregnancy.

20 weeks

Gestational age 20 weeks is considered the middle of pregnancy. During this period, the load on the cervix increases significantly and an increased increase in abdominal parameters begins. It is at 20 weeks that a woman will undergo a second scheduled ultrasound scan during pregnancy.

In the normal course of bearing a child in the period from 20 to 25 weeks, the cervix should have a length of about 4 cm. According to the results of an ultrasound examination The norm is considered to be within 3 cm. If the length of the cervix is ​​less than this value, then a diagnosis of “short cervix” is made.

A short cervix during pregnancy, detected at 20 weeks, is subject to weekly monitoring and, as it progresses, requires the use of various treatment methods. The main measure to prevent miscarriage in this period is the woman’s complete physical and sexual rest.

30 weeks

At this time The length of the cervical canal should be within 2.5 cm. If this figure is lower according to ultrasound, there is cause for concern. Despite the fact that at 30 weeks the fetus is already viable and can survive if premature birth occurs, it is still better to prevent such a situation.

A good circumstance for a pregnant woman who is diagnosed with a short cervix at 30 weeks is that maternity leave begins right now.

This will allow you to spend more time at rest, without exposing your body to various physical and psychological stress.

32 weeks

During this period, the female body is already beginning to prepare for the upcoming birth. The ratio of hormones in the blood changes, which leads to gradual softening and possible shortening of the cervix. The normal length of the cervical canal at this stage is 2 cm. Measurements are carried out at the third planned ultrasound.

A short cervix detected during pregnancy at 32 weeks can cause premature birth. However, now it will not be as dangerous as before.

To prevent the birth of a child before the due date, a woman needs medical supervision and constant bed rest. For this purpose, hospital treatment is recommended for pregnant women with a short neck at 32 weeks.

Treatments used for a short cervix

The doctor’s tactics and the choice of treatment method for a short cervix depend on many factors: the length of the cervix, the length of the pregnancy, a history of gynecological operations, the location of the placenta and the presence of uterine tone. In this regard, the following treatment methods are distinguished:

Surgical correction.

This method involves placing special surgical sutures on the cervix under anesthesia. The manipulation is called “cervical cerclage”. This procedure is carried out until 28 weeks.

After applying U-shaped sutures to the cervix, a woman must take antibacterial drugs, as the risk of infectious complications increases. Sutures are removed at 38 weeks.

Non-surgical methods.

They include placing a pessary on the cervix - a special silicone ring that keeps the cervix from dilating. This method of treatment is used for minor shortening of the cervix and for non-progressive pathology.

A pessary is applied on an outpatient basis no earlier than 28 weeks of gestation. After this procedure, the woman must be examined by a gynecologist every two weeks to monitor the installation of the ring and carry out preventive sanitation of the vagina. The pessary is removed before delivery, usually at 38 weeks.

Drug therapy.

If a woman is diagnosed with a hormonal nature of the occurrence of ICI, then she is prescribed progesterone-type drugs: Duphaston or Utrozhestan. The use of these medications significantly reduces the risk of spontaneous abortion.

Synthetic progesterones can reduce the tone of the uterus, thereby reducing the load on the cervix and preventing the opening of the cervical canal. The drugs can be used either orally in the form of tablets or intravaginally in the form of suppositories.

Also, a shortened cervix, diagnosed during pregnancy, requires a woman to observe a special lifestyle: minimizing physical activity, eliminating stressful conditions, sexual rest, bed rest, prevention of genital tract infections.

Having a healthy baby is the dream of every woman. But its implementation is in jeopardy if difficulties arise during pregnancy. A change in the length of the uterine cervix (towards a decrease) during gestation is one of these complications. If the deviation is diagnosed in the early stages, pregnancy prolongation is carried out successfully. However, the prevalence of the problem is quite wide.

Short cervix during pregnancy - there is a reliable solution to the problem

Most women are unaware that the cervix is ​​not long enough. This serious pathology affects women's health. Its symptoms are especially dangerous during pregnancy. The diagnosis is made directly during pregnancy. To achieve this, a number of studies are being carried out using ultrasound and medical equipment.

Length before pregnancy

The cervix is ​​a dense muscular ring. It is located between the uterus and vagina. For a woman before pregnancy, the norm is considered to be a length of 30 mm, the pharynx is closed. Its standard length is defined as 1/3 of the total size of the uterus.

What should be the length of the cervix during pregnancy?

During gestation, deviations occur in the length and consistency of the uterine cervix, and also the size of the opening of the pharynx changes. In the early stages, the length should not be less than 35-40 mm (12-37 weeks). Shortening of the cervix Only by the 38th week of gestation should the cervix shorten - this is considered normal. A significant change in length occurs shortly before the onset of labor - up to 15 - 10 mm.

During this period, the cervix occupies a central position in the pelvis. If there is a shortening of the cervix within 30 mm, then special attention is required. A woman whose length has decreased to 15-20 mm is better off under constant observation in a hospital.

Is it dangerous if you have a short cervix?

If such a diagnosis is made, then its consequences are very serious - a woman has a 50% risk of giving birth in the next 2 weeks. The threat of miscarriage and premature birth are caused by a shortened cervix. In this state, it may not perform an important function - to hold the uterus together with the ever-increasing fetus.

Infection of the gestating fetus as a result of the lack of complete protection poses a great threat. A pregnant woman faces the danger of rapid labor development. The result of which is often ruptures of the vagina, cervix, and perineum. Diagnosing the problem at an early stage of pregnancy allows you to correctly determine the method of treating the pathology.

Reasons for shortening

The reasons why the cervix undergoes shrinkage are different. The following factors are common:

1. Natural anomaly of the structure of the uterus (underdeveloped cervical canal; defects that arose during the development of the uterus; the presence of genital infantilism).
2. Hyperandrogenism (the presence of excess amounts of androgens - sex hormones characteristic of men).
3. Hormonal disorders arising during pregnancy (no symptoms). Damage resulting from previous childbirth.
4. Injuries that occurred during surgical interventions, abortions.
5. Organ pathology caused by connective tissue dysplasia.

Symptoms in the second trimester

Detection of pathological manifestations of the cervix is ​​possible during the second trimester using ultrasound or gynecological examination. Typically, a vaginal examination of pregnant women is rarely performed, but if a woman complains, it is mandatory.

When carrying a fetus, a woman should be alert to symptoms such as:

1. The appearance of tingling pain in the vagina.
2. The occurrence of cramping pain in the lower abdomen, in the lower back.
3. The presence of unusual secretions - thick mucus, bloody, watery secretions that have a specific odor.

The appearance of the latter (liquid, with a characteristic odor) indicates that amniotic fluid is leaking out. The development of such symptoms is observed from 22 weeks. If any of these signs appear, you should immediately contact your gynecologist.

What are the dangers of reducing length?

The pathology threatens spontaneous miscarriage and premature birth. This is due to the fact that pressure from the growing baby occurs, and the cervix may open prematurely. This provokes a weakening of the fetus’s defense against infections. If childbirth occurs in a timely manner, then this state of the organ causes a rapid course of events. It may be accompanied by ruptures not only of the cervix, but also of the perineum.

Deformation of the uterine cervix is ​​one of the signs of ICI (isthvicocervical insufficiency). With this condition, there is a risk of pregnancy failure due to physiological problems associated with keeping the fetus within the uterus. The cervix and isthmus are under constant pressure from the developing baby.

If a pregnant woman regularly visits a gynecologist and undergoes routine ultrasound examinations, then if there is a pathology, it will definitely be detected by the doctor. Timely measures taken will help prolong pregnancy.

If narrow and short

The most correct solution would be systematic observation by a gynecologist if it is discovered that the length of the cervix has decreased. Be sure to remain calm, take care of yourself and follow the advice of a specialist. It is necessary to pay attention to the tone, which affects the early maturation of the cervix, affects the decrease in its length and opening.

Physical activity is limited. It is recommended to wear a bandage. If this pathology is detected, the woman will be offered corrective treatment. The doctor chooses the tactics; it depends on the duration and causes of the violation. The most common mistake women make is fear of undergoing procedures.

How to lengthen or treat

Depending on the clinical picture and gestation period, the pathology treatment method is selected. It can be preventative, conservative, or require surgical intervention. If there is a need, the method used is adjusted.

If the critical length of the cervix (30 mm) is fixed at 20 weeks, then this is a reason to take the woman under mandatory control. In this situation, she will have to visit the gynecologist on a special schedule. To lengthen the organ, non-surgical cerclage is prescribed - supporting obstetric pessaries are used, which have various designs. The place of their installation is the cervix.

If by the end of the second trimester the cervix has become shorter - up to 20 mm, then surgical intervention is used. For these purposes they can:

• strengthen the muscles of the walls using a mechanical method;
• the external pharynx is closed by stitching it;
• narrow the inside of the throat using a mechanical option.

The surgical method can be used starting from the 1st trimester. If the problem is detected at an early stage (week 7), surgery can be performed. A woman needs to be calmer, reduce her activity, and perhaps use bed rest. Medications are used to reduce the tone of the uterus.

Each of these 3 methods helps a pregnant woman give birth to a full-term baby.

Treatment of a shortened cervix helps eliminate the threat of premature birth and makes it possible to safely carry and successfully give birth to an excellent child at the right time.

Forecast

Proper treatment has a positive prognosis. This is facilitated by the use of effective methods that are aimed at reducing tone and reliably retaining the fetus in the uterine cavity. The most common methods are the installation of an obstetric pessary, as well as suturing.

The timely initiation of therapy and strict adherence to all medical recommendations are of great importance. Therapy makes it possible to eliminate complications and prolong pregnancy. Measures aimed at prolonging pregnancy must be taken on time. This is only possible if the woman attends all the necessary examinations. The diagnosis can be made using ultrasound, which is performed at 15-17 weeks.

Shortening of the cervix during pregnancy is a common problem. It is important to follow all the doctor’s recommendations - give up an overly active life, wear a bandage. Get treatment if necessary. Then, with this diagnosis, the woman will be able to carry the baby and give birth to him on her own. An absolutely healthy child will be born.

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Content

Every woman dreams of a successful pregnancy. When carrying a child, difficulties often arise, threats of miscarriage, and the provocateur of premature birth is mainly a shortened cervix.

How to understand

In order to understand that the cervix is ​​shortened, a woman needs to undergo an ultrasound examination, in other words, cervicometry. There are no specific symptoms with shortening of the cervical spine. A pregnant woman may notice nagging pain in the lumbar region, lower abdomen, uterine tone, and increased discharge. But this doesn't always happen. Most often, a woman learns about a shortened cervix at an appointment with a gynecologist after an examination in the chair. The doctor notes after palpation examination that the cervical region is short. In some situations, the uterine os may allow one finger to pass through. This condition is dangerous before 36 weeks.

The normal length of the cervical region is 40 mm in the first trimester and at least 30 mm in subsequent trimesters. The internal os should be closed.

If the cervix shortens ahead of schedule, a diagnosis of “isthmic-cervical insufficiency” is established.

For what reasons does the cervix shorten?

The fact that the cervix is ​​shortened is usually discovered after 17 weeks. In the second trimester of pregnancy, the fetus begins to quickly gain weight and, if necessary, the organ begins to shorten.

Reasons for shortening:

1. Violation of the ratio of various types of tissues due to burdened heredity or improper formation of an organ during intrauterine development. The number of muscle fibers becomes insufficient, and the number of connective tissue fibers becomes excessive. As a result, the neck cannot withstand mechanical pressure and shortens.
2. An excess of male sex hormones and their metabolites, which provokes uterine contractions, hypertonicity and leads to gradual dilatation.
3. Numerous cervical injuries caused by abortions, cleansings and other interventions.
4. An active infection that occurs during pregnancy in the cervix and vagina is endocervicitis, vaginitis.
5. Cicatricial deformation of the cervix, which is a consequence of ruptures in previous births and as a consequence of treatment of erosions (history of diathermocoagulation).
6. Multiple pregnancy.
7. Polyhydramnios.

A shortened cervix represents threat of premature birth.

Pathogenesis

The cervical region of the uterus in a healthy woman must withstand the load placed on it throughout pregnancy. This is achieved in two ways: the proportional content of muscle and connective tissue fibers, as well as a harmonious hormonal background.

In the vast majority of cases, isthmic-cervical insufficiency or shortening of the cervix is ​​recorded precisely for mechanical reasons, when the cervical region cannot withstand the load. Scars, ruptures, and intrauterine developmental disorders of the reproductive organs most often cause pathology in the form of shortening. There is a hereditary predisposition to isthmic-cervical insufficiency - precisely in the aspect of a violation of the ratio of two types of tissues in the cervix.

Often, a disease such as polycystic ovary syndrome is accompanied by increased production of male sex hormones - a woman entering pregnancy is at risk of developing ICI. In addition, there are isolated causes of increased levels of hormones such as testosterone, DHEA sulfate, 17-OH-progesterone.

In ordinary life, this is accompanied by menstrual irregularities, acne, excess weight. Excessive levels of male sex hormones during pregnancy lead to hypertonicity and shortening of the cervix.

A healthy cervix gradually shortens throughout pregnancy in order to open during labor. But with its length of 30 mm in the second trimester, the risk of premature birth and intrauterine infection in the fetus increases. As a rule, shortening of the cervix is ​​accompanied by opening of the cervical canal, which leads to the penetration of bacteria and viruses from the genital tract to the fetal membranes.

The opening of the internal os, which often accompanies ICI, leads to prolapse of the amniotic sac. With a sudden movement, getting out of bed, turning, the section of the bubble that gets into the funnel of the internal pharynx may burst. This process leads to premature birth.

Symptoms

Many patients ask the question: if the cervix is ​​shortened, what does this mean? The length of the cervical uterus in a pregnant woman in the first trimester is from 35 to 45 mm. Starting from 17–19 weeks, the cervical region gradually shortens and its length should not be less than 30 mm until 36 weeks. The internal os should be closed until delivery.

In the vast majority of cases, shortening of the cervix is ​​asymptomatic.

Every pregnant woman who is worried about the health of her unborn baby is interested in how to understand that the cervix is ​​shortened. There are a number of symptoms that the patient should pay attention to:

1. During pregnancy, a woman may often be bothered by increased tone of the uterus - a feeling of “petrification” in the lower abdomen, heaviness and minor discomfort.
2. Periodic nagging pain in the lumbar region.
3. Increased mucous discharge from the vagina.
4. The appearance of blood streaks in the discharge from the genital tract.

If signs appear that threaten the development of cervical shortening, the pregnant woman should visit an obstetrician-gynecologist. The doctor will examine the woman in a chair and prescribe cervicometry using ultrasound. On palpation, the cervical region will be softened, the external pharynx may allow the tip of the finger to pass through. But when examined on a chair, you can only get general information about the characteristics of the organ. It should be borne in mind that in multiparous women, the external os can normally allow the tip of a finger to pass through. Gynecologists attach primary importance to the width of the cervical canal and the condition of the internal pharynx.

Treatment

A shortened cervix can be corrected using surgical or conservative methods. This depends on the duration of pregnancy, the length of the cervix, the condition of the internal os, the presence of infection in the genital tract, and the condition of the fetus.

Pregnancy is maintained if ultrasound results are satisfactory. fetal and Doppler measurements, no evidence of intrauterine infection, with a whole amniotic sac.

Conservative tactics include:

• bed rest;
• progesterone preparations in the first and second trimester;
• Ginipral;
• Dexamethasone, Metypred;
• Magnesia.

Surgical treatment includes the application of a relieving obstetric pessary and sutures (cerclage). This type of pregnancy preservation is carried out with a cervical length of at least 20 mm.

With an open internal pharynx, the decision on surgical treatment occurs on a case-by-case basis. A prolapsed bladder can become an obstacle to the application of a pessary and sutures.

To treat a shortened cervix, a woman is hospitalized in the pregnancy pathology department. After a detailed examination, the doctor decides on the type of therapy. The pregnant woman is tested for smears from the genital tract for infection, ultrasound and CTG are performed at a period of more than 28 weeks. A general blood and urine test is also performed. The levels of male sex hormones in the blood or urine are examined (urine for 17-KS or blood for DEA sulfate).

A short cervix is ​​treated with surgical tactics from 16 to 34 weeks of pregnancy.

Removal of sutures and pessaries is performed at 37–38 weeks of gestation.

With timely diagnosis of a shortened cervix, the prognosis is favorable. The woman takes medications, observes the protective regime and gives birth on time. If the symptoms are ignored and there is no proper diagnosis, a short cervix leads to premature rupture of amniotic fluid, infection of the membranes, which can lead to fetal death for up to 28 weeks.

The birth of a child can truly be called the greatest miracle of miracles. Unfortunately, sometimes nature fails at the genetic level. And sometimes even mechanical human intervention in certain processes can lead to terrifying consequences. Thus, a long-awaited pregnancy may not occur at all or may occur but end in miscarriage or premature birth. And it can lead to the birth of a person with congenital pathologies and defects.

A short cervix is ​​one of the causes of miscarriages and premature births. Why does this happen and is it possible to carry and give birth to an absolutely healthy baby with such a diagnosis?

What does a short cervix mean during pregnancy?

The uterus is located in the pelvic area. Its shape resembles a pear, its main function is to bear a child. In the picture below you can see the structure of the uterus:

• neck,
• isthmus,
• fundus of the uterus,
• body of the uterus.

On average, a normal cervix in women is about 3-5 cm, usually 4. If its length is 2 cm or less, then they speak of a short cervix.

Causes of a short cervix during pregnancy

A short cervix during pregnancy can be a congenital phenomenon or acquired after certain surgical interventions (for example, mechanical abortion). It also happens that the cervix can shorten due to a hormonal surge during pregnancy. The most dangerous period in this regard is considered to be from the 1st to the 27th week, the peak falls on the 16th.

How to recognize a short cervix during pregnancy

If the cervix is ​​shortened from birth, then when a woman is required to regularly visit a gynecologist from the moment of puberty, it will be possible to establish this long before the onset of pregnancy, and to take this point into account at the planning stage.

If a woman is already pregnant, then a simple examination on a gynecological chair will help establish this fact. If the doctor suspects something wrong, he will refer the patient for a transvaginal ultrasound, which will confirm or refute his assumptions.

Short cervix during pregnancy: consequences

• A short cervix during pregnancy is one of the main signs of ICI (isthvicocervical insufficiency). This is a certain condition when pregnancy is at an increasing risk due to the physical impossibility of holding the constantly growing and gaining weight in the uterine area. Possible miscarriage or premature birth.
• The cervix, under pressure, gradually opens and softens ahead of schedule, which means there is a high risk of all kinds of infections reaching the baby.
• Plus, such an early opening means a rapid birth, which is fraught with ruptures, which then take quite a long time to heal under the condition of complete rest and minimal physical activity. And after the birth of the baby, complete rest is unlikely to be ensured.

The risks increase significantly if a woman has polyhydramnios, a large fetus, or is carrying several babies at once.

What to do with a short cervix?

If you regularly go to the doctor and undergo all the examinations prescribed by him, then such a factor as a short cervix will not go unnoticed. And forewarned is forearmed!

Fortunately, medicine today has made great progress, so depending on the specific situation, doctors will offer several options for solving this problem.

If ICI is a consequence of hormonal changes in the body, then a treatment regimen with medications will be prescribed.

In case of urgent need, temporary sutures will be placed on the cervix to prevent its early dilatation. The stitches will be removed just before delivery. This procedure can be roughly compared to an inflated balloon, which is tied with a rope so that the air does not escape from the balloon. This procedure is called cervical cervical cording and is performed under general anesthesia, the composition of which is carefully controlled by an anesthesiologist, taking into account the characteristics of the woman’s position and the duration of her pregnancy.

In some cases, a special gynecological ring or pessary is placed on the cervix, which keeps it in a stable state without the slightest risk of dilatation and the onset of premature labor.

Of course, it happens that even with the diagnosis of ICI, the pregnancy itself proceeded safely and ended in childbirth on time. But the chances of losing a child are great, is it worth the risk? If the doctor insists that certain measures are necessary, then it is better to take them.

Much depends on the expectant mothers themselves. We must try to organize our daily life in peace and quiet, without unnecessary stress, quarrels and disputes. No excessive physical activity, and special gymnastics and swimming in the pool only after the official permission of a gynecologist!

Short cervix during pregnancy 20 weeks

The 20th week is a kind of equator, approximately the middle of pregnancy. Most women can already feel the kicks of their baby in their tummy. Now the active growth of the uterus has begun, it is moving towards the navel and can put pressure on the abdominal wall, causing the navel to protrude outward. Active growth of the uterus is accompanied by the risk of miscarriage in the presence of a short cervix. Close supervision by a doctor is necessary during this period; a routine ultrasound is performed at 20-21 weeks, so you don’t have to go to the consultation again.

Short cervix during pregnancy 30 weeks

It’s not for nothing that in Russia people go on maternity leave at the 30th week. The belly is already quite large, women are quite clumsy at such a long time.

For women with a short cervix, the risk of premature birth has increased by an order of magnitude, especially if the pregnancy is multiple! The good news is that babies born at this stage are already viable with appropriate medical care. But it’s better that it doesn’t come to that. Therefore, it’s time to relax, now without work it’s much easier to surround yourself with only pleasant emotions, sleep more, and be less nervous. If you have a short neck, you should not overexert yourself with physical activity and excessive activity. Only peace and harmony!

Short cervix during pregnancy 32 weeks

32 weeks is the time to have your last ultrasound. If you have a short cervix, a specialist will definitely assess its condition at this time. There is less and less time before birth, which means that the baby has an increasingly greater chance of survival and normal development after birth. But it’s better that he’s born on time. The recommendations remain the same - more sleep and rest. Perhaps, at such a long time, the doctor will prescribe bed rest or even suggest hospitalization, so that the pregnant woman is under the supervision of doctors and certainly observes bed rest, which is not so easy to organize at home.

Increased uterine tone

A short cervix during pregnancy is directly related to the threat of miscarriage, and, therefore, is often accompanied by increased uterine tone.

Signs of uterine tone:

1. Pain in the lower abdomen.
2. Discharge with blood.
3. Feeling of a stone, hard, tense abdomen.
4. Dizziness, nausea.

A gynecologist will be able to determine the increased tone of the uterus during an examination, and it can be confirmed using an ultrasound machine. In some cases, the expectant mother will be able to guess for herself based on the signs described above. If, with increased tone, a woman has a short cervix, the risks of miscarriage or premature birth increase significantly. Even hospitalization is possible.

The causes of uterine tone can be malignant tumors, kidney diseases, liver diseases, cardiovascular and hypertension diseases. A woman’s psychological mood also plays an important role. In a family where the expectant mother is emotionally stable, receives all possible support and care from family and friends, the phenomenon of uterine tone is much less common than in families where quarrels, scandals and showdowns are the daily norm of life.

If you have uterine tone, you should immediately consult a doctor, but you can help yourself a little before your appointment. It’s enough to lie down, relax as much as possible, and rest. Try not to be nervous. You can stroke your belly, chat with your baby while listening to classical soft music, or meditate.

Doctors, as a rule, prescribe hormonal treatment for women with uterine tone to compensate for the deficiency of the hormone progesterone in order to avoid miscarriage or premature birth.

What is important to know about progesterone

This is a hormone necessary to maintain pregnancy, which is initially produced by the ovaries, and later by the placenta (as it is finally formed). Progesterone is needed at every stage of pregnancy, from conception to labor. Without it, the woman’s body simply will not accept foreign DNA and will reject the fetus. But this is not all that the hormone progesterone contributes to a successful pregnancy. It controls the growth of the uterus, preparing it for a strong increase in size. It prepares the mammary glands to produce colostrum and then breast milk. It stimulates the growth of the endometrium (the inner layer of the uterus), thereby creating fertile soil for the successful attachment of the embryo, and then its successful growth and active development. Ultimately, it relaxes the walls of the uterus to avoid hypertonicity.

Progesterone deficiency with a short cervix necessarily requires additional measures to maintain pregnancy. Suturing or installing a pessary is no longer enough; hormonal therapy is also necessary.

Utrozhestan for a short cervix during pregnancy

Utrozhestan is a synthetic analogue of the hormone progesterone. The hormone molecules are surrounded by peanut butter, since in this form the body is able to accept it and absorb it as much as possible.

Composition of the drug:

• progesterone;
• peanut butter;
• soy lecithin;
• gelatin;
• glycerol

The medicine may interact with other drugs because it does not contain substances that could react negatively to such an interaction.

Progesterone deficiency can occur at any stage of pregnancy planning. But in the 1-2 trimesters, uterine activity is not so great. The danger of a lack of progesterone lies in the fact that the egg (or the fetus subsequently) will be rejected by the mother's body. And against the background of redistribution of progesterone production between the ovaries and placenta, any violation is fraught. Therefore, at these times there is no danger in taking Utrozhestan. As for the 3rd trimester, excess progesterone is more dangerous here than its deficiency. Therefore, taking the medicine is no longer advisable.

When taken orally, the drug replenishes the deficiency of progesterone, while it does not affect the weight of the pregnant woman and does not contribute to the manifestation of swelling. Under its influence, the uterus relaxes, the maternal body calmly accepts the fetus, creating conditions for its further development.

Like any other drug, Utrozhestan contains a number of contraindications (liver failure, diabetes, bronchial asthma, and so on). Side effects may include dizziness, lethargy, and drowsiness, so after taking it it is better to stay at home for some time.

There are two ways to take the medicine - capsules or suppositories. Typically taken 3 times a day for 2-3 weeks, but this schedule may vary depending on the specific situation.

Never engage in self-diagnosis, much less self-medication! Only a doctor can recommend Utrozhestan and calculate the individual dosage! Therefore, at the first signs of uterine tone, knowing at the same time that you have a short cervix, and, therefore, there is already a high risk of miscarriage/premature birth, you should urgently run to the doctor. And before taking it, be sure to try to relax and calm down.

Let's sum it up

A short cervix can have dire consequences. You should know about yourself and your condition in advance, ideally, even at the stage of pregnancy planning. If it turned out as it turned out, do not delay your visit to the consultation at the first signs of pregnancy. It is in the early stages that a woman faces all sorts of dangers, which is why it is important to see a specialist as early as possible! You can give birth to a healthy baby at the right time if you really want it and do everything you can on your part! Be reasonable!

Video " Cervical length during pregnancy"

The cervix plays an important role in pregnancy. With a long cervix, pregnancy proceeds safely. Women with a short cervix during pregnancy are at risk for miscarriage.

A short cervix is ​​rare, as an anatomical structural feature; more often, the cervix becomes shorter after mechanical damage. Abortion and any gynecological interventions contribute to the dilation of the cervix and lead to its shortening. In addition, scars form that deform the cervix, causing it to shorten.

Therefore, at the stage of pregnancy planning, it is necessary to be examined by a gynecologist to identify this pathology, as well as regular visits to the doctor throughout pregnancy.

The cervix is ​​a dense ring of muscle that is located at the end of the uterus and connects it to the vagina. The cervix of a non-pregnant woman has a length of about 30 mm and a closed pharynx. Throughout pregnancy, the length of the cervix, its consistency and the size of the opening of the pharynx changes.

How the cervix changes during pregnancy

Changes in the cervix occur during pregnancy. During pregnancy, uterine blood flow increases, and plethora is manifested by the appearance of a cyanotic (bluish) tint of the cervix. The endocervical epithelium grows and produces thick mucus, which prevents the penetration of pathogenic microflora.

The epithelium of the cervix is ​​sensitive to changes in estrogen levels during pregnancy. Estrogens cause hypertrophy of the muscular layer of the uterus, so the volume and length of the cervix increases during pregnancy.
An increase in the diameter of the cervix entails eversion of the endocervical epithelium into the vaginal cavity. Inversion of the cervix during pregnancy is called ectopia, but during pregnancy it is considered a normal variant.

What does the change in cervical length during pregnancy indicate?

The length of the cervix during pregnancy is monitored by a doctor throughout the entire period, since the success of bearing the fetus depends on this indicator. The length of the cervix during pregnancy is periodically measured by ultrasound in order to prevent the threat of miscarriage.

If we take the early stages of pregnancy, the cervix is ​​still dense and inelastic, and in the period between 12-37 weeks its length should be 35 - 45 mm. The cervix shortens only at 38 weeks of pregnancy. And only before the birth itself, the length of the cervix is ​​reduced to 15-10 mm, by which time it is located in the center of the small pelvis.

A short cervix during pregnancy indicates a threat of premature birth. If the cervix has shortened to 30 mm, special monitoring of the pregnant woman is required.

A small (short) cervix during pregnancy is observed due to hormonal imbalances, and most often this occurs at 16 weeks. If there is a short (20 mm) cervix during pregnancy, a diagnosis is made of isthmic-cervical insufficiency, which is subject to surgical correction.

The risk of premature birth is indicated not only by the length, but also by the diameter of the cervical pharynx. If the diameter is more than 6 mm, then this indicates that dilatation has begun and premature birth. In the early stages of pregnancy, dilation of the internal os of the cervix is ​​a threat of miscarriage.

During pregnancy, the cervix changes consistency - it softens; even in the early stages of pregnancy, when examining the cervix, a significant softening of the isthmus is determined. Therefore, there is a slight shift in any direction and a backward bend.

Towards the end of pregnancy, the cervix is ​​fully “ripened” - this means readiness for childbirth.

Dilatation of the cervical canal by 5 - 10 mm and cramping pain indicate the beginning of labor. The opening of the cervix during the birth itself reaches 10 cm in diameter - this allows the fetus to pass through the birth canal.

Thus, the maturity of the cervix and readiness for childbirth is determined by its length, consistency and opening of the cervical canal.

Tactics of doctors when diagnosing a “short cervix” in a woman during pregnancy

Women with a small cervix during pregnancy should be constantly monitored by a doctor. You need complete rest, careful attitude towards yourself and observation of changes in your well-being.

If isthmic-cervical insufficiency is caused by hormonal disorders, then it is corrected with medications. In some cases, surgery during pregnancy is suggested for a short cervix.

A surgical procedure called cervical cerclage is performed - sutures are placed on the cervix to keep it closed, which prevents premature dilatation, rupture of the membranes and premature birth.

A promising method for correcting cervical insufficiency, which is used as it progresses, is non-surgical cerclage - the use of supporting obstetric pessaries of various designs that are placed on the cervix. All these treatment methods help a woman endure pregnancy and give birth to a full-term baby.