What does the length of the cervix mean 2 cm. Deviations from the norm. Features of the examination of the cervical canal

The screening of the first trimester of pregnancy is over, time passes, the tummy grows, and new worries appear.
Have you heard or read somewhere about isthmic-cervical insufficiency (ICI), premature birth, ultrasound of the cervix and now you don’t know if this threatens you and whether you need such a study, and if necessary, when?
In this article I will try to talk about such a pathology as ICI, about modern methods its diagnosis, formation of a high-risk group premature birth and methods of treatment.

Premature births are those that occur between 22 and 37 weeks (259 days) of pregnancy, starting from the first day of the last normal menstruation with regular menstrual cycle, while the body weight of the fetus is from 500 to 2500 g.

The frequency of preterm birth in the world in recent years is 5-10% and, despite the emergence of new technologies, is not decreasing. And in developed countries, it increases, first of all, as a result of the use of new reproductive technologies.

Approximately 15% of pregnant women fall into the high risk group for preterm birth even at the stage of anamnesis. These are women who have a history of late miscarriages or spontaneous preterm birth. In the population of such pregnant women, about 3%. In these women, the risk of recurrence is inversely related to the gestational age of the previous preterm birth, i.e. the earlier a preterm birth occurred in a previous pregnancy, the higher the risk of recurrence. In addition, this group can include women with uterine anomalies, such as a unicornuate uterus, a septum in the uterine cavity, or injuries, surgical treatment cervix.

The problem is that 85% of preterm births occur in 97% of women in the population who have this first pregnancy or previous pregnancies ended in full-term birth. Therefore, any strategy to reduce the number of preterm births that targets only a group of women with a history of preterm birth will have very little effect on general level premature birth.

The cervix plays very important role in the preservation of pregnancy and the normal course of childbirth. Its main task is to serve as a barrier that prevents the fetus from being pushed out of the uterine cavity. In addition, the glands of the endocervix secrete special mucus, which, when accumulated, forms a mucous plug - a reliable biochemical barrier for microorganisms.

"Maturation of the cervix" is a term that is used to describe the rather complex changes that occur in the cervix, related to the properties of the extracellular matrix and the amount of collagen. The result of these changes is the softening of the cervix, its shortening up to smoothing and expansion cervical canal. All these processes are the norm at full-term pregnancy and are necessary for normal course childbirth.

Some pregnant women have various reasons"cervical ripening" occurs ahead of time. The barrier function of the cervix is ​​sharply reduced, which can lead to premature birth. It should be noted that this process does not clinical manifestations, not accompanied painful sensations or bloody discharge from the genital tract.

What is an ICN?

Various authors have proposed a number of definitions for this condition. The most common is: ICI is an insufficiency of the isthmus and cervix, leading to premature birth in II or III trimester pregnancy.
or such : CCI is a painless dilatation of the cervix in the absence of
uterine contractions leading to spontaneous interruption
pregnancy.

But after all, the diagnosis should be made even before the termination of pregnancy occurred, and we don’t know whether it will happen. Moreover, most pregnant women diagnosed with CI will deliver at term.
In my opinion, ICI is a condition of the cervix, in which the risk of preterm birth in this pregnant woman is higher than the general population.

AT modern medicine, the most reliable way to assess the cervix is transvaginal ultrasound with cervicometry - measurement of the length of the closed part of the cervix.

Who is shown an ultrasound of the cervix and how many times?

Here are the recommendations from https://www.fetalmedicine.org/ The Fetal Medicine Foundation:
If a pregnant woman belongs to those 15% with high risk preterm birth, then such women are shown an ultrasound of the cervix every 2 weeks from the 14th to the 24th week of pregnancy.
For all other pregnant women, a single ultrasound of the cervix is ​​recommended for a period of 20-24 weeks of pregnancy.

Cervicometry technique

Woman emptying bladder and lies on the back with bent knees (lithotomy position).
The ultrasound transducer is carefully inserted into the vagina towards the anterior fornix so as not to exert excessive pressure on the cervix, which can artificially increase the length.
Obtain a sagittal view of the cervix. The mucosa of the endocervix (which may or may not be echogenic compared to the cervix) provides a good guide to the true position of the internal os and helps avoid confusion with the lower uterine segment.
The closed part of the cervix is ​​measured from the external os to the V-shaped notch of the internal os.
The cervix is ​​often curved and in these cases the length of the cervix, considered as a straight line between the internal and external os, is inevitably shorter than the measurement taken along the cervical canal. FROM clinical point The measurement method is not important because when the cervix is ​​short, it is always straight.

Each study should be completed within 2-3 minutes. In about 1% of cases, the length of the cervix can change depending on the contractions of the uterus. In such cases, the lowest values ​​should be recorded. In addition, the length of the cervix in the II trimester may vary depending on the position of the fetus - closer to the bottom of the uterus or in the lower segment, in a transverse position.

You can evaluate the cervix and transabdominally (through the abdomen), but this is a visual assessment, not cervicometry. The length of the cervix with transabdominal and transvaginal access significantly differs by more than 0.5 cm, both up and down.

Interpretation of research results

If the length of the cervix is ​​more than 30 mm, then the risk of preterm birth is less than 1% and does not exceed the general population. Hospitalization is not indicated for such women, even in the presence of subjective clinical data: pain in the uterus and minor changes in the cervix, copious discharge from the vagina.

• In case of detecting a shortening of the cervix less than 15 mm in a singleton pregnancy or 25 mm in a multiple pregnancy, urgent hospitalization and further management of pregnancy in a hospital with the possibility of intensive care for newborns. The probability of delivery within 7 days in this case is 30%, and the probability of preterm birth before 32 weeks of pregnancy is 50%.

• Shortening of the cervix to 30-25 mm in a singleton pregnancy is an indication for consultation with an obstetrician-gynecologist and weekly ultrasound monitoring.

• If the length of the cervix is ​​less than 25 mm, the conclusion is made: “ECHO-signs of CI” in the 2nd trimester, or: “Considering the length of the closed part of the cervix, the risk of preterm birth is high” in the 3rd trimester, and it is recommended to consult an obstetrician gynecologist with the aim deciding whether to prescribe micronized progesterone, perform a cervical cerclage, or install an obstetric pessary.

A few words about the opening and shape of the internal os. When conducting an ultrasound of the cervix, you can find various forms internal os: T, U, V, Y - figurative, moreover, it changes in the same woman during pregnancy.
With ICI, along with shortening and softening of the cervix, it dilates, i.e. expansion of the cervical canal, opening and changing the shape of the internal pharynx is one process.
Conducted FMF major multicenter study showed that the shape of the internal os by itself, without shortening the cervix, does not increase the statistical probability of preterm birth.

Methods of treatment

The effectiveness of two methods of preventing preterm birth has been proven:

• Cervical cerclage (suturing the cervix) reduces the risk of delivery before the 34th week by about 25% in women with a history of preterm birth. There are two approaches in the treatment of patients with previous preterm births. The first is to cerclage all such women shortly after 11-13 weeks. The second is to measure the length of the cervix every two weeks from weeks 14 to 24, and suturing only if the length of the cervix becomes less than 25 mm. General indicator preterm delivery is similar for both approaches, but the second approach is preferred as it reduces the need for cerclage by about 50%.

• Prescribing Progesterone from 20 to 34 weeks reduces the risk of delivery before 34 weeks by about 25% in women with a history of preterm birth, and by 45% in women with an uncomplicated anamnesis, but a shortening of the cervix up to 15 mm is detected. Recently, a study was completed that showed that the only progesterone that can be used for a short cervix is ​​micronized vaginal progesterone at a dose of 200 mg per day.

• Currently, multicenter studies of the effectiveness of the use of a vaginal pessary are ongoing. A pessary, which is made of flexible silicone, is used to support the cervix and change its direction towards the sacrum. This reduces the load on the cervix due to a decrease in the pressure of the fetal egg. You can read more about the obstetric pessary, as well as the results of recent research in this area.

After suturing the cervix or with an obstetric pessary installed, ultrasound of the cervix is ​​impractical.

See you in two weeks!

Health and normal condition The reproductive system is necessary for the full bearing of a child, so doctors regularly examine this organ, how the fetus develops and whether there are threats of miscarriage. The length of the cervix during pregnancy by weeks should change as the fetus grows. What is the normal size of the cervix during pregnancy.

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Organ Description

The neck is not just a component of the reproductive system, but is considered an important component female body, without which it is impossible to fully bear a child and.

What does the cervix look like during pregnancy. It is a hollow muscle, the front of which can be seen during the examination of a woman on a gynecological chair.

Usually her condition is assessed using a mirror that gives correct information about the development of the fetus.

Where is the cervix located. It is located in the vaginal cavity in the lower part of the small pelvis.

Because of it, the uterus itself is not visible during manual examination, it can only be seen during an ultrasound scan.

Normal sizes this body are 3.5-4.5 cm, however, during the bearing of the baby, this indicator may vary slightly.

What does it look like. After conception, it becomes more flattened. There is also a change in its color, which becomes cyanotic, and not pale pink. The part that is in the vaginal cavity is called the external os. If a woman has not had a childbirth, it is completely closed; in patients who give birth again, it is able to skip 1 finger.

Attention! Short or long neck uterus during pregnancy should remain dense, because it the main task- keep the baby in the womb until the onset of labor.

As soon as the woman's contractions begin, the external pharynx will begin to shorten and smooth out, turning into a ring. As a rule, after the start of the first contraction, it begins to gradually open from 2 cm to 10 - in this case, the baby will it is easy to be born through it. If the organ begins to open before 36 weeks, this can end in failure, as the consequences for the baby are unpredictable.

What is the norm for the weeks of the cervix, why immediately after conception the organ is shortened, and is it possible to lengthen it. It all depends on the structure of the female genital organs. If the size of the uterus is less than normal, then the pharynx will be short and narrow. In this case, not every woman can fully bear a child. To avoid unpleasant consequences for the baby, doctors need to take measures to preserve normal development fetus.

Organ Characteristics

Checking the condition of the expanding organ is the key to successful gestation. After all, if it is weak, the child, as it grows, will not be able to hold normally in the uterine cavity, which will eventually lead to early childbirth. However, it is not necessary to check the condition of the baby at each visit to the gynecologist, for this it is enough to have several times when the gynecologist needs to examine the patient. Also examination should be carried out if the patient has complaints.

There are several ways to identify the condition and size of the cervix during pregnancy by weeks, namely:

1. Manual inspection, which is recommended to be carried out on a chair.
2. Conducting an ultrasound, where a transvaginal probe will be used, inserted into the vaginal cavity.

During a manual examination, the doctor needs to assess the softness, as well as check the condition of the organ:

if it is soft and slightly open, this indicates the readiness of the organ. Besides,

this signals the onset of labor in the last weeks or miscarriage in the 1st and 2nd trimester.

However, more often the pharynx begins to open as the baby grows, when he has already managed to gain weight.

To understand if the pregnancy is proceeding normally,

required evaluate the following indicators:

• the length of the organ, which should be more than 3.5 cm,
• the pharynx must be completely closed, and its structure is dense.

Assessment of the state of the neck according to the results of ultrasound is considered more reliable, since the sensor will show the length strictly in mm. Also, ultrasound will help to assess the density of the organ, which is important for the normal bearing of the baby. What it is is an indicator by which it is possible to assess the possibility of disclosure under the action of certain factors on the organ. Special attention is given to the color, which, when carrying a baby, is bluish-red.

Can the cervix lengthen during pregnancy. No - the exception is the last weeks of gestation, when the fetus strongly presses on the external pharynx. In this case, it will either open or become a little longer.

little uterus

small size reproductive organ is considered its clear violation, leading to its improper functioning. Unfortunately, not every woman with hypoplasia (the so-called disease) is able to bear the fetus, because reproductive system and the pelvic components are not able to hold the baby.

If a woman has small reproductive muscle, a shortened cervix during pregnancy will not allow you to fully bear the fetus.

To on early stage identify this problem, you should find out the symptoms of this condition, because trying to conceive a child with such a disease without preparation and treatment is not recommended.

Main features:

• dysmenorrhea;
• amenorrhea;
• inability to bear fruit;
• lack of conception;
• decreased sex drive;
• severe pain during menstruation.

Normal indicators are:

• length 7-8 cm;
• width 40-50 cm;
• wall thickness 2-3 cm.

To ensure the norm external pharynx for weeks, you need to constantly visit a gynecologist and conduct an examination. If the pharynx begins to open before the onset of labor, the doctor will take appropriate measures.

The size is above the norm

With age, the size of the reproductive organ becomes a little larger - this is not a pathology, since this is a natural phenomenon.

Sometimes it increases in size, which is characterized by the following symptoms:

• discomfort during intimacy;
• aching pain in the lower abdomen;
• urinary incontinence;
• painful periods with discharge big clots blood.

Can the cervix lengthen during pregnancy. If a woman has a large muscle cavity, lengthening of the pharynx is quite possible. This facilitates the process of bearing a baby, but complicates childbirth.

Maturity

So that childbirth does not begin prematurely, the doctor must evaluate maturity. To understand how this is done, you can read the table:

Depending on the week of bearing the baby, on which the doctor has established the degree of maturity, the further prognosis of the course depends. If a woman has a short pharynx, she needs to be constantly monitored until 37 weeks, otherwise the pathology can cause

Length per week

To assess the state and functioning of the reproductive system, a special table was created, which indicates optimal length every week of child development. Often, this measurement is carried out only after the 20th week, when the fetus begins to gradually gain weight.

The size of the cervix during pregnancy by week:

Such indicators may be slightly changed, depending on the state of health. reproductive organs, as well as the general condition of the woman, but almost always the results should match the table.

If the indicators are far from normal, cervicometry is performed during pregnancy, which allows you to assess the condition, degree of maturity and other criteria for the external os.

maturation process

What is the normal state of the external pharynx, we found out. Now it is important to understand how he begins to behave before the onset of labor.

A couple of weeks before the appearance of the baby, the pharynx begins to ripen at lightning speed - it becomes softer, smoother and shorter (the length should be 1 cm).

Also, the maturation of the internal pharynx gradually occurs, which kept the fetus in the small pelvis for all 9 months.

However, there is another picture: if the body is not yet ready for the onset of labor, the pharynx remains dense and completely closed. In this case, it can be called immature. Basically, this phenomenon is caused by a violation hormonal levels which prevents the body from fulfilling natural requirements.

Important! For a normal delivery, a woman is given drugs based on prostaglandins, preparing her for childbirth in a natural way.

If the body of the expectant mother is again not ready for labor, a caesarean section is performed.

How to lengthen the neck. If the bearing of the baby is overshadowed physiological characteristics body, the doctor may recommend that the woman secure the external os to prevent its early opening. For this, special threads or staples are used, which are removed before the onset of labor.

Useful video: cervical dimensions, normal

Pregnancy is an important period in the life of every woman. To prevent development possible pathologies, health status future mother requires careful monitoring. For this, she becomes registered with a gynecologist. medical specialist monitors the development of the fetus according to a certain system. An important indicator of the normal course of the study prenatal development fetus is the length of the cervix. What is a study of the cervix, what standards are set for it, every expectant mother should know.

Authority Role

The female reproductive system is designed in such a way as to create all the conditions for bearing a fetus. The cervix is important body in this process. It has a number of functions. Her biometrics, studied during pregnancy, can tell a lot about the course of this process. Therefore, such a study is carried out by all gynecologists in such cases. How this body works needs to be studied in more detail.

Structure

The organ in question is a ring of muscle tissue, which is located in lower section uterus. It connects the female reproductive organ to the vagina. In the middle is the cervical canal.

It is through him that they are brought out bloody issues during menstruation. In the opposite direction, spermatozoa move along this duct. In the normal state, the length of the cervix is ​​approximately 34–35 mm. This body is conditionally divided into two parts:

• Internal section (located above the vagina).
• External section (located in the vagina).

During the examination, the gynecologist can only see outer part organ. The cervical canal in medicine is also called a pharynx. This organ does not have nerve endings. Its shape changes over time. Before labor, the neck is flat, outwardly resembling a cylinder. After the appearance of the baby, the body takes the form of a trapezoid. After surgical interventions, the neck changes in parameters.

Functions during pregnancy

Cervicometry is a study of the length of the cervix to obtain information about the course of fetal development and forecasts of its birth. And it is no coincidence. After all, the body performs several extremely important functions. This is especially true for the period of gestation. These include the following cervical appointments:

• Protection of the uterine cavity from penetration into it various kinds infectious agents. For this, the cervical canal during pregnancy in the first month of its course produces a special mucus. A kind of plug is formed from it. This mechanism prevents the entry of microbes, bacteria from the vagina into the inside. At the same time, the pharynx itself becomes dense and closed.
• Retention of the fetus in the cavity of the reproductive organ of the mother. The length of the cervix during pregnancy can tell whether it is able to perform this function or not. The organ must be of sufficient length. A short neck is not able to keep the baby in the mother's tummy for a long time.

Based on these basic functions of the body, you can use the results of medical research and clearly determine the norm during pregnancy. To do this, doctors use several approaches in the study of this issue.

Research methods

To date, there is not a single gynecologist who would not use the methods listed below in the process of monitoring fetal development. This allows you to accurately determine whether the cervix is ​​​​short or long at the time of the study, as well as accurately measure its size. There are two main approaches to this issue:

1. The size of the organ is determined on examination by the supervising physician. He evaluates the density and length of the neck, as well as its location and expansion and the condition of the pharynx.
2. Measurement using ultrasound (cervicometry). This method is performed according to a certain technique. The maturity of the neck is assessed. Based on the data obtained, the gynecologist makes a conclusion about the course of pregnancy and makes a prognosis for its further development.

The listed methods begin to be applied from the 20th week. In each period, the indicator changes. Therefore, it is extremely important to study it weekly. It is at a period of 20 weeks that the second planned ultrasound is performed. From this point on, monitoring the condition of the cervix should be regular.

Examination at the gynecologist

The length of the cervix is ​​initially estimated by the gynecologist during the examination of the patient. For a period of 20 weeks, the supervising physician must characterize the condition of the organ, its size and secretions.

During this period, the pharynx should be tightly closed. The deviation of the neck should be in relation to the axis of the pelvis posteriorly. After the initial examination, an ultrasound diagnosis is required.

Assessment with ultrasound

On the early dates Pregnancy ultrasound is performed using a transvaginal sensor, as it is more sensitive. The second planned ultrasound at week 20 may well be performed using a transabdominal probe. It is found on the tummy of the future mother.

In addition to length, at this time of the survey, the maturity of the organ is studied. There is a technique that allows you to evaluate this indicator in points. It is often used by practicing gynecologists.

Maturity assessment methodology

The assessment is made according to the results of ultrasound and examination of the patient according to several parameters. This is a pretty accurate approach. First, the consistency of the neck is evaluated:

• The body has high density– 0 points.
• The consistency is soft, but has a seal in the throat area - 1 point.
• Soft structure - 2 points.

The next parameter in the assessment is the length of the cervix. This indicator is obtained during the survey and evaluated. This option is defined like this:

• Length more than 20 mm - 0 points.
• The indicator is in the range of 10–20 mm - 1 point.
• The organ parameter was defined as smooth or less than 10 mm - 2 points.

In addition to the ultrasound results this technique takes into account the data obtained during the examination of the patient. Here the patency of the pharynx is studied. It looks like this:

• The cervical canal during pregnancy is tightly closed, only the tip of the finger lets through - 0 points.
• Zev is closed, but 1 finger already passes inside - 1 point.
• Passes inside 2 fingers - 2 points.

The last indicator of this technique is the position of the neck relative to the axis of the pelvis. According to this indicator, experienced gynecologists also draw accurate conclusions about the maturity of the organ. The technique evaluates this parameter as follows:

• Posterior position - 0 points.
• Placement relative to the axis of the pelvis anteriorly - 1 point.
• The neck located in the middle - 2 points.

The results obtained are then summarized. An immature condition is diagnosed with a score of 1 to 3. A ripening neck is determined with a score of 4–6 points. 7–10 points indicates that the organ is mature.

Organ length

Medicine has established a standard, which in certain periods the neck must match. Since the study has been conducted since the 20th week, more attention is paid to this period. However, in early pregnancy, it should also be of interest. Conventionally, research is divided into two stages:

1. During the gestation period.
2. Before childbirth.

Each of them has its own rules. Therefore, the study of the indicator must be carried out in this context. The technique involves performing measurements weekly.

gestation period

From the earliest dates, the length of the neck is controlled. This allows you to correctly determine the processes that occur in maternal organism. Identification of threats of pregnancy occurs using this method. The length measurement standard is as follows:

• 10-14 weeks - the indicator is 34-36 mm.
• 15-19 weeks - the length of the cervix reaches 38-39 mm.
• 20-25 weeks - measurements are 40 mm.
• 25-29 weeks - final stage organ elongation. It is equal to 41 mm.

After 29 weeks there is reverse process. The organ after gradual growth begins to shorten. However, this also happens according to a certain trend. Too short organ length indicates the risk of preterm birth. The indicator for 30–32 weeks is 30–33 mm. From this moment, the body begins to prepare for childbirth.

prenatal period

Starting at 32 weeks, a woman's body begins to prepare for childbirth. In this case, there is a decrease in the cervix in size. However, it should not be too short. Starting from the gestation period of 32 weeks, this figure is within the following limits:

• 32-36 weeks - the indicator is in the range of 33-36 mm.
• 36-40 weeks - the length reaches 29-30 mm.

During this period, the pharynx opens and the organ softens. Also on ultrasound, a smoothed shape of the neck is determined. it normal phenomenon. It does not need treatment and indicates an imminent labor activity.

Pathology

A pathologically short cervix is ​​a concern and is called in medicine isthmic-cervical insufficiency (ICI). It is usually diagnosed starting from the 20th week of pregnancy, during the second scheduled ultrasound. Until 37 weeks, the organ should be characterized as immature. To do this, doctors use the method presented above. When examining at 20–25 weeks of pregnancy, the doctor makes a prognosis:

1. If the organ is less than 1 cm long, delivery will occur at 30–32 weeks.
2. A length of 1–1.5 cm indicates the birth of a child at 33 weeks.
3. If the indicator is 2 cm, presumably generic activity will come at 34 weeks.
4. The result of measurements in the range of 2–2.5 cm predicts the birth of a baby at 36 weeks.

This is a deviation from the norm and forces the gynecologist to look for the cause of such violations. There are quite a few factors that provoke pathology.

What causes deviations?

There are several main factors that can lead to serious consequences when carrying a baby. They can be determined by the doctor during the examination. The most common causes of pathology are:

• Disruptions of a hormonal nature.
• Injuries of the cervix (during abortion, surgical interventions or severe previous birth).
• Genital tract infection.
• Anatomical features.
• Fear, stress, heavy loads.

If a woman is at risk for the above signs, the doctor controls the length of the neck during pregnancy. He will take appropriate action if necessary.

Problem Solving Methods

If a disappointing diagnosis was made by the supervising gynecologist, then expectant mother will need to undergo appropriate treatment. This takes into account the degree of shortening of the body and the duration of pregnancy. The technique is developed exclusively by a gynecologist. There can be no talk of self-treatment here. There are several ways to solve the problem:

1. Taking drugs-tocolytics, progesterone.
2. Stitching on the cervix. It is removed just before the birth.
3. Installation of a pessary - a rubber ring. This takes the pressure off the neck.

In addition to the procedures listed above, you will need to perform several simple recommendations. Physical exercise needs to be minimized. Especially those that are aimed at the abdomen.

It is not allowed to conduct such a diagnosis sexual life before giving birth. You also have to take sedatives natural origin(motherwort, valerian).

The doctor will also prescribe antispasmodic drugs. By following the recommendations of a gynecologist, carefully and responsibly treating her health, a woman will be able to safely give birth healthy baby even with a diagnosis of a short cervix.

Before pregnancy, a woman does not think about how her body works, what the cervical canal is for, where it is located and what functions it performs. But pregnancy is the most radically changes attitude towards own body and the body.

What is the cervical canal?

cervical canal- This is the part of the cervix that connects the uterine cavity with the vagina. Simply put, this is a hole, the inner pharynx of which is directed towards the uterus, and the outer one - into the vagina.

It is through this hole during menstruation that blood from the uterine cavity enters the vagina, and it is through it that the spermatozoon enters the uterus during intercourse.

cervical canal strewn epithelial tissue, which secretes a special secret (mucus).

Average channel width is 7-8 mm. The cervical canal does not have an exact shape, since it depends on a wide variety of factors, for example, on whether a woman has given birth or not, on age, hormonal background and much more.

Those pregnant women who have already given birth once know what it is. It is just located in the cervical canal.

The mucous plug is formed from the secretion secreted by the epithelial cells of the cervical canal and protects the fetus from unwanted infections.

In a nulliparous woman, the cervical canal is about 4 cm long. If the woman had an abortion or other interventions were performed, then the length of the cervical canal (cervix) may change.

It is by the external pharynx of the cervical canal that the doctor can determine. With the onset of pregnancy, the external pharynx becomes cyanotic. But the length of the hole does not change.

From the moment of conception, the cervix performs a locking function, keeping the fetus in the uterus for all 9 months, preventing. The cervix is ​​a muscular ring that closes tightly with the onset of pregnancy and is in good shape until the onset of childbirth.

The length of the cervical canal - the norm

During the appointment, the gynecologist carefully examines the woman, especially the cervix, and, assuming the presence of pregnancy, prescribes Ultrasound and tests. After receiving the results of the examination, the doctor can draw conclusions about whether there is a pregnancy and how it proceeds.

At the first ultrasound, not only the position of the fetus, its size, the place of attachment is determined, but also cervical canal length, since it is this indicator that may indicate the threat of termination of pregnancy in the early stages.

The normal length of the cervical canal a pregnant woman should have 3.5-4 cm, the inner and outer pharynx holes are tightly closed. It is by the state of the cervical canal that the moment of childbirth is determined.

The mucous plug that closes the canal protects the baby from various infections. Some time before birth, it most often departs.

The mucus plug is different for every woman. For some, it departs 2-3 weeks before birth, for others, 2-3 hours. But if the cork hasn’t come off at all, don’t be alarmed, this also happens. Then the doctor will remove it himself already during childbirth. The cork can depart as a whole, or in parts.

A woman may notice a clot of mucus on her underwear, possibly streaked with blood, this is the mucus plug. But most often the cork leaves at the time of urination, then the woman will not see anything at all, but she may feel that something has fallen out from the inside.

If the mucus plug comes off gradually, in small parts, then brownish marks can be seen on the underwear for 1-3 days.

cervical canal during pregnancy shortens closer to birth the cervix becomes soft.

With the onset of regular contractions, the lumen of the canal increases by 2-3 cm, then more. When the hole expands to 10 cm ( full disclosure cervix), and the uterus with the vagina will become one by birth, we can talk about the beginning of the second - the expulsion of the fetus.

If the cervical canal is dilated

Ultrasound or examination may reveal that cervical canal dilated- isthmic-cervical insufficiency, that is, the cervix is ​​\u200b\u200bnot able to perform its functions, hold fertilized egg, and already in the early stages of pregnancy there is a threat of miscarriage.

Most often this happens for a period of 16-18 weeks, when the baby is growing rapidly, and even actively moving.

The reason for the expansion cervical canal during pregnancy can become a large number of male sex hormones that soften the cervix, as well as multiple pregnancy, at which the pressure on the neck increases significantly.

There are other reasons, for example, developmental anomalies and injuries of the cervical canal.

At timely handling abortion can be prevented. For this, it is best to continue observation in the hospital.

AT stationary conditions after careful examination, take several ways to prevent the threat of miscarriage.

It can be medical preparations that will strengthen the cervix. Often a pessary is placed(the ring, which is removed only at 37 weeks).

The cervix can also be sutured, that is, to suture around the cervical canal. Such operations are performed in stationary conditions under anesthesia, usually at 16-18 weeks of gestation.

This method has many disadvantages, for example, infection and damage to the integrity of amniotic sac. Therefore, they are used only in the most extreme cases.

Polyp of the cervical canal

Often during pregnancy, a woman can hear very terrible diagnosis – cervical polyp. But it only sounds scary, in fact, everything is much simpler.

When making such a diagnosis, the doctor prescribes and conducts a cytological and histological examination.

All this for to reveal the nature of the origin of the polyp and understand whether it is a true polyp or a decidual pseudopolyp (a polypoid formation that occurs during pregnancy and disappears in the postpartum period).

Most often, a pregnant woman is found precisely decidual polyp, which could be caused by hormonal disorder against the backdrop of pregnancy.

In this case you don’t have to worry, the polyp is not removed or touched, only carry out local anti-inflammatory treatment. This polyp may fall off on its own during childbirth or begin to develop into reverse side in the postpartum period.

AT rare cases polyp may be true, but the probability of this is very low. If the polyp was already there before the birth, but the woman simply did not know about it, then the onset of pregnancy in this case is unlikely.

For a woman to become pregnant, first need to get rid of the polyp. But if you imagine that a polyp formed during pregnancy, and it is still true, then you should not rush.

During pregnancy, especially in the early stages, try not to touch the polyp, and are removed only in very rare cases, when it is vital.

Decidual pseudopolyp does not threaten either the pregnant woman or the baby. The most important thing is to remove inflammatory process. And already during the examination, the question of eliminating or treating the polyp will be decided, if it has not disappeared.

But if the polyp is true, after childbirth will have to continue the examination, observation and treatment.

During pregnancy, you may encounter the most various problems and unpleasant diagnoses. Some of them just sound scary, but in fact, neither mother nor baby is in danger.

Still, it is worth listening to some diagnoses and taking measures, go to the hospital and go through additional examination. If you are in doubt, then you can go for a consultation with another specialist.

It's bad for pregnant women to worry, that's why it is better to solve all problems as they come.