Edema of the cervix in childbirth
The main organ in the body of a woman, without whichit would be impossible to endure and give birth to a baby, is the uterus. Uterus is a hollow muscular organ. It distinguishes three main parts: the bottom, the body and the neck. As can be seen, the cervix is an integral part of the main organ during pregnancy, so the normal course of the processes of gestation and natural delivery will also depend on its condition, respectively. How? Let's figure it out.
Cervix in pregnancy
The cervix is a tube,connecting the uterus and vagina, the ends of which end with holes (the inner yoke - opens into the uterus, the outer - into the vagina), and the cervical canal passes inside. Normally, during almost the entire gestation period, it should have a dense consistency with a closed "tightly" cervical canal, which allows to hold the fetus in the uterine cavity, and also protect it from the penetration of infections from the vagina.
information Only a few weeks before the date of the allegedthe birth of the cervix begins to undergo changes that will later allow the baby to move freely along the birth canal of a woman and easily appear.
Sometimes these changes can begin earlier. Disclosure of the cervix during pregnancy is a poor diagnostic sign, threatening loss of a child or premature birth. The reasons for this state are often:
- Isthmicocervical insufficiency;
- Weighed down obstetric history (abortions, miscarriages at early and late stages);
- Injuries to the cervix (surgery, delivery of a large fetus, breaks in previous births);
- Cervical erosion;
- Hormonal disorders (progesterone insufficiency).
Softening and opening of the cervix should occur immediately before childbirth!
During the process of pregnancy progression into the cervixA partial replacement of muscle tissue by a connective tissue takes place. Formed "young" collagen fibers, which have increased flexibility and extensibility than similar outside of pregnancy. Some of them dissolve, forming the main substance, which leads to an increase in the hydrophilicity of the tissue. Clinically, this is manifested by loosening and shortening of the cervix and the gaping of the cervical canal.
Preparation of the cervix for delivery beginsapproximately 32-34 weeks of gestation. It starts to soften on the periphery, but the area of dense tissue along the cervical canal still persists. In primiparous women with vaginal examination, the external sore can pass the tip of the finger, the reproductive canal passes through to the internal pharynx for 1 finger. Already by 36-38 weeks, the cervix is almost completely softened. The fetus starts to fall into a small pelvis, with its weight it creates a certain pressure on the neck, which helps its further opening.
Disclosure of the cervix begins with an internal throat. In primiparas, the canal takes the form of a truncated cone with a base pointing to the top. The fruit, gradually moving forward, stretches and the external pharynx. In maternity females, the opening of the cervix is easier and faster, due to the fact that the outer yoke at the end of pregnancy is most often already open on 1 finger. At them the opening of the external and internal pharynx occurs practically simultaneously.
Immediately before the onset of labor, the cervix,both in primiparous women and in maternity females are sharply shortened (smoothed), depleted, the canal is passed by 2 fingers or more. Gradually there is a full opening of the neck to 10-12 cm, which allows you to pass through the birth canal to the fetal head and its torso.
Starting from 37-38 weeks of pregnancy, the dominantpregnancy is replaced by the dominant of birth, and the uterus from the fetus is transformed into an expelling organ. Some pregnant women are very afraid of the onset of labor, building a psychological barrier to the formation of the very necessary dominant. Against the background of nervous overstrain and lack of proper psycho-preventive preparation for childbirth, the woman inhibits the production of the necessary hormones. The cervix remains unchanged, and preparation for the birth of the body is delayed.
For full and normal opening of the cervixthe development of regular labor is necessary. If the weakness of labor pain develops, the process of opening the neck also stops. This happens rarely in case of polyhydramnios (the uterus overgrowth and, as a consequence, its contractility decreases) or lack of water (a flaccid or flat fetal bladder does not properly affect the cervix).
Women, whose age has crossed the 35-year mark, run the risk of encountering this problem. In their case, the cause may be rigidity (decreased elasticity) of tissues.
remember General condition of the woman before deliveryplays an important role. The presence of extragenital endocrine diseases (diabetes mellitus, hypothyroidism, obesity) often leads to the development of complications during childbirth.
Stimulation of the preparation of the cervix for delivery
Often just before the date of the alleged deliveryafter visiting a doctor, a woman can find out that her cervix is "not mature" and there is a need for artificial preparation for delivery. Especially this issue becomes relevant after 40 weeks of pregnancy, because at these times the placenta depletes its functional capabilities, which leads to fetal hypoxia.
Stimulation of this process can be carried out by two methods: medicamentous and non-drug.
Drug method allows you to achieve the desired result with the help of medicines and only in a hospital.
- Introduction to the cervical canal of laminaria rods. Laminaria rods (seaweed)placed in the cervical canal for its entire length. Under the influence of moisture, after about 4-5 hours, they start swelling, mechanically opening the channel. Laminaria is also secreted by endogenous prostaglandins, which are necessary for cervical ripening. The gradual mechanical and biochemical effects of laminaria rods lead to fast and careful preparation of the cervix for childbirth;
- Introduction to the cervical channel of synthetic prostaglandin in the form of candles or gel. Allows you to achieve the desired effect within a few hours;
- In a hospital amniotomy (puncture of the amniotic bladder). After this procedure, the front waters leave, the fetal head descends, the pressure on the neck increases, and the opening begins to occur more quickly.
Non-pharmacological method can be used at home, but it should be extremely cautious and take into account all the pros and cons.
- Cleansing enema. Its use irritates the posterior wall of the uterus,causing its reduction. It was also noticed that after this procedure, the mucous plug goes away, and the cervix opens. But it can only be done by women whose expected date of delivery has already occurred or has passed;
- Sex. A natural stimulant of labor. First, it causes a reduction in the musculature of the uterus, increasing the flow of blood to it. Secondly, semen contains prostaglandins, the "hormone of birth." Contraindication: the mucus cork that has receded (the probability of infection is high);
- Physical exercise. Long walks, cleaning in the house, climbing the stairs to the upper floors. Contraindicated in gestosis. hypertension, placenta previa.
Now you know how, when and whythere is preparation of the cervix for childbirth. You know the reasons why this may not happen and how to fix it. Having information, you can correct or prevent possible problems. Do not forget one thing: it is better to do it in concert with your doctor!