home Audience 6 Diagnosis of “short cervix”: what is its danger for a pregnant woman? What does a short cervix mean during pregnancy?

Diagnosis of “short cervix”: what is its danger for a pregnant woman? What does a short cervix mean during pregnancy?

Every woman dreams of a smooth pregnancy, without complications, and especially without the threat of miscarriage and premature birth. There are certain risks that lead to undesirable consequences - miscarriages and rapid premature birth. One of these threats is a short cervix.

What it is

The cervix is the rounded part of the uterus that connects it to the vagina. In a healthy state, its length varies from 3 to 4 cm, which is approximately a third of the entire length of the uterus. Under the influence of negative factors, this indicator can decrease to two or less centimeters, as a result of which the pregnant woman develops isthmic-cervical insufficiency.

The pathological condition is reflected in the performance of certain functions by the cervix - under the pressure of the increasing size of the fetus, the organ continues to shorten, opens prematurely and provokes miscarriage or premature birth. With this pathological condition of the cervix, infection of the fetus is possible, since the protective function is significantly weakened. During childbirth, there is a high risk of perineal and vaginal ruptures.

Causes

a short cervix may be a consequence of the anatomical structure of the female body;
- a consequence of hormonal changes in the body caused by pregnancy. The pathology is especially pronounced in the second trimester;
deformation of the cervix caused by previous abortions, surgery or multiple births;
a lack of ;
stressful situations, fears, worries;
diseases of the uterus and cervix of an infectious and inflammatory nature, as a result of which the tissues of the organ are deformed and scarring occurs;
deformation caused by uterine bleeding.

Examination and diagnosis of isthmic-cervical insufficiency
Isthmic-cervical insufficiency can be diagnosed with maximum accuracy in the second half of pregnancy, namely in the period from 14 to 24 weeks.

Examination by a gynecologist. At the appointment, the specialist assesses the condition of the cervix, the presence of discharge and its nature, as well as the size of the external pharynx. In a healthy state, the cervix should be tight, have a deviation in the backward direction, the external pharynx should be tightly closed and not allow a finger to pass through.
Ultrasound examination using a special sensor. In the first trimester, diagnosis is carried out with a transvaginal probe; in the future, transabdominal examination is used. Based on the diagnostic results, the specialist decides on further treatment methods that will allow you to maintain the pregnancy.

Normal cervical length by week

Also, ultrasound determines the degree of maturity of the cervix, in conclusion, this indicator is assessed in points.

Table of criteria by which cervical maturity is assessed

Each criterion is assessed by a corresponding number of points, which are summed up. The results look like this:

from 0 to 3 – immature cervix;
from 4 to 6 – not fully mature cervix, developing isthmic-cervical insufficiency;
from 7 to 10 – fully matured cervix.

In a healthy state, until the 37th week, the cervix should be in an immature state, and transition to a mature state only before the onset of labor. It is important to consider that the inability of the cervix to transform into a mature state is also regarded as a pathology that requires specialist supervision and correction of the pregnant woman’s condition. It is likely that the woman will be offered delivery by caesarean section.

If ultrasounds indicate borderline examination results and symptoms of premature birth are recorded, the pregnant woman is prescribed a repeat examination - ultrasound diagnostics - to confirm the diagnosis and make appropriate correction.

If the cervix is less than 1 cm in length, labor may begin at 32 weeks.
With a cervical length of 1 to 1.5 cm, birth occurs at 33 weeks.
With a cervical length of 1.5 to 2 cm, the duration of pregnancy is reduced to 34 weeks.
If the cervix is between 2 and 2.5 cm long, labor begins at 36 weeks.

What to do with ICN
First of all, it is necessary to evaluate the results of the examinations and determine a further scheme of preventive and therapeutic measures. A short cervix is one of the pathologies that can be avoided with due care and preventive measures. To do this you need:

visit a gynecologist in a timely manner, because only during an examination can the first signs of pathology be identified and treatment prescribed;
if the moment for conception is unfavorable, you need to use reliable methods of contraception;
It is important to plan your pregnancy, this primarily applies to women who have had miscarriages.

Treatment

In many ways, success and the absence of problems during pregnancy with a short cervix depend on the efforts and attention of the woman herself. It is important not to miss visits to the gynecologist, to rest more to eliminate the possibility. It is necessary to wear a bandage and avoid physical activity. These simple preventive measures significantly reduce the risk of premature birth.

If changes in the structure of the cervix are minor, conservative therapy is prescribed. To do this, a course of drugs is prescribed that normalize the physiological state of the uterus and relieve symptoms of tone. Treatment can be carried out with tablets or in the form of droppers.

If the cause of the pathology is hormonal imbalance - an excess of male hormones - drugs are prescribed that normalize the woman’s condition.

If after a course of therapy no improvements are recorded or the pathological condition is caused by a mechanical effect on the cervix, surgical correction or cervical cerclage is prescribed. The procedure is carried out under intravenous or epidural anesthesia; special fixing sutures are placed on the cervix to hold the fetus. The correction is carried out between 17 and 21 weeks. After the procedure, the patient remains in hospital for 2-3 weeks under the supervision of a doctor and is treated with antispasmodic drugs to avoid increased uterine tone. If pathogenic microflora or symptoms of infection are detected, a course of antibacterial drugs is prescribed, which are allowed during pregnancy. After discharge, the patient is required to visit a gynecologist every two weeks to monitor the condition of the cervix. Every month, a bacteriological culture and smear are taken from the pregnant woman to identify pathogenic microflora. At week 37, the woman is hospitalized to prepare for childbirth and the stitches are removed so that they do not damage the cervix during childbirth.

Note: if the amniotic fluid has broken and labor begins, the sutures must be removed immediately, regardless of the stage of pregnancy.

If the diagnosis of “short cervix” is aggravated by concomitant infection or for other reasons surgical intervention is prohibited, non-surgical cerclage is performed. A special uterine ring is placed on the cervix - an obstetric pessary. The procedure can be carried out at least 5 weeks into pregnancy. The pessary functions as a kind of bandage that will help reduce pressure on the weakened cervix, protect the fetus from infection, and also preserve the cerumen plug.

An obstetric pessary requires regular treatment, it is carried out every two to three weeks. At 37-38 weeks, the medical structure is removed.

Childbirth with ICN

A short cervix imposes certain characteristics on the course of labor. Isthmic-cervical insufficiency causes the following processes:

at the initial stage of labor, a pregnant woman experiences a dilatation of the cervix of 3-4 cm, usually such dilatation is recorded already in the active phase of labor;
when active, regular contractions begin, the cervix dilates much more actively than in a healthy state - by 1 cm in 1.5-2 hours;

As a result, labor progresses and ends much faster; doctors distinguish two types of childbirth:

fast - for first-time mothers less than six hours, for multiparous women about four hours;
rapid - for primiparous women, labor ends in less than four hours, and for multiparous women in 2 hours.

Note: thus, a short cervix is assessed by gynecologists as a serious, pathological condition that requires immediate correction and elimination. Doctors today give preference to a less invasive method of therapy - the introduction of an obstetric pessary.

Sex with a short cervix

Intimate relationships during pregnancy, like ultrasound using sensors, cannot cause miscarriage or premature labor. However, when diagnosing isthmic-cervical insufficiency, it is better for spouses to refrain from intimacy or exercise extreme caution so as not to complicate the course of the pathological process.

It is impossible to deprive a pregnant woman of intimacy, since as the size of the uterus increases, the outflow of blood from the genital organs slows down, and this causes an increase in libido. It is possible to normalize blood flow in the pelvic area, uterus, and also to activate the blood supply to the fetus only with the help of intimate release of the expectant mother. Sexual intercourse interrupted before achieving orgasm has a negative impact on the emotional state of a woman, leading to sleep disturbances, irritability and stagnation of venous blood in the pelvic organs.

sexual intercourse should be calm;
the penetration should not be deep, this will eliminate the likelihood of injury to the cervix;
the sexual partner should not have any infections, otherwise a condom should be used;
during intimacy, it is necessary to exclude pressure on the mother’s abdominal area; the main criterion for choosing a position is that the woman should be comfortable;
contractions of the muscular layer of the uterus during orgasm cannot provoke an increase in the tone of the uterus;
semen contains substances that help soften the cervix, for this reason ejaculation into the vagina is prohibited before the 35th week of pregnancy;
during anal sex, you need to use a condom or lubricant; it is not advisable to use the same means of protection to continue sexual intercourse and penetration into the vagina, this can cause infection of the fetus, infection of the amniotic membranes and their rupture before the due date.

Note: during pregnancy, women often face the problem of swelling of hemorrhoids, in which case there is a high risk of injury and infection. To avoid unpleasant discomfort, you must avoid anal sex.

During pregnancy, you should not rely on your own feelings, especially when diagnosing a short cervix and isthmic-cervical insufficiency. It is important to inform your gynecologist about any unknown changes in your health status. A timely examination, examination, and prescribed therapy will help to avoid many complications and unpleasant consequences during childbirth.

The condition of the female genital organs changes during pregnancy. If the doctor reveals that the expectant mother has a shortened cervix, the course of pregnancy may be complicated. This article will tell expectant mothers more about this common pathology.

What it is?

The main reproductive organ in which the baby develops is the uterus. It is located in the lower half of the abdomen. During pregnancy, the size of the uterus changes significantly. This is necessary so that the baby during childbirth passed unhindered through the birth canal.

The cervix is a kind of entrance to the uterine cavity. Its sizes vary for different women. The average length of this organ is, as a rule, 3.5 cm. For most women, this size is from 3 to 5 cm.

Changes in cervical length are a very important clinical indicator. Doctors note that this organ can be shortened to 2 cm or less. It is this pathology that is called shortening.

The cervix changes significantly during pregnancy. During this period, uterine and then placental blood flow in the female body increases significantly. This process contributes to the strong proliferation of the cervical epithelium. This situation, as it develops, leads to the fact that the length of the cervix decreases significantly.

The proliferation of epithelial cells occurs during pregnancy under the influence of various specific hormones. Estrogens promote too much hypertrophy of the muscular layer of the uterus, which leads to changes in the tone and condition of the cervix and cervical canal.

This situation in many women can even lead to the development of many pathologies, which may lead to the need for surgical gynecological treatment.

Reasons for shortening

A narrow and short cervix is often a congenital pathology. Also, this pathological condition in the expectant mother can appear as a result of exposure to various traumatic actions. The cervix is shortened after abortions, as well as during other surgical interventions.

Heredity is an important feature that can contribute to the development of such a disorder. In this case, similar changes occur in the mother, grandmother or sister of a pregnant woman.

In such a situation, quite often they even develop similar pathologies that appeared during pregnancy. Quite often, adverse symptoms develop at 25-30 weeks of pregnancy.

Significant physical activity can also lead to shortening of the cervix. It is for this reason that doctors prohibit the expectant mother from engaging in active sports or putting a lot of stress on her body. Regular walks in the fresh air are suitable for optimal physical activity.

Another possible reason for the development of this condition is the consequences of various infectious diseases. Pregnancy is a period in a woman’s life accompanied by a decrease in immunity. This condition contributes to the fact that any pathogenic microbes can easily get to the cervix and cause inflammation there.

In order to reduce the likelihood of developing this condition even before pregnancy, a woman should definitely visit her doctor regularly.

The appearance of various scars on the cervix can also contribute to the shortening of this organ. These formations appear after any surgical interventions on the cervix, which are performed by obstetricians-gynecologists.

Pathologies that led to the treatment of this organ using a laser or alternative techniques can also contribute to the formation of various scars on this organ.

If the expectant mother is carrying a large baby or twins, then the risk of developing shortening also increases significantly. In this case adverse symptoms progress as pregnancy progresses.

This situation is due to the fact that the baby, developing in the mother’s womb, puts strong pressure on the cervix. Compression of this organ leads to the fact that it shortens significantly and becomes narrower.

Pathological conditions of the placenta can also lead to the development of this pathology. One of these pathological conditions is its presentation. The large size of the placenta, putting pressure on the cervix, causes its compression, which contributes to the development of shortening of this organ.

Experts identify several of the most dangerous periods during pregnancy. This includes the time from 20 to 30 weeks of pregnancy. The most dangerous period for the development of this condition is the 16th week.

Symptoms

During the entire period of pregnancy, a woman should closely monitor her health. She may develop unfavorable signs at any time.

If the expectant mother begins to feel that her health is deteriorating, it is better for her to contact her obstetrician-gynecologist unscheduled.

Quite often, unfavorable symptoms appear in women at 21 weeks of pregnancy. This period of bearing a child is very important. At this time, the woman usually begins to feel the active movements of her baby

Reviews from many mothers indicate that they feel “jolts” or “kicks” in their tummy. This state causes them a sea of positive emotions and greatly inspires them.

If, against the background of such symptoms, a pregnant woman begins to notice that she has some kind of pain in the lower abdomen or bloody discharge from the vagina, then she should Be sure to quickly contact your doctor.

31-32 weeks of pregnancy is another dangerous period of pregnancy when a woman’s condition may worsen. Expectant mothers who are carrying twins or triplets should watch themselves most closely at this time.

Women suffering from polyhydramnios are also at increased risk for the development of this pathology. To prevent unfavorable symptoms from progressing during this period, doctors recommend that the expectant mother Get plenty of rest and limit physical activity.

Any psycho-emotional stress is also excluded. A correct and rational daily routine is a very important task.

Danger to the expectant mother and fetus

Shortening of the cervix can lead to a significant threat to the course of labor. This condition threatens the development of isthmic-cervical insufficiency. This pathology can lead to premature birth.

Strong physical activity in this case can contribute to the deterioration of the general condition of the mother and her baby. This situation cannot be avoided without medical intervention.

If the mucous membranes of this organ begin to soften greatly against the background of shortening, the lumen of the cervix expands. This contributes to the fact that the risk of infection of the baby increases many times over. This situation also contributes to the penetration of pathogenic microbes into the uterine cavity and into the cervical canal.

A uterus that is too short, according to statistics, leads to an increase in premature births. Doctors note that women suffering from this pathology may require emergency obstetric care at 34-37 weeks of pregnancy.

A narrow and short uterus, especially in petite women, means that they may experience various injuries and ruptures during childbirth. In this case, stitches may be required. This condition requires longer rehabilitation and can significantly aggravate the first weeks of life after the long-awaited birth.

The risk of developing this pathology increases significantly in women who are carrying an overly large baby or several children at the same time.

Cervical ruptures

Quite often, a short cervix leads to the development of hypertonicity. This pathology also increases the risk of premature birth. This condition is manifested by the appearance of pain in the abdomen, bleeding from the vagina, dizziness and severe fatigue. Only an obstetrician-gynecologist can identify this pathology during an extensive gynecological examination.

If hypertonicity against the background of a short cervix is detected already in late pregnancy, then in a dangerous situation, hospitalization may even be required. In this case, the expectant mother will undergo intensive treatment in a hospital setting. In this situation, “conservation” will also be offered to women with multiple pregnancies.

What to do?

It is important to note that if a woman has a short cervix before pregnancy, she should regularly visit her gynecologist. This is necessary in order to monitor the condition of this organ. Quite often, shortening of the uterus leads to the development of many dangerous pathologies.

However, in most cases, this pathological condition is determined only during pregnancy. It is identified by a gynecologist during an examination of the expectant mother on a chair. If violations are detected, the doctor must refer the woman for additional transvaginal ultrasound examination.

Maintaining a daily routine

Doctors recommend that expectant mothers strictly monitor what they do during the day. The daily routine is very important. In order to normalize the tone of the uterus, you should definitely get enough sleep regularly. Sleep should be at least 8-9 hours a day.

To prevent the cervix from further shrinking, The expectant mother should monitor her excessive emotions. Severe anxiety or worry over trifles leads to disruption of nervous activity and spastic contraction of smooth muscles. This condition can only increase the shortening of the cervix.

Optimal physical activity helps the expectant mother maintain the tone of the female genital muscles. To normalize it, yoga classes for pregnant women or regular walks in the fresh air are suitable. Also, to prevent the worsening of this pathology, doctors prohibit the expectant mother from lifting weights.

Normalizing excess body weight is a very important condition for maintaining the health of the female genital organs. During pregnancy, the expectant mother already gains weight. This is due to the baby growing in her tummy, as well as the entire mass of all the placental membranes. Too much weight can lead to compression of the reproductive organs, which also causes shortening of the cervix.

In some cases, doctors may recommend that women suffering from this pathology wear special bandage. It helps to fix certain parts of the spine, and also somewhat reduces the likelihood of premature birth.

Shortening of the cervix is not a contraindication for sexual intercourse. Only in certain acute pathologies can doctors recommend that women limit their sexual activity. As a rule, such recommendations are given to expectant mothers in the last stages of their pregnancy.

Gynecological treatment

If, against the background of a short cervix, a woman has developed isthmic-cervical insufficiency, then she will require special treatment methods. In this case, doctors usually apply sutures that fix the os of the uterus. They will be removed only immediately before childbirth.

Some of the methods are surgical and are performed in an operating room. As a rule, in this case, mandatory intervention of an anesthesiologist is required.

Cervical cerclage is an invasive procedure that is performed to correct disorders that have arisen on the cervix. In this case, temporary sutures are placed on the cervix. They are necessary to ensure that it remains “closed” until the birth itself. Usually in this situation, sutures are applied before 26-27 weeks of pregnancy, since in the future this measure will be ineffective.

Another method of treating isthmic-cervical insufficiency caused by a too short cervix is the application of an obstetric pessary. This special device is inserted into the cervical canal and fixes the pharynx from the inside. An obstetrician-gynecologist installs an obstetric pessary.

This procedure is invasive, so requires mandatory training. It is better that it is performed only by an experienced and qualified doctor. After installing an obstetric pessary, doctors limit physical activity and recommend that expectant mothers get plenty of rest.

Drug therapy

In some situations, doctors may recommend hormonal treatment to the expectant mother. This is possible in cases where pathological changes in a woman occur against the background of existing dishormonal disorders. In such a situation, doctors prescribe medications that compensate for the lack of specific female hormones.

"Utrozhestan"- This is one of the medications prescribed to correct the problems that have arisen. Gynecologists can prescribe this drug at various periods of pregnancy. For up to 12 weeks, taking Utrozhestan promotes the attachment of the fetus to the wall of the uterus, as well as the beginning of its intrauterine development.

Taking this drug also significantly reduces the risk of spontaneous miscarriage. By the later weeks of pregnancy, the increase in progesterone in the blood decreases slightly. This physiological reaction is necessary for the expulsion of the fetus from the mother's womb. In this case, taking Utrozhestan may lead to a worsening of the final stage of pregnancy.

This drug can be prescribed in the form of capsules or various suppositories. In most cases, it is taken three times a day. Dosages are selected individually, taking into account the patient’s weight, the presence of concomitant diseases, as well as the nature of the pregnancy.

Expectant mothers should remember that Any hormonal medications must be prescribed by a doctor. Self-use of such drugs can lead to the development of quite dangerous conditions for the fetus and her own health.

A short cervix is not at all a contraindication for planning pregnancy. With such a physiological feature, a woman can become a mother more than once. For the normal course of pregnancy, only timely monitoring of the baby’s condition while he is in the mother’s tummy is required.

It is better to determine the shortening of the cervix before conceiving the baby. The only exception is if this pathology occurs in a pregnant woman directly during pregnancy. Timely diagnosis of this condition can reduce the significant risk of developing various diseases in both the pregnant woman and her baby.

Gynecologist Lyudmila Shupenyuk will talk about how long the cervix should be during pregnancy in the next video.

A short cervix during pregnancy is a fairly common pathology. It is dangerous because it can cause miscarriage or premature birth, since the cervix is not able to hold the baby inside the uterus, it opens under his weight. But if a woman regularly visits a gynecologist and undergoes ultrasound examinations, the doctor will definitely notice this cervical pathology and take measures to prolong pregnancy.

Why the cervix opens prematurely and diagnosis of pathology

This pathology is medically called isthmic-cervical insufficiency (ICI). Its signs: premature shortening, softening and dilatation of the cervix. These signs are most often diagnosed at 15-20 weeks, when rapid weight gain in the fetus begins and the cervix experiences heavy loads during pregnancy. A doctor can notice abnormalities during a gynecological examination, as well as during an ultrasound. The expectant mother herself may notice heavy watery or bloody discharge. But in most cases there are no symptoms.

There are many reasons for this pathology. These include various injuries resulting from cervical ruptures during childbirth, during medical abortion, during conization, application of obstetric forceps, etc. The situation is aggravated by multiple pregnancies, polyhydramnios, and a large fetus.

ICI can also be congenital and caused by hormonal disorders, due to which the length of the cervix during pregnancy begins to decrease long before the date of birth.

All women with cervical injuries, as well as with a poor medical history (miscarriages in the second trimester of pregnancy) are under especially careful medical supervision.

Methods of prevention and treatment

Early prevention includes reliable contraception, which will help avoid abortions. In second place is a regular, at least once a year, visit to the gynecologist. Preventive medical examinations will help to identify cervical pathology in time and treat it conservatively. And finally, planning a pregnancy. This is especially true for those women who have had pregnancies in the past with an unfavorable outcome, and the loss of pregnancy occurred at a longer period.

If a short cervix is detected during pregnancy, treatment is prescribed depending on whether there is dilation, as well as directly on the gestational age. Let us remind you that a short one is less than 2.5-3 cm. Actually, there are 2 treatment methods: suturing and an obstetric ring pessary. Sutures are placed before 27 weeks, and the sooner, the more effective the measure will be. Stitches will help even if the cervix is slightly open. Meanwhile, as a conservative method - a ring, it is put on rather for prophylactic purposes, when there is no significant shortening, but the doctor suspects ICI in the patient.

In addition, it is recommended to ensure that the uterus is not in good shape during pregnancy, as this also provokes ripening of the cervix. Minimal physical activity and wearing a bandage are recommended.

Sutures are removed if the amniotic fluid has broken, labor or bleeding has begun. If everything is in order, then the stitches are routinely removed at 38 weeks. If a caesarean section is planned, in most cases the stitches will not be removed at all.

Know that isthmic-cervical insufficiency is not a death sentence if you take timely measures to prevent further dilatation of the cervix and follow the doctor’s recommendations.

A short cervix is not a death sentence for a woman, however, when planning a pregnancy, such a pathology should not be ignored. The fact is that it is precisely because of the shortened cervix (the length of which is less than 2.5-2 cm) that the process of bearing a child can occur with very serious complications, the main of which is considered to be isthmic-cervical insufficiency. This problem often causes a threat of miscarriage or premature (premature) birth.

What to do if the cervix is short? First of all, strictly follow all the doctor’s recommendations and prescriptions aimed at maintaining pregnancy. Unfortunately, this pathology is most often discovered during the period of pregnancy, during a gynecological examination, and is confirmed by an ultrasound examination during an intravaginal examination.

If there is such a problem, a woman may be unable to carry a normal pregnancy and give birth without medical intervention. A normal cervix has a length of approximately 4 cm. If in the 1st-2nd trimesters its shortening to 2-3 cm is observed, we can talk about the development of isthmic-cervical insufficiency. This condition is characterized by softening and expansion of the sphincter, as a result of which the first section of the birth canal may open, and this is fraught with premature birth.

The congenital form of ICI is most often associated with genetic predisposition or individual characteristics of the female body structure. The acquired nature of this pathological condition can be a consequence of medical and spontaneous abortions (miscarriages), previous births that were complicated by injuries (ruptures), as well as surgical interventions in the uterine cavity and other factors that one way or another lead to injury to the cervix and its deformation , scar formation, etc. Thus, an expectant mother diagnosed with a “short cervix” must follow the instructions of a gynecologist and, if necessary, undergo treatment in a hospital in order to maintain the pregnancy.

Drug treatment for short cervix

If a pregnant woman is diagnosed with a “short cervix,” the doctor prescribes treatment based on the specific situation. It is necessary to take into account the condition of the pregnant woman, the length of the cervix, concomitant pathologies, the results of studies and diagnostic measures. To avoid possible consequences, it is important to carry out early prevention of the disease: visit a gynecologist in a timely manner, use reliable methods of contraception, and plan your pregnancy wisely.

The medications prescribed for therapy will depend on the causes of the pathology. First of all, a pregnant woman needs to take a blood test to determine hormone levels. If the cause of cervical shortening is a hormonal imbalance, the danger can be eliminated with the help of hormonal therapy. A pregnant woman is prescribed glucocorticoid drugs: Microfollin, human chorionic gonadotropin, Turinal, Dexamethasone, etc.).

For minor changes in the cervix, a conservative method is used, which consists of intravenous administration of Ginipral or Magnesia. These medications eliminate the tone of the uterus. Other drugs include sedatives (motherwort, valerian), multivitamins, as well as drugs that relax the smooth muscles of the uterus. Several weeks of intensive therapy give a positive result, and the condition of the cervix stabilizes. If the problem remains, surgical correction (suturing) or an obstetric pessary is used to hold the uterus in the correct position.

If cervical insufficiency has developed due to a short cervix, the expectant mother is prescribed tocolytics - medications that help relax the uterus (b-adrenergic agonists, Magnesium sulfate, Indomethacin). To prevent placental insufficiency, vasodilators and vasoactive drugs, as well as low molecular weight dextrans, are used. Non-drug methods of therapy include acupuncture, electrorelaxation of the uterus, electroanalgesia, and endonasal galvanization.

Utrozhestan

A short cervix during pregnancy is often a factor that provokes the threat of miscarriage. If the condition worsens due to hormonal imbalance, the expectant mother is prescribed drugs whose action is aimed at reducing the contractile activity of the uterus.

Utrozhestan is one of these drugs (available in the form of capsules and vaginal suppositories). Its purpose is associated with a situation when insufficient production of the hormone progesterone occurs in the body of a pregnant woman. The dosage of this medication is selected individually in each case, based on the symptoms of threatened interruption and their severity. The usual dose is 200 to 400 mg/day. every 12 hours. The drug is contraindicated for liver disease and varicose veins.

In modern medicine, the use of Utrozhestan is widely practiced when there is a threat of miscarriage due to a lack of progesterone. Therefore, a pregnant woman should not worry that this hormonal drug may harm her health or negatively affect the development of the fetus. On the contrary, this medicine is necessary, and if taken as prescribed by the doctor, there will be no side effects. Moreover, we obtain this natural progesterone from plant materials. In the first trimester, intravaginal use of the drug is recommended, however, when used vaginally, the medicine is absorbed faster and better tolerated by the body.

Ginipral

A short cervix often provokes unforeseen complications during pregnancy (ICI, increased uterine tone, infection of the fetus), so it is important to identify the pathology in time and avoid serious problems.

Ginipral is prescribed to the expectant mother if she has uterine hypertonicity. This condition not only increases the risk of miscarriage or premature birth, but also “inhibits” the flow of nutrients and oxygen to the fetus. The drug is available in tablet form or as injections and has a direct effect on the vessels of the uterus, promoting “soft” relaxation of the reproductive organ. It should be noted that in the first trimester, taking this drug is contraindicated. Its administration is possible only after the 16th week, and the dosage and duration of administration are determined by the doctor. This requires control of blood pressure and blood sugar levels. If a pregnant woman has strong uterine tone, the dose of Ginipral can reach 500 mcg when taken every 3 hours.

Contraindications can also be noted: individual intolerance to the components of the drug, hyperfunction of the thyroid gland, glaucoma, bronchial asthma, heart disease, renal and liver failure. Side effects associated with the use of this medication include headaches, rapid heartbeat, agitation, and dizziness. Therefore, along with Ginipral, drugs are prescribed whose action is aimed at reducing cardiac activity. To avoid swelling in a pregnant woman, it is recommended to limit fluid and salt intake. The withdrawal of the drug is carried out gradually, the dose is reduced at each dose.

Magnesia

A short cervix is a factor in the development of isthmic-cervical insufficiency, which means that a pregnant woman is at risk of spontaneous miscarriage or premature birth. When a pathology is identified, it is necessary to prescribe medications, the action of which is aimed at eliminating the main problem - uterine hypertonicity.

Magnesia (magnesium sulfate) is an effective drug that helps prevent various complications when there is a threat of miscarriage. Its action is aimed at relaxing muscle muscles and the walls of blood vessels, normalizing pressure, and accelerating the removal of fluid from the body. The effectiveness of this drug is manifested only with intramuscular and intravenous administration. Taking it in powder form will not give the desired result, since the drug will not enter the bloodstream from the intestinal tract.

The use of the drug is contraindicated before childbirth and in the first trimester of pregnancy. At later stages of pregnancy, such treatment should take place exclusively in a hospital, under the strict supervision of the attending physician. The dosage of magnesium will depend on the situation, i.e. the health status of the pregnant woman, as well as concomitant pathologies. As a rule, the usual dose of 25% of the medicine is 1-2 times a day, for the second stage of nephropathy - 4 times. It should be noted that the introduction of magnesium is a very painful process that requires the experience and skill of a medical specialist.

Side effects that may occur as a result of taking magnesia include weakness, drowsiness, anxiety, headaches, sweating, hypotension, and speech impairment. If blood pressure is low, the drug cannot be prescribed. In addition, its combination with biological food additives and calcium supplements is not allowed. Since there are risks involved in taking this medication, your doctor will weigh the pros and cons based on your specific situation before starting treatment.

Duphaston for short cervix

A short cervix can become a prerequisite for the threat of miscarriage, especially against the background of hormonal changes in the female body during pregnancy. In particular, this is due to a lack of progesterone, confirmed by laboratory tests.

Duphaston for a short cervix is used if a pregnant woman has problems bearing a child and has uterine hypertonicity. This drug is a synthetic analogue of the hormone, but its structure is close to natural progesterone produced in a woman’s body. The effectiveness and safety of the drug (especially in the early stages, up to 16 weeks) has been proven by many years of its use. A positive property of the drug is its gentle effect on the liver and blood clotting. The treatment regimen and dosage of Duphaston should be selected by the doctor individually, based on the clinical picture and condition of the patient.

Typically, if there is a threat of miscarriage, the dosage of the drug is 40 mg once, and then reduced to 10 mg every 8 hours. Therapy continues until symptoms disappear completely. If symptoms recur after stopping Duphaston, it is necessary to continue therapy by returning to the optimal dosage.

Traditional treatment

A short cervix is a pathology that can lead to such a dangerous condition during pregnancy as isthmic-cervical insufficiency. At the same time, the internal cervical pharynx is not able to cope with the “obturator” function, and it is more difficult for the uterus to hold the growing fetus in its cavity. Under pressure, the cervix shortens and opens even more, which provokes the threat of miscarriage or premature (most often rapid) labor. In addition, due to the deformed neck, favorable conditions are created for the penetration of infections.

Alternative treatment for the threat of miscarriage should be used with extreme caution, only after consultation with your doctor. In this case, effective means are:

A decoction of viburnum bark. One teaspoon of crushed viburnum root is poured into a glass of boiling water, placed on low heat and removed after 5 minutes. After the decoction has infused, you can start taking: 1-2 tbsp. spoons of the product throughout the day. You can also use viburnum flowers by taking approximately 30 grams of raw material and pouring 1.5 liters of boiling water over it. The broth is infused in a thermos for about 2 hours, then taken ¼ cup 3-4 times a day.

Dandelion decoction. A pinch of herb (5-10 g) should be poured with a glass of boiling water and boiled a little. It is recommended to use the finished product ¼ cup several times a day. Dandelion root can be used in the same dosages.

A good remedy is an infusion made from calendula flowers and St. John's wort. The ingredients should be taken in equal proportions and pour 200 g of boiling water, then leave in a thermos for half an hour. The finished infusion should be consumed throughout the day, 2 glasses each (you can add honey to taste).

Herbal treatment

A diagnosis such as a short cervix, if established during pregnancy, requires immediate methods to solve the problem, i.e. prescribing effective therapy aimed at preventing the threat of miscarriage. In addition to medications, which should be prescribed by a gynecologist (self-medication is excluded), herbs are often used that have a beneficial effect on the condition of the cervix and decrease the tone of the uterus.

Treatment with herbs should be strictly under the supervision of a doctor and with his permission, since some plants can have the opposite effect and harm the expectant mother and her child. Herbs that have proven to have a positive effect on the cervix, in particular its preparation for childbirth, include evening primrose (plant oil). This product is available in capsules and is most often prescribed to pregnant women from the 36th week. The plant promotes the synthesis of estrogen and testosterone, and also stimulates the production of prostaglandins. In addition, it is rich in healthy fatty acids (especially gamma-linolenic acid), which contributes to the elasticity of the cervix, as well as the prevention of cervical rupture during childbirth. Primrose is taken in the form of capsules, 2 pcs. per day, but from the 39th week you can gradually increase the dose to 3 capsules.

Decoctions of herbs (calendula, St. John's wort, viburnum, chamomile, etc.) also have a general strengthening effect on the pregnant woman's body, and also improve the tone of the uterus and help prevent the threat of miscarriage in combination with medications. Tea made from raspberry leaves has a good effect, it is recommended to take ½ cup before meals. Infusions of hawthorn and rose hips should be consumed in the morning, on an empty stomach.

No less useful is a decoction of strawberries, for the preparation of which you need to take 100 grams of berries and pour 1 liter of boiling water along with crushed dry leaves. Then the broth is brought to a boil and boiled for 30 minutes, filtered, cooled and taken half a glass (at least 1 liter) throughout the day.

Homeopathy

A short cervix during pregnancy can cause the expectant mother a lot of troubles, one of which is ICI, leading to the threat of miscarriage or rapid labor (at a later stage). Along with drug therapy, the use of various homeopathic drugs is used, but their prescription should be carried out under the strict supervision of a doctor and only according to his instructions.

Homeopathy, aimed at preventing the threat of miscarriage and improving the condition of the uterus, includes taking the following medications:

Arnica – used in complex treatment for the development of isthmic-cervical insufficiency and the threat of miscarriage; improves blood circulation of the pelvic organs;
Aconitum - usually combined with other remedies for feelings of fear and anxiety, accelerated pulse accompanying ICN, has a calming effect on the nervous system;
Arsenicum album is an effective remedy that helps with the body’s tendency to miscarriage and is used to prevent recurrent miscarriage;
Chininum arsenicosum - this remedy has a good immunomodulatory effect and is prescribed for miscarriage and the threat of miscarriage due to infection of the genital tract, including due to a short cervix;
Sabina - the drug is indicated to prevent miscarriage, often in the early stages (8-12 weeks);
Zincum valerianicum - this remedy is used for hyperestrogenism, because. enhances the secretion of the hormone progesterone.

In addition to the above homeopathic drugs, a pregnant woman can be prescribed Calcium carbonicum, Sulfur, Silicea (as auxiliary drugs if the therapy is ineffective). When prescribing homeopathy, anamnesis is taken into account, as well as the characteristics of the patient’s constitutional type.

Surgical treatment of a short cervix

A short cervix diagnosed in a pregnant woman may require surgical intervention, especially when the threat of miscarriage increases, i.e. severe, progressive isthmic-cervical insufficiency is observed.

Surgical treatment includes the use of the following methods:

mechanical narrowing of the uterine internal os (a gentler method);
suturing the external pharynx (circular suture);
narrowing of the neck by strengthening its muscles along the side walls.

The main indications for the above manipulations are cases of premature birth and a history of miscarriages, as well as progressive insufficiency of the uterine cervix, i.e. its constant softening and shortening.

The main contraindications to surgical treatment can be:

increased excitability (uncorrectable) of the uterine walls;
various diseases of internal organs (liver, kidneys, heart);
genetic, mental illnesses;
bleeding during pregnancy;
the presence of developmental defects in the fetus.

It is most advisable to perform operations in the period from the 13th to the 27th week. In order to prevent the rise of infection, interventions can be carried out at a stage from 7 to 13 weeks. If there are contraindications, the pregnant woman is prescribed conservative therapy (drug reduction of uterine excitability), bed rest is recommended.

Bandage for short cervix

A short cervix is not a death sentence, but during pregnancy it is advisable to prevent the development of isthmic-cervical insufficiency in order to maintain pregnancy. Many women are interested in whether it is possible to wear a bandage in this case.

A bandage for a short cervix is indicated when the expectant mother experiences uterine hypertonicity against the background of a shortened cervix, which is physiologically unable to maintain the pressure of the uterus with the growing fetus. The fact is that high tone of the uterine muscles can provoke premature ripening of the cervix. This is fraught with its softening and opening, as well as increasing the risk of premature birth or miscarriage. In such cases, the pregnant woman is recommended to completely abstain from any physical activity and wear a special device - a support bandage.

You need to wear it correctly, without squeezing your tummy. Thanks to this proven remedy, it is possible to prevent early descent of the fetus, as well as ensure its correct location in the uterine cavity. In addition, modern bandages help a woman prevent the appearance of stretch marks, relieve physical fatigue, make walking easier, and avoid fatigue and heaviness in the body. A well-designed bandage can relieve excess stress from the spine and prevent the occurrence of lower back pain.

There are practically no contraindications to the use of such a device, but consultation with a doctor is mandatory. Typically, the use of a bandage is recommended for expectant mothers at 4-5 months of pregnancy, when the tummy begins to increase in size and the pressure of the fetus on the short cervix increases every day.

Ring for short cervix

A short cervix can cause many problems for a woman carrying a baby. This is due to the constant pressure of the uterus on the cervix due to the growing fetus. As a result of softening and even further shortening of this organ, isthmic-cervical insufficiency may occur, i.e. threat of miscarriage. In particularly severe cases, medical practice uses a special device - the so-called. "obstetric pessary". This involves a procedure called non-surgical cerclage.

The ring for a short cervix is most often used for a period of 25 weeks or more, when suturing the cervix is contraindicated for a pregnant woman to avoid injury to the amniotic sac and infection of the fetus. An analogy can be drawn between a pessary and a bandage, since both devices are designed to reduce the pressure of the uterus on the cervix and, thus, reduce the risk of infection of the fetus by preserving the cerumen plug.

To prevent infectious complications, the vagina and installed pessary are treated with special antiseptic agents every 15 days. This design is removed at 37-38 weeks of pregnancy.

There is also a relief pessary called a Meyer ring. This device is made of plastic and has a special shape. It is inserted into the vagina to support the cervix, as well as redistribute the weight of the fetus. This is one of the most effective methods of treating ICI, allowing you to maintain pregnancy. The Meyer ring is installed at any stage when the pregnant woman’s condition is not aggravated by other pathologies and the ICI is not advanced. Otherwise, this method of treatment can be used only as an auxiliary one.

Exercises for a short cervix

A short cervix is a problem for a pregnant woman, because due to the short length (2.5-2 cm) of this organ, isthmic-cervical insufficiency can develop when the cervix softens and opens, causing the threat of miscarriage. In this case, the woman is prescribed special therapy aimed at maintaining pregnancy. She is advised to limit physical activity and adhere to bed rest (in particularly dangerous cases).

Exercises for a short cervix can only be prescribed by the attending physician, since with such a pathology you need to be as careful as possible so as not to provoke premature dilatation of the cervix. A pregnant woman should definitely consult a doctor on questions regarding physical exercise, its types and frequency.

If the expectant mother has uterine hypertonicity, low blood pressure, varicose veins, and there is also a threat of miscarriage due to a short cervix, gymnastics is contraindicated. In such situations, it is advisable to perform breathing exercises. In especially severe cases, when the threat of miscarriage increases, any physical activity should be avoided, since it can cause the most dangerous consequences (miscarriage, premature birth).

Today, many pregnant women practice Kegel exercises, aimed at physically preparing the muscles of the perineum and cervix for labor. These exercises can only be performed with the permission of a gynecologist, who will objectively assess the situation and health status of the expectant mother. The essence of Kegel exercises is to tighten the muscles of the vagina. The technique is simple: sitting on a chair, you need to slightly tilt your body forward, and then squeeze and unclench your vaginal muscles 10 times. You should do such simple but effective gymnastics 2-3 times a day.

Sometimes, even during a successful pregnancy, unpleasant surprises happen. Similar diagnoses include shortening of the cervix.

A woman may not be aware of the existing pathology either before pregnancy or during its onset.

The problem will appear only after the 15th week, when active growth of the fetus begins and its pressure on the cervix increases. The diagnosis of “shortening of the cervix” is directly related to isthmic-cervical insufficiency - a dangerous condition that threatens termination of pregnancy.

The cervix is the lower part of the uterus. This is a kind of muscular seal that holds the fetus in the mother’s stomach, protecting it from mechanical damage and infections. The part of the cervix facing the vagina is called the external os, and the inner edge is called the internal os.

As the fetus grows, the cervix stretches from the side of the internal pharynx and, accordingly, becomes shorter. If the external os is also included in the process, the obturator function of the cervix is disrupted, and there is a threat of prolapse of the membranes, infection, and miscarriage.

Even in the absence of symptoms of the disease, it is recommended for a period of 24 weeks. A value of 3.5 cm is considered normal. Shortening of the cervix to 2.2 cm indicates the possibility of miscarriage in 20% of cases, and shortening to 1.5 cm increases the risk of premature birth by 50%.

Diagnosis: what are the symptoms?

The pathology of shortening of the cervix does not have any symptoms as such. The doctor will notice a possible danger during a routine obstetric examination. But to clarify the diagnosis, the woman is sent for an ultrasound.

Examination with a vaginal sensor will allow you to make accurate measurements and assess the threat.

If the diagnosis has already been confirmed and there is a risk of miscarriage, an examination is performed with an external, transabdominal sensor to monitor the condition of the cervix.

At the same time, at a period of 16-20 weeks, a cervix of 4-4.5 cm is considered the norm, at 26-28 weeks the norm will be 3.5-4 cm, but closer to childbirth, the cervix naturally shortens and at 34-36 weeks size 3 .5-3 cm will be an indicator of the preparation of the birth canal by the time the baby is born.

1-2 weeks before birth, the cervix decreases to 1 cm, this indicates the opening and smoothing of the wall from the internal os.

Causes

Some reasons are available for diagnosis even before pregnancy. Among them:

congenital anatomical features;
cervical injuries from previous births or abortions;
scars after a protracted inflammatory process.

Many of these problems can be corrected surgically, so it is important to see a doctor if you.

But if a woman has undergone a medical examination and no problems were found in the cervix, can she be sure that the problem will not affect her during pregnancy? The doctor cannot give such a guarantee. Some factors that are not normally present and are associated specifically with pregnancy can also affect the condition of the cervix.

Hormones.

This could be a hormonal imbalance in the woman’s body, or the endocrine system of the growing fetus becoming active. Around 16-18 weeks, when the adrenal glands are formed, androgen production begins. Under the influence of hormones, the tissues of the cervix become softer, more pliable, and open faster under the load of the fetal bladder.

or .

The “margin of safety” inherent in nature is sufficient for the successful carrying of a normal pregnancy, when one fetus of medium-standard size develops in the mother’s body. But when carrying twins, the pressure on the cervix increases significantly: both because of the additional weight and because of the atypical position of the babies in the womb.

Under pressure, the cervix becomes wider and, accordingly, shorter. The same thing happens if the unborn baby gains weight too quickly. In such a situation, isthmic-cervical insufficiency may even develop.

If near the internal os is not the small head of the child, but the placenta - a larger, wider organ, this leads to excessive stretching of the uterus in the lower part, which will result in a shortening of the cervix.

Shortening of the cervix does not always pose a threat to pregnancy, but it is a condition that requires additional monitoring.

What is dangerous about shortening the cervix?

An important role is played not only by the fact of diagnosing shortening, but also by the period of pregnancy at which this occurred.

Shortening in the 2nd trimester

If the pathology is detected early enough, from 15 to 26 weeks, then there is a high probability of premature birth. This means that additional monitoring of the development of pregnancy is required.

You may need to use special medications to prepare the baby's lungs for birth.

if at the indicated date the size of the cervix does not exceed 2-2.5 cm, with a high degree of probability the child will be born no later than 36 weeks;
if the cervix is 1.5-2 cm, the baby will appear at 33-34 weeks;
with a size of less than 1 cm, pregnancy can hardly be carried beyond 32 weeks.

In this case, the birth will take place in a special hospital, where there are conditions for caring for low birth weight premature babies. The newborn will be admitted to the pediatric intensive care unit and will be discharged home after he or she has grown and gained weight.

Shortening in the 3rd trimester

Shortening diagnosed in the third trimester no longer threatens such an early birth, but development can lead to infection of the amniotic fluid or loss of membranes.

Therefore, a woman should pay special attention to hygiene issues and rest regime. Visit your doctor regularly to monitor the condition of your cervix.

How to maintain pregnancy?

Measures to maintain pregnancy depend on the causes of shortening, timing of diagnosis, development (or absence) of symptoms of isthmic-cervical insufficiency:

If the cause is previous injuries or anatomical features and the uterus is shortened before pregnancy, surgical plastic surgery is possible.

The elasticity of the muscle and its size are restored. Pregnancy is possible several months after surgery.

Shortening of the cervix during pregnancy, caused by hormonal imbalance, is corrected with appropriate medications, diet, and vitamin therapy.
With pronounced ICI and the threat of early disclosure, or.

Both methods are aimed at mechanically holding the walls of the cervix in a closed state. The pessary also plays the additional role of a medical bandage, redistributing pressure on the lower segment of the uterus and preventing premature effacement of the cervix.

Preventive measures

Proper treatment of vaginitis and other inflammatory diseases of the genital organs will preserve the elasticity of the cervix. This applies equally to the period before pregnancy and to pregnant women.

Vitamins or hormone therapy prescribed by doctors can normalize the density of muscle tissue and the conduction of impulses, and will help the cervix in performing its main functions.

Excess weight of the woman herself and non-compliance with the diet during pregnancy put additional stress on the organs. It is important to monitor nutrition and weight dynamics during pregnancy.

If shortening is diagnosed, it is necessary to limit physical activity, heavy lifting, and bending. A woman should be able to lie down 2-3 times during the day and have a good night's rest.

When installing a pessary or applying sutures, the doctor will tell you about additional features of the regimen. Hospitalization will be required on the eve of the planned birth.

The diagnosis of “shortening of the cervix” made during pregnancy means a deviation of the diagnosed size from the norm. But it doesn't always talk about. It is possible to preserve the obturator function of the cervix if you follow the regimen and follow the doctor’s prescriptions.