The female reproductive system has a complex structure. Because of this, after a visit to the doctor, the diagnoses are surprising, although in some cases there is no reason for panic. In order not to worry in vain, find out what kind of structure the reproductive system has, where the cervical canal is, what endocervix is and what diseases they are exposed to.
What is the cervical canal?
The cervical canal is the cervical canal that connects the vagina and the cavity of this organ. It has two small holes - inner and outer throat, the normal diameter of which is 2-3 millimeters. The external pharynx is visible with a standard examination, it has a pinpoint form if the woman has not given birth, and after giving birth or abortion becomes slit-like. The layer of mucous membrane covering the neck is called endocervix.
Atresia of the cervical canal
A disorder that is manifested by congestion or obstruction of the cervix is called atresia of the cervical canal. The disease may be a congenital abnormality or acquired as a result of illness or injury. Congenital disorder is a case of abnormal formation and development of internal organs. Acquired atresias are in most cases caused by abortions, cervical cancer, inflammation in the inner, outer layers of the canal tissue.
The cervical canal is closed, what does it mean
In many respects, it depends on the state of the cervix whether spermatozoa will pass to the egg cell. When the neck is closed in whole or in part, doctors diagnose stenosis. You can distinguish it by the following symptoms: the absence or pain of menstruation, infertility, pain during intercourse. Narrow cervical canal and conception are poorly compatible, first you need to eliminate the cause, then carry out a bougienage. If you still succeed in getting pregnant with this disease, there is a high probability of discoordination of labor and subsequent cesarean section.
The cervical canal is expanded, what does this mean
At any time during pregnancy, the doctor can tell the news that the cervical canal is enlarged - what does this mean? This means that the cervix cannot perform its function of holding the fetus. The expansion of the cervical canal can be caused by an increased amount of male hormones that soften the cervix, multiple pregnancies, developmental abnormalities, and injuries. To prevent a possible miscarriage, the following actions can be taken:
- medicines are prescribed that strengthen the cervix,
- installation of a special ring, which will be removed only at 37 weeks,
- stitched around the cervix.
Causes of inflammation of the cervical canal can be infectious and non-infectious. Inflammation can cause: gonococci, streptococci, E. coli, chlamydia, herpes viruses, candida and papillomas. Noncommunicable causes include:
- cervical prolapse.
To determine the cause of the disease and treatment options, it is necessary to undergo an examination, to pass a scraping on the analysis. Inflammation of the cervical canal is seen during the initial examination - there is redness, swelling, and purulent discharge possible. To determine the pathogen, it is necessary to pass a diagnostic material - a smear, bacteriological seeding of secretions - and conduct a study on the identification of genital infections.
In cases of blockage of the glands of the mucous membrane of the uterine lumen, cysts are formed. This is because the outflow of mucus is difficult and when it accumulates, the ducts begin to expand. Frequent causes are neck inflammation, cauterization of erosion. A cyst of the cervical canal is a benign neoplasm, inside which there is a fluid that is often found in women of childbearing age.
Cysts can be single or multiple and often they do not require treatment, because they do not cause any complications and do not harm health. Cysts do not have any effect on pregnancy and may spontaneously disappear after childbirth. Only those tumors that are large in size and incessant growth are subject to opening.
Cervical canal during pregnancy
After the moment of fertilization, the cervix is tightly closed and is in tension before the onset of labor. It is very important to monitor the cervical canal during pregnancy, because of its condition depends on the positive outcome of childbirth. The cervix is smoothed and opened, its length decreases one or two weeks before delivery. If this happens earlier, you can talk about the serious risk of miscarriage.
Outside, the neck is covered with a layer of cells secreting mucus, which during pregnancy forms a dense stopper. Its main functions:
- to separate the uterus from the vagina,
- protect the fetus from harmful microorganisms that may be in the vagina.
The procedure for dilating the cervix is called bougienage of the cervical canal. The reason for this operation may be partial and complete atresia. The operation is performed under local anesthesia, if the narrowing is insignificant, under the general, if the closure is complete. Before surgery, you must pass the following examinations:
- smear on infection, white blood cell count,
- blood tests - general, biochemical, for AIDS, for hepatitis B, C,
- smear microscopy
- seeding from the vagina and CC,
In cases where medication treatment no longer helps, doctors go to an extreme measure - surgery. Scraping the cervical canal - what is it and what are the indications for surgery? This is a simple procedure performed by a gynecologist under general anesthesia. Before the operation, it is necessary to undergo a standard examination, pass a blood test, seeding, smear for infection.
One of the reasons for the formation of polyps and the indications for their removal, polypectomy, may be the onset of postmenopausal, but more often it is not the treatment of inflammatory processes of the cervix. Such an operation can be prescribed for the detection of the following diseases:
- decidual polyps,
- fibrous polyp,
- oncological diseases,
- endothermic hyperplasia,
- dysplasia of the uterus.
The cervical canal is part of the female urogenital system. The menstrual flow comes through the vagina, spermatozoa penetrate into the uterus after intercourse, during childbirth or miscarriage, the fetus and placenta leave the uterus.
Through the cervical canal also pathogenic microorganisms penetrate into the uterus.
Before giving birth, the cervical canal expands (the cervix dilates), and in primiparous, the internal pharynx first increases, and the cervical canal during the opening is a cone pointing outward (down). For multiparous, the opening of the internal and external pharynx occurs simultaneously. [one]
In order to diagnose the state of the uterus and fetus, a probe is inserted into the uterine cavity through the cervical canal during internal hysterography, a miniature radio station with radio telemetry, etc.
Developmental abnormalities : Ginatresia (fusion), bifurcation.
Cervical insufficiency - soft tissue of the cervix and the open pharynx of the cervical canal or the gaping of the entire canal leads to miscarriage at 20−22 weeks of gestation. It is treated promptly since 1955, the effectiveness of surgical treatment is 94%. 
Obstetrics: A textbook for medical schools / E. Ailamazyan - 4th ed., Supplement .. - SPb. : SpecLit, 2003. - 528 p. - ISBN 5-299-00255-6.
Anatomy of the cervical canal of the cervix
Performing the function of a link of the female system of the internal and external genital organs, the cervical canal is located in the very thickness of the cervix. It does not reach its size immediately, but gradually increases in girls from birth to the moment of full-fledged puberty.
The following location of the female genital organs is considered normal: the uterus, begins with the internal uterine throat and passes into the cervical canal of the cervix, which passes, in turn, into the cervix, ending with the external uterine throat, passing into the vagina. Thanks to this anatomical structure, it is possible to control the process of labor in its first stage.
The existence of uterine throat allows the cervical canal to open sequentially. The process begins with an internal uterine pharynx, and only then the external one opens. The reverse process in the postpartum period occurs in a similar pattern: at the end of the first week, the internal pharynx of the cervical canal closes, and after 3 weeks the external uterine pharynx closes.
Anatomical feature is that after the first birth, the closure of the external pharynx of the cervical canal is not fully completed, which significantly speeds up the repeated birth process.
The cervical canal of the cervix also has the features of the structure of its histology. In contrast to the exocervix (in other words, it is the mucous canal that unites the uterus and vagina, otherwise called the cervical cervical canal), covered with a stratified squamous epithelium of a non-squamous type, the endocervix is lined with a single-layer epithelium of the cylindrical type. In order to fully understand the concept and threat of such a term as “dysplasia”, it is necessary to know that the tissues of the ENDocervix and the ECOcervix are separated from each other by a special zone located in the area of the outer uterine pharynx.
The presence of any pathology of the system of internal genital organs can be assumed when viewed with the help of a special mirror of the external cervix of the cervix, knowing its normal anatomical feature. Such knowledge will not be superfluous to the woman herself, who will be able to soberly assess the diagnosis made by specialists.
During gestation of the fetus, the cervical canal is modified by the action of a large number of hormones produced and the general preparation of the body, as well as the birth canal, in particular, for childbirth.
Normally considered to be the length of the cervix of the order of 3.5-4.5 centimeters, and a width of 0.5 centimeters. The inconsistency of these parameters to a greater or lesser side usually indicates the danger of the development of complications. The exception to the rule is the physiological shortening of the cervix to a length of 3.5 centimeters in the third trimester of pregnancy, when the female body is already preparing for childbirth as much as possible.
When shortening the cervix to the 30th week of pregnancy to a value of 2-2.5 centimeters, it is said that there is a cervical insufficiency. This pathology increases the chance of preterm labor and requires surgical intervention in the form of a pessary. This type of obstetric suture is an obstacle to further dilation of the cervix, circularly fixing its canal. The pessary is promptly removed after the full 8 months of pregnancy. With no diagnosis and lack of necessary information, the fetus is likely to die in preterm labor.
Reverse pathology, that is, lengthening of the cervix to 4.5 centimeters and above, also has a negative effect on the process of gestation of pregnancy and delivery. The long cervix, in violation of the anatomical structure of the cervical canal, increases the likelihood of pathology of attachment of the placenta. In this case, low, lateral or central attachment is possible.
Possible generic complications are manifested by an increase in their duration from 12 hours in women who give birth for the first time, and from 9 hours in women who have previously given birth. This complication occurs against the background of the unpreparedness of the elongated cervix to the process of labor and, as a consequence, its slow disclosure. The hardness and length of the neck does not allow the process of its normal smoothing to occur. This situation leads to an increase in the overall duration of contractions and overstrain of the parturient woman, which exacerbates the weakness of labor activity. This situation requires direct medical intervention by specialists for the purpose of stimulation.
In addition, the elongated cervix, due to its unavailability, may interfere with the process of dropping the prelying part of the child into the birth canal. This condition increases the risk of fetal hypoxia and requires the assistance of physicians.
It should also be said about the important protective function of the cervical canal of the cervix. The glands of the epithelium of the endocervix, being in a healthy state, produce a large amount of secretion, which, accumulating, forms a mucus plug that prevents the entry of foreign microorganisms into the uterine cavity throughout pregnancy. Cork moves naturally in anticipation of the onset of labor.
Making a conclusion from the above, the cervical canal performs many important functions related to the reproductive life of a woman. That is why it is necessary with particular care to approach the related violations and regularly carry out all the necessary diagnostics.
Cervical Canal Diseases
Regardless of the state of pregnancy and the age of the woman, violations of the cervical canal are a serious problem with the risk of infertility.
Pathological conditions of the cervical canal can be divided into:
- Structural anomalies of the cervical canal.
- Inflammatory diseases.
- The emergence of tumors.
Structural anomalies of the cervical canal
Structural anomalies of the cervical canal, in turn, are divided into congenital and acquired. Usually, congenital anomalies cover the entire genital system of a woman. Some pathologies, respectively, may be in the structure of the uterus or vagina. In practice, deformations acquired during surgery, as well as structural anomalies that have arisen in the process of scarring or soldering, are more common. The most common are the circular canal, narrowing and obstruction of the cervical canal of the cervix.
Circular canal of the cervix, in medical practice - a deviation in the organs of the reproductive system, characterized by the appearance of formations. The changes that are taking place can negatively affect both the possibility of the egg to fertilize itself and the whole process of carrying a child as a whole. The cause of such deformations are the breaks in the internal organs, their prompt restoration and improper accretion. With this type of pathological changes in the cervical canal, its main reproductive functions are not affected, while maintaining the connection of the uterus with the ovaries. However, a false contraction of muscle fibers can cause complications in subsequent births, causing discoordination of the activity, and as a result, problems when opening the cervix. Such deformation does not provide for mandatory treatment. It is carried out only symptomatically, if there are any complications.
When the cervical canal reaches a size of less than 0.5 centimeter and its stupor, they indicate a narrowing of the cervical canal. This pathology may manifest itself as a violation of the usual menstrual cycle of a woman with the type of oligomenorrhea: an increase in the duration of discharge, with a decrease in the volume itself, due to a narrowing that interferes with the menstruation process.
With regard to pregnancy and the birth process in the presence of this anomaly, the process depends on the female hormonal background and the flow of labor with the dynamics of the opening of the cervix and further delivery. However, in the case of a reverse situation and in conditions of scanty labor, the narrowing of the cervical canal is one of the direct indicators to a cesarean section. The most severe form of pathology is obstruction of the canal.
Obstruction of the cervical canal of the cervix is a pathology that requires urgent medical surgery and directly threatens the life of a woman. The manifestation of this anomaly is the presence of a mechanical barrier that prevents the normal release of menstruation and their accumulation. The symptom of this condition, called the hematometer, is the occurrence of severe abdominal pain, the tension of its front wall and the repeated delay of menstruation. The uterus is felt for tension and the presence of acute pain.
The most common inflammatory disease is endocervicitis. This violation is characterized by the presence of inflammation of the focal type of the cervical canal itself. Any microorganism with any level of pathogenicity that enters the environment of the cervical canal in a natural way can become a factor in the etiological type of such a disease. Symptoms of endocervicitis are purulent discharge, unpleasant sensations that can occur during intercourse or even in a state of rest, menstrual disorders. In addition to the symptoms of the reproductive system itself, the disease can be expressed in an increase in body temperature, intoxication of the body, the presence of abnormalities in the general blood test. Treatment of this disease is carried out immediately by two approaches:
- Местное лечение подразумевает спринцевание влагалищной среды специальными антисептиками, применением вагинальных свеч и повышенную гигиену внешних половых органов.
- General treatment refers to a seven-day course of antibiotics and treatment of the symptoms that appear. Naturally, during the whole course of treatment sex is prohibited. Regular partners are treated together. If there are several such partners, this will only aggravate the situation.
The appearance of tumors
As for tumors, they can be both benign and malignant. The most common type of benign neoplasm is the cervical polyp. This violation is a formation that looks like a cauliflower on a thick stand. This education is easy to see. The most common cause is the human papillomavirus, which infects the epithelial cells of the internal genital organs, due to a high level of tropism. Rarely local form of the disease. Most often, the polyp of the cervical canal is localized in several places, combining the “islands” with each other. Removal of a polyp of the cervical canal depends on the specific case and symptoms.
The cyst is another common pathology of the cervical canal of the cervix. This neoplasm has a high growth rate, a fine structure and a liquid-filled infectious component. Due to the limited space in the cervical canal, there are frequent cases of rupture of a cyst, when all its contents shoot out. Despite the possible absence of symptoms, the cyst requires complex treatment by specialists. Filling cysts can also be menstrual flow. This cyst will be called endometrioid. Such a neoplasm may well become the object of operative treatment.
For malignant neoplasms include primarily cancer of the cervical canal. This is a rather rare type of pathology, compared to other cancer sites. The main danger of this education is its asymptomatic, which is why it can be detected by random examination in the later stages, when the disease has time to metastasize to other organs. In the case of early detection of cancer of the cervical canal, conduct a comprehensive treatment, which includes both radical surgical methods for the complete removal of the uterus and the nearest affected lymph nodes, and radiation therapy.
Diagnosis of cervical canal pathology of the cervix
To exclude the presence of pathologies conducted a comprehensive survey of women.
First, a conversation is conducted with the patient, during which all the existing symptoms are detailed and a complete history of the woman is drawn up, including the determination of the date of the onset of the last menstruation and data about her. Inspection is carried out using a special mirror external uterine throat. The presence of polyposis in the vagina indicates the possibility of the existence of polyps and deeper, in the cervical cervix itself. In addition, this way you can see the presence of possible discharge (bloody or purulent), characteristic of rupture of the cyst of the cervical canal.
The main step in the diagnosis of pathologies is smearing. For objectivity of results, not only a swab from the cervical canal is taken, but also an intermediate zone. The resulting smears are histological and cytological examination.
Thanks to cytology, metaplasia is diagnosed - a precancerous cervical pathology, which is a dangerous disease. Histology gives an idea of the presence of other diseases.
The main types of smears include:
- histology of a healthy patient,
- changes in a benign or inflammatory smear,
- intraepithelial neoplasia of the cervical canal,
- metaplasia of the first level - the presence of dysplastic cells, spreading no more than 1/3 of the epithelium,
- metaplasia of the second level - the presence of dysplastic cells, spread no more than 2/3 of the epithelium,
- metaplasia of the third level - the presence of dysplastic cells, spread over more than 2/3, without invasion of the basement membrane,
- cancer speculation
- re-smear required - due to lack of any type of epithelium.
With a smear from type 3, additional examinations are required.
During pregnancy, cervicometry is performed on planned ultrasounds, which determines the cervical canal parameters of the cervix. When finding any of the indicated pathologies, a decision is made on the safest correction of a woman’s condition. For example, a polyp of the cervical canal during pregnancy is observed in the dynamics, without resorting to radical methods of surgical intervention.
Operations on the cervical canal
It is very difficult to get into the cervical canal itself, so operations on it are extremely rare. Operate, as a rule, individual localized areas prone to pathologies. The more common interventions are minimally invasive in the presence of evidence to them.
Violation of the structure of the cervical canal of the cervix is corrected by the procedure of dilation of the canal. It consists in correcting the shape of the channel with the help of a special tool - the bougie, which is a metal instrument, selected individually. The procedure is repeated several times until the desired result is obtained.
Among the operational methods of treatment of polyps, cryodestruction is used - laser burning of the localization of polyps using liquid nitrogen. After cauterization of polyps, they disappear on their own.
A popular method is laser therapy, which acts like a scalpel.
Both as a diagnostic method and for medical purposes, curettage of the cervical canal is performed. This method is also used in case of suspicion of the presence of a foreign body in the cervical canal, including ectopic pregnancy and complications in the postpartum period. Less commonly, it is used to treat polyposis with multiple foci or not responding to minimally invasive treatments.
Performing a connecting function in the female system of internal and external genital organs, the cervical canal is an important and integral part of the reproductive system. The normal state of this anatomical formation ensures the functioning of the processes of conception, gestation and successful childbearing. Regular surveys of the channel and timely diagnosis of diseases will help to avoid surgery and preserve women's health for many years.
The cervical canal provides several important functions:
- connecting element of the external and internal genital organs,
- barrier and protective function
- ensuring conception
- inference function
- birth path function.
The inability to perform at least one of these functions may cause unpredictable consequences. As a rule, the doctors try to keep the homeostasis of precisely these possibilities under control.
Barrier and protective function
In the cervical canal there is a process of synthesis of a substance, which is an excellent barrier from various pathogenic organisms capable of penetrating into the body. The substance forms a kind of "tube", which serves as a protective obstacle. Moreover, the channel also has its own immune system, which synthesizes immune cells. Through the cervical canal, the female reproductive system remains sterile in terms of the presence of pathogenic organisms.
To pass the process of conception, the sperm must pass a path that runs through the channel. And a lot of problems, in this case, arise precisely because the male sex cells are simply not able to pass through the cervical canal.
Barrier and protective function of the cervical canal
In the female cycle, there is a certain period when the secret produced by the channel promotes the formation of an alkaline environment, which causes the expansion of the channel. Through the dilated cervical canal sperm easily penetrate to the egg. But only healthy and strong spermatozoa are able to get there. The fact is that the secret is able to “select” male germ cells.
The rate of performance in a healthy woman
There are certain manipulations to control the state of the female reproductive system. In particular, we are talking about analyzes from the cervical canal. But to obtain the necessary information should know the normal performance.
For example, the cervical canal is the rate of leukocytes - no more than 30 in sight. Anything that exceeds this indicator indicates the presence of inflammatory processes.
You must be examined to determine the cause of the disease.
In addition, it is from the cervical canal that a sample is taken for microflora, which allows to determine the following parameters:
- Staphylococcus aureus - absent (normal)
- sticks (lactobacilli) - 95% (normal),
- abnormal cells - absent (normal),
- Candida - absent (normal)
- Trichomonas - absent (normal)
- gonococcus is absent (normal)
- E. coli is absent (normal).
Symptoms of pathologies
There are many pathologies of the cervical canal that have a different character. The most common are:
Most pathologies can be detected only after using special tools or after analyzes.
Practice has shown that the symptoms of pathologies of the cervical canal can be common. In particular, we are talking about the discharge of fluid, which may have a different color and different consistency. In inflammatory processes that have passed into the acute stage, body temperature may rise.
To obtain more accurate information, it is necessary to conduct a detailed examination of the patient and send it for analysis. Only in this case, you can make an accurate diagnosis.
Only after using special tools can most of the pathologies be detected
The size of the cervical canal in women at different periods of life will be different. In addition, this fact is influenced by the individual characteristics of the body. For example, during the menstruation period, the cervical canal is expanded, because the synthesis of mucus is currently maximal. If there is an expansion of the cervical canal in the postmenopausal, then this indicates the presence of the pathological condition of the woman. It is during this period that changes occur in the female body that can complicate health.
Many women often ask themselves: “The cervical canal is closed, what does this mean?”. First of all, you need to know that to determine such pathology is possible only after a thorough examination of the patient. Basically, the problem is diagnosed by ultrasound.
Another term that can be heard from doctors, and about the meaning of which patients have no idea - "occlusion of the cervical canal." At its core, it means a violation of patency.
Cervical canal stenosis is an anatomical pathology leading to impaired patency. Stenosis can be either a congenital problem or an acquired one. In any case, it can be diagnosed only through the use of special tools or computer equipment. As a rule, pathology occurs as a result of cervical disease.
Atresia of the cervical canal in postmenopausal women is considered normal. But in some cases, atresia can be the result of various disorders leading to complex consequences. Given this fact, a specialist can prescribe a course of treatment that will help fix the problem.
Anatomical pathology leading to impaired patency-stenosis of the cervical canal
Inflammation of the cervical canal is a common problem with which women come to the doctor. The result of this problem may be infertility, and in some cases a significant deterioration in the condition of the woman.
There are certain signs in which you can identify the problem. Inflammation of the cervical canal symptoms:
- large amounts of mucus in the cervical canal
- pain down below
- discomfort during intercourse.
If the inflammation is too advanced, the body temperature may rise. Usually, the temperature rises if a purulent liquid is present in the cervical canal.
A cyst of the cervical canal is considered a benign growth. This formation has a liquid or porridge-like filling. The main cause of the problem is the blockage of the glands in the mucous membrane of the cervix. Cysts can be either single formation or multiple. A characteristic feature of the pathology is the possibility of self-extinction.
Polyp is the formation of a benign character. The cause of the polyp is an inflammatory process. The growth of this neoplasm is triggered by hormonal disorders or may be a consequence of injuries after abortions or childbirth. Pathology requires mandatory surgical intervention. Moreover, therapy is prescribed only after histological examination.
The inflammatory process is the cause of the polyp
Hyperplasia of the cervical canal, as a rule, is characterized by a benign course. The cause of the disease is the use of progestin-containing drugs. As a result of hyperplasia, there is a likelihood of infertility. But, apart from infertility, if you do not start treatment in a timely manner, oncology may occur.
Given the anatomical features of the cervical canal, not all of its pathologies can be determined with the help of a routine examination.
There are other methods for this:
- inspection using mirrors and spatulas,
For example, the expansion of the cervical canal on ultrasound will be well marked. And if everything is clear with more traditional methods, then not every patient knows colposcopy and cervicoscopy.
Cervicoscopy - examination using a hysterocervicoscope. The equipment makes it possible to perform a biopsy and to make scraping.
How does the channel change during pregnancy?
In pregnant women, the cervical canal has a bluish tinge. It is known that before the onset of the state of pregnancy, the channel is characterized by pink color. In many cases, the doctor determines the position on the basis of this feature.
Due to the active synthesis of mucus, the intensity of which increases during pregnancy, a plug forms in the cervical canal. This tube is a reliable protection for the fetus from bacteria. But in order to control the safety of the fetus and the expectant mother, it is necessary to take a smear from the cervical canal during pregnancy.
During pregnancy, there are procedures that are strictly prohibited. One such procedure is scraping. Scraping from the cervical canal, what is it? Few patients know what this manipulation is.
During the scraping, the cervical canal tube is destroyed, which is strictly prohibited during pregnancy. In its normal state, the stopper resumes at every menstruation. In the case of pregnancy - this is impossible.
Pregnancy is considered a unique condition of women during which there are many changes in their bodies. Given this fact, some indicators characterizing the state of a woman may differ.
For example, the length of the cervical canal during pregnancy is normal from 30 to 45mm. The same thing happens with the channel width. The normal rate for pregnancy is from 2 cm to 10. It should be borne in mind that all this happens during the contractions, and before them the channel is tightly closed with a stopper.
Initial examination shows inflammation of the cervical canal.
Deviation from the norm
Given many factors, there are many cases where during the course of pregnancy some important indicators may deviate from the norm. Inner throat is closed during pregnancy - this is the norm. Gradual disclosure occurs after 38 weeks. If this occurs earlier, it is considered a deviation, which in turn requires elimination.
You also need to know that if the cervical canal is enlarged to 2 mm, then in its essence this is already the “first bell” indicating possible problems. If the expansion occurs in the last month of pregnancy, this is not enough, which, again, is considered a deviation from the norm.
Treatment and prevention of ICN in pregnant women
If the patient is diagnosed with isthmic-cervical insufficiency (ICN), she will definitely need rest.
It is especially important to protect the future mother from the factors that negatively affect her condition:
- physical exercise,
- harmful working conditions.
As a classic method of assistance in this state is the installation of the ring Meyer. Ring Meier makes it possible to reduce the pressure of the fetus. The recommended period for the implementation of the procedure is 28 weeks in the case of a minimum opening of the throat. In addition to surgical manipulation, a course of therapy is required. The essence of therapy is to take antibacterial drugs.
Профилактика ИЦН заключается в диагностировании и лечении патологий еще до зачатия. Уже после зачатия, пациентка должна регулярно наблюдаться у ведущего ее врача.
When pregnancy is very important to monitor the cervical canal.
Modern medicine involves several methods of treatment of ICN:
- non-surgical method
- surgical method.
The first method is characterized by a number of positive aspects:
- it can be applied inpatient and outpatient,
- the technique is completely safe
- use in early pregnancy,
- Anesthesia is not required.
Using the device, the cervix is closed by means of the walls of the hole located in the center of the pessary. As a result, an incompletely open organ is formed. Due to this it is possible to reduce the pressure of the fetus.
Non-surgical method can not always bring a positive result. In this case, you have to resort to surgical procedures.
In stitching the cervix is the essence of the method
The method is based on sewing the organ and is recommended for:
- spontaneous abortions, indicated in history,
- premature labor, observed previously,
- progressive ICN.
But, besides the indications for using the technique, there are also contraindications. Usually, in such situations, the main reason why surgery is not recommended is the presence of pathologies of the cardiovascular system, liver, or genetic disorders. The technique is not recommended for inflammatory processes of the genital organs.
How does the cervical canal change during pregnancy
After conception, the natural pink color becomes closer to blue. For this reason, the gynecologist determines that a woman is carrying a child.
During pregnancy, inside the throat, a cork of mucus is formed. It is a protection for an unborn baby.
When childbirth begins, it departs. The exact dates when this happens cannot be said. Separation of the tube can happen and a couple of hours before the start of delivery, and two weeks.
Not in all cases, women have time to notice her discharge, as it happens in parts.
Problems with the cervical canal during pregnancy
Now that it has become completely clear what the cervical canal is, it is necessary to find out the causes of the onset and the consequences of its pathology.
A couple of weeks before delivery, a gradual opening of the cervix occurs. When this happens earlier, the length of the cervical canal is reduced. This may cause premature delivery.
Often this pathology occurs in the second trimester. It occurs because of cervical insufficiency.
She, in turn, appears from hormonal deficiency, congenital pathologies, previously performed abortions and cervical injuries. When confirming the diagnosis of a pregnant woman, it is recommended to perform cervical closure.
Often during pregnancy polyps are formed. The reason for its appearance are hormonal changes.
To determine if a polyp has a benign or malignant nature, doctors perform a colposcopy, take a smear test for oncology and do a biopsy of the cervical canal.
When a polyp is benign and does not bother, treatment may be postponed for a postpartum period. Sometimes he disappears on his own.
Another common problem is endocervicitis. The cause of the appearance are various pathogenic microbes. They penetrate the wound that can appear from a mechanical injury. The inflammatory process may eventually spread to the cervix and its muscle layer.
You can get injured after:
- diagnostic curettage
- poor processing of inspection tools,
- intrauterine devices, which were used without medical supervision,
- rupture of the cervix at the birth of a child.
Also, the increased sensitivity of the mucous membrane to the components of contraceptive preparations may affect the appearance of inflammation.
It is worth noting that microbes such as chlamydia and staphylococcus can cause inflammation of the canal even if it is not injured.
Endocervicitis can lead to an increased uterine tone, lack of oxygen to the fetus, looseness of the fetal membranes and delivery before the prescribed period.
Channel examination during pregnancy
One of the main tests during pregnancy is bacterial culture from the cervical canal.
The timely detection of the accumulation of dangerous microorganisms ensures the birth of a healthy baby.
A smear is taken for examination absolutely painless.
Canal norms during pregnancy
In the normal state, the cervical canal is securely closed. This makes it possible to retain the fetus inside the uterus for the entire period of childbearing.
Before delivery, the cervix gradually softens and smoothes. From this moment on, the cervical canal expands. It opens gradually from a couple of centimeters to 10.
As the opening of the pharynx, the doctors determine the patient's readiness for childbirth.
The length of the cervix varies throughout pregnancy. After evaluating its size at the time of diagnosis, the doctor will be able to tell exactly the term of conception.
Normal length of the cervical canal during pregnancy is up to 4 cm, if this figure is higher, miscarriage may occur.
Slightly shorter pharynx may be in multiparative women.
Signs of pathology in pregnant
There are no obvious symptoms of ICN. One can learn that a woman has pathology only after a premature discharge of water. But still it is worth contacting an obstetrician-gynecologist leading a pregnancy with a feeling of heaviness in the lower abdomen, frequent urination and discharge.
The doctor can provide accurate information about the condition of the pharynx after the examination of the vagina and cervix.
About ICN says that,
- the cervix is shorter than normal,
- its walls are thinned and relaxed
- the outer edge of the channel is slightly open,
- one or two fingers pass through the channel.
During the examination at the doctor in the mirror may be visible fetal bladder.
With endocervicitis, there are abundant discharge, which may contain pus. During the development of this pathology, a pregnant woman during urination experiences itching and burning. There may be painful sensations in the lower abdomen.
On examination, endocervicitis shows severe redness and swelling. If the pathology is not detected in time, it can turn into a chronic form.
If the cervical canal is expanded, what to do
In cases where the patient has an expansion of the cervical canal, the doctor raises the question of the need for hospitalization.
This is the main symptom of cervical insufficiency. During this period, the cervix opens prematurely. The fruit over time, increasing even more pressure on her, provoking her further discovery.
If there is a multiple pregnancy, the expansion of the pharynx is observed in almost all cases.
To eliminate the pathology applied medical and surgical techniques.
Medications are prescribed to normalize hormones or eliminate the increased tone of the uterus.
Surgical treatment is used in the detection of cervical pathology, its injuries or existing polyp.
With polypous growths, a course of treatment is carried out, and if necessary, the formation is removed.
The concept of the cervical canal
What is a cervical canal? This question is asked by many women. Actually, the cervical canal is the part of the cervix that binds together the uterine cavity with the vagina. It is spindle-shaped, has two anatomical constrictions, called the sheds:
On examination, the gynecologist sees the external pharynx. This anatomical part of the organ separates the cavity of the cervix from the vagina. Internal pharynx is located on the uterine side. He holds the fetus when carrying a child.
The length of the cervical canal is normally 30–40 mm, diameter 6–8 mm. Through it monthly menstrual blood comes out of the uterus.
Cervical canal function
The female cervical canal is an organ whose inner surface is lined with hormone-dependent epithelium. It contains mucus producing glands. During the different phases of the menstrual cycle, the mucus and the secret glands have a different consistency.
In the middle of the cycle, this secret becomes abundant, liquid, with a high content of sex hormones. The acidity of the medium changes from neutral to slightly alkaline. The outer and inner throat opens slightly. This is a sign of ovulation.
The liquid mucus sperm easily penetrate into the uterine cavity and move to the egg for fertilization. A weakly alkaline environment allows sperm cells to remain alive in the cervix for several days.
On the eve and after menstruation mucus production is negligible. The secret has a weakly acidic environment that prevents microorganisms from entering the sterile uterus and the development of inflammation.
During pregnancy, the cervical mucus thickens, forming a mucus plug that protects the fetus from infection rising from the vagina. With the advent of precursors of labor, the uterus, or rather, the cervix gradually opens, the mucus plug comes out. Its function ends here.
Smear and backwater
When healthy immunity mucus destroys microorganisms trapped in the vagina. Normally, the cavity inside the uterine cervix is sterile. But staphylococci, streptococci, candida, Escherichia, diplococci can penetrate it. The following states contribute to this:
- reduced immunity
- associated urinary tract inflammation,
- hormonal deficiency,
- insufficient body hygiene,
- unprotected sex.
To study the state of the cervical canal, a smear for the flora is used. Take a sample of mucus for planting on a nutrient medium and determining the pathogen, as well as the sensitivity of the pathogen to antibiotics. Epithelial scraping is an equally important diagnostic procedure used to identify atypical cells.
Cervical Canal Treatment
Therapy of pathologies of the cervical canal is to eliminate the cause of the disease. First of all, it is necessary to exclude an infectious agent. Based on the results of the examination, specific treatment is prescribed.
Hysteroscopy allows you to remove polyps, cysts, small nodes that are in the uterus.
Scraping makes it possible to remove altered mucosa and glandular polyps. The material is sent for histological and cytological examination, and according to their results further therapy is prescribed.
Bougienage of the cervical canal allows you to deal with stenosis and contractions by mechanical expansion of the cervix. This allows you to improve the outflow of fluid from the uterus.
Diseases of the cervical canal
Pathology of the cervix can play a large role in the development of diseases, both during pregnancy and outside of pregnancy, even with possible infertility.
Conventionally, the pathology of the cervical canal can be divided into:
- anomalies of the structure and structure of the cervical canal,
- inflammatory diseases,
- neoplasm of the cervical canal.
Anomalies of the structure and structure of the cervical canal can be both congenital and acquired. Congenital anomalies are usually accompanied by concomitant anomalies of other genital organs - the vagina, uterus. More often in women of reproductive age there are acquired anomalies of the structure of the cervical canal, which occurs as a result of adhesive processes, scars, deformities after various surgical interventions. Among these pathologies is a circular cervical canal, narrowing of the cervical canal and its obstruction.
Circular canal of the cervix - it is a pathology in which the channel has a funnel shape due to improper location of the muscle fibers in the circular direction. This pathology can occur during ruptures of the internal genital organs due to childbirth and their surgical treatment - closure; in the future this may be the cause of such a process if the tissues do not heal properly. This pathology may not manifest in any way because of its insignificance, that is, all physiological processes in the uterus and ovaries do not suffer. Problems may occur during the next pregnancy, when there may be discoordination of labor due to improper contraction of the muscle fibers of the cervical canal, which prevents the normal opening of the cervix. The treatment of this pathology, as such, does not exist, since these are structural changes that cannot be corrected. Treatment may be symptomatic if complications appear.
The narrowing of the cervical canal - It is its size less than 5 millimeters. In this case, a woman of reproductive age may already have symptoms, in the form of menstrual irregularities of the oligomenorrhea type, since the narrow canal of the cervix can interfere with normal menstruation, which prolongs the period of menstruation with a small amount of secretions. As for pregnancy, it can be a direct threat to normal labor, in case of poor opening of the cervix and an indication for cesarean section. But there can also be a sufficient hormonal background with good dynamics of the opening of the cervix and labor, then this condition is not dangerous. Extreme narrowing of the cervical canal is its obstruction. Cervical cervical obstruction is a condition that already requires intervention, as there are complications. With this pathology, a mechanical obstruction is formed, which in women of reproductive age can cause the delay of menstrual blood with its accumulation in the uterus and the formation of acute conditions in gynecology - hematometer. Then there is a clinic of acute abdominal pain, tension of the anterior abdominal wall, and data from the anamnesis indicate that menstruation is delayed for several weeks or several times in a row. On examination, it is possible to determine the tension and tenderness of the uterus. This is a condition that requires immediate surgical intervention.
Among the inflammatory diseases of the cervical canal of the cervix, endocervicitis is the most common, a pathology characterized by focal inflammation of the cervical canal. The etiological cause can be any pathogenic or conditionally pathogenic microorganism, which enters the ascending pathway. At the same time, inflammation of the cervical canal occurs with local symptoms in the form of purulent discharge from the vagina, pain during intercourse and at rest, menstruation disturbance. In addition to local symptoms, general symptoms appear in the form of fever, intoxication, and changes in blood tests. Treatment needs to be carried out complex - local and general. Local treatment is syringing with antiseptics, candles with an antibiotic, and hygiene of the genitals. General treatment involves the systemic use of antibiotics for a course of 7-10 days, as well as symptomatic therapy. At the time of illness and treatment, it is necessary to exclude sexual relations and treat a better partner at the same time, especially in the case of verification of specific urogenital flora.
Cervical neoplasms can be benign and malignant. Among benign diseases, polyps of the cervical canal of the cervix are most common. This is a pathology that is characterized by the formation of a characteristic structure in the form of cauliflower on a leg or on a broad basis. This structure is visible to the naked eye. The cause of this formation is most often the human papillomavirus, which infects the epithelial cells of the genital organs due to high tropism. Polyposis of the cervical canal of the cervix is often multiple and is combined with another localization of the polyps - in the cervix, vagina.
Among the benign formations of the cervical canal of the cervix is also found a cyst. This is a thin-walled formation that has a thin capsule, liquid contents inside and a tendency to grow. Since the cervical canal has a limited diameter, complications often arise in the form of a cyst rupture or infection. Then it is also necessary to conduct a comprehensive treatment. For such a cyst with small sizes may be asymptomatic, then it may just be a random finding on an ultrasound. Sometimes the contents of a cyst may be menstrual blood, then they talk about an endometriotic cyst. Tactics of treatment can be operative in case of accidental discovery of such an entity.
Among the malignant tumors may be cervical cervical canal. This pathology is not as common as other localization of cancer, but quite dangerous in terms of asymptomatic course. Therefore, such a cancer is often diagnosed already at the stage of metastasis to other organs. In the first or second stage of the disease, the treatment is radical operative with extirpation of the uterus and regional lymph nodes, as well as preoperative and postoperative radiation therapy. In the later stages of treatment combined.
These are the main diseases that can be localized in the cervical cervical canal.
What is meant by scraping?
Scraping the cervical canal is one of the diagnostic methods to determine the cause of the pathological changes. During scraping with the help of tools, the upper layer of the epithelium is removed. Затем, образец ткани отправляется на анализ, что дает возможность установить причины патогенных процессов.
Существует следующая классификация выскабливания:
- separate diagnostic (carried out in combination with other manipulations),
- split (using a hysteroscope).
Scraping the cervical canal
In the first case, scraping is transmitted to histological studies. Separate diagnostic curettage is prescribed in case of uterus pathologies. And separate curettage is appointed when necessary, the removal of tumors, as well as to assess the state of the endometrium.
Course of operation
Before starting the operation, the patient should be placed in the gynecological chair and anesthesia should be administered. After she falls asleep, you can begin the procedure. The external genitals are treated with antiseptics, and the vagina is expanded with a mirror. Then, the cervix opens and is fixed.
A curette is inserted inside, which is carefully scraped with the necessary tissue. Upon completion of the procedure, the doctor carefully removes the instruments.
What is bougienage?
Medical terminology has always provoked more questions than answers. And the term “bougienage” was no exception. Bougienage of the cervical canal, what is it?
This is a surgical procedure, the essence of which is to expand, as well as to restore the patency of the channel. In the course of the manipulation, a specific tool is used - the bougé, because of what the procedure was called.
Given the specifics of manipulation, it should be carried out only in the hospital and under general anesthesia. During the procedure, a bougie is introduced into the cervical canal. The channel can be expanded by increasing the diameter of the nozzle of the bougie.
Upon completion of the manipulation for several hours, the patient should be in the hospital. The fact is that there is a risk of bleeding. The risk is greatly increased if, in addition to the bougienage, scraping was performed.
Bleeding, by its nature, is reminiscent of menstrual and can last for about two, three days, gradually losing its intensity. If the patient has copious blood flow, this is a deviation from the norm. Moreover, if the body temperature rises and all this is accompanied by pain in the lower abdomen, then the help of a doctor will be required.
If several hours after the operation the patient has no complaints about her condition, she is allowed to go home. But this treatment does not end there, they prescribe a drug treatment course that can last for one week.