Health and normal condition the reproductive system is necessary for the full bearing of a child, so doctors regularly examine this organ, how the fetus is developing and whether there are threats of miscarriage. The length of the cervix during pregnancy by week should change as the fetus grows. What are the normal sizes of the cervix during pregnancy?
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Organ description
The neck is not just a component of the reproductive system, but is considered an important component of the female body, without which full-fledged bearing of a child is impossible, etc.
What does the cervix look like during pregnancy? It is a hollow muscle, the front of which can be seen during examination of a woman in a gynecological chair.
Usually, her condition is assessed using a mirror, which gives correct information about the development of the fetus.
Where is the cervix. It is located in the vaginal cavity in the lower part of the pelvis.
Because of it, the uterus itself is not visible during a manual examination; it is possible to see it only during an ultrasound scan.
The normal size of this organ are 3.5-4.5 cm, however, during the carrying of a baby, this indicator may change slightly.
What it looks like. After conception, it becomes more flattened. Also, there is a change in its color, which becomes cyanotic, and not pale pink. The part that is located in the vaginal cavity is called the external pharynx. If a woman has not had childbirth, it is completely closed; in re-laboring patients, it is able to skip 1 finger.
Attention! A short or long cervix during pregnancy should remain tight, because its main task is to keep the baby in the womb until the onset of labor.
As soon as a woman's contractions begin, the external pharynx will begin to shorten and flatten, turning into a ring. As a rule, after the start of the first contraction, it begins to gradually open from 2 cm to 10 cm - in this case, the baby will it is easy to be born through it. If the organ begins to open earlier than 36 weeks, it can end in failure, since the consequences for the baby are unpredictable.
What is the norm for weeks of the cervix, why immediately after conception the organ is shortened, and is it possible to lengthen it. It all depends on the structure of the female genital organs. If the size of the uterus is less than normal, then the pharynx will be short and narrow. In this case, not every woman can fully bear the child. In order to avoid unpleasant consequences for the baby, doctors need to take measures to preserve the normal development of the fetus.
Organ characteristics
Checking the condition of the erect organ is the key to successful bearing of the fetus. After all, if he is weak, the child, as he grows, will not be able to normally keep in the uterine cavity, which will eventually lead to early childbirth. However, it is not required to check the baby's condition at every visit to the gynecologist; for this, several times are enough when the gynecologist needs to examine the patient. Also inspection should be carried out if the patient has complaints.
There are several ways to identify the condition and size of the cervix during pregnancy by weeks, namely:
- Manual inspection, which is recommended on the chair.
- An ultrasound scan, which will use a transvaginal sensor inserted into the vaginal cavity.
During a manual examination, the doctor needs to assess the softness, as well as check the condition of the organ:
if it is soft and slightly open, this indicates the readiness of the organ. Besides,
this signals the onset of labor in the last weeks or miscarriage in the 1st and 2nd trimester.
However, more often the pharynx begins to open as the baby grows, when he has already gained weight.
To understand if pregnancy is proceeding normally,
required evaluate the following indicators:
- the length of the organ, which should be more than 3.5 cm,
- the throat must be completely closed, and its structure is dense.
Assessment of the condition of the neck according to the results of ultrasound is considered more reliable, since the sensor will show the length strictly in mm. Also, ultrasound will help to assess the density of the organ, which is important for the normal bearing of the baby. What is it - an indicator by which it is possible to assess the possibility of disclosure when certain factors act on the organ. Particular attention is paid to the color, which is bluish red when carrying a baby.
Can the cervix lengthen during pregnancy? No - the exception is the last weeks of gestation, when the fetus presses heavily on the outer pharynx. In this case, it will either open or become slightly longer.
Small uterus
The small size of the genital organ is considered a clear violation of it, leading to its malfunctioning. Unfortunately, not every woman with hypoplasia (this is the name of the disease) is able to bear the fetus, since the reproductive system and the components of the small pelvis are not able to hold the child.
If a woman has small reproductive muscle, a shortened cervix during pregnancy will not allow full bearing of the fetus.
To identify at an early stage this problem, you should find out the symptoms of this condition, because trying to conceive a child with such a disease without preparation and treatment is not recommended.
The main signs are:
- dysmenorrhea;
- amenorrhea;
- inability to bear fetuses;
- lack of conception;
- decreased sex drive;
- severe pain during menstruation.
Normal indicators are:
- length 7-8 cm;
- width 40-50 cm;
- wall thickness 2-3 cm.
To ensure the norm external pharynx for weeks, it is required to constantly visit the gynecologist and conduct an examination. If the pharynx begins to open before the onset of labor, the doctor will take appropriate action.
Above normal size
With age, the size of the genital organ becomes a little larger - this is not a pathology, since this is a natural phenomenon.
Sometimes it increases in size, which is characterized by the following symptoms:
- discomfort during intimacy;
- aching pains in the lower abdomen;
- urinary incontinence;
- painful periods with large blood clots.
Can the cervix lengthen during pregnancy? If a woman has a large muscular cavity, lengthening of the pharynx is quite possible. This makes the process of carrying a baby easier, but complicates childbirth.
Degree of maturity
To ensure that childbirth does not start ahead of time, the doctor definitely needs assess the degree of maturity. To understand how this is done, you can see the table:
Depending on the week of bearing the baby, at which the doctor established the degree of maturity, the further prognosis of the course depends. If a woman has a short throat, up to 37 weeks she needs to be constantly monitored, otherwise pathology can cause
Length by week
To assess the state and functioning of the reproductive system, a special table was created, which indicates the optimal length for each week of the child's development. Often, this measurement is taken only after 20 weeks, when the fetus begins to gradually gain weight.
The size of the cervix during pregnancy by week:
| Week of pregnancy | 10-14 | 15-19 | 20-24 | 25-29 | 30-34 | 35-40 |
| Number of observations | 204 | 192 | 185 | 173 | 171 | 190 |
| Length in mm | 35,4 | 36,2 | 40,3 | 41 | 36,4 | 28,6 |
| Multiple bearing of the fetus | 35,6 | 36,7 | 40,1 | 42,3 | 36,3 | 28,4 |
| First conception | 35,3 | 36,5 | 40,4 | 40,9 | 35,8 | 28,1 |
| Range in mm | 28-45 | 30-48 | 32-48 | 34-49 | 34-43 | 20-37 |
| Standard deviation from the norm | 5,1 | 5,3 | 4,5 | 4,3 | 3,7 | 4,5 |
| Meaning | — | more than 0.05 | less than 0.0001 | 0,0001 | 0,013 | 0,0001 |
Such indicators may be slightly changed, depending on the state of health of the reproductive organs, and also general condition women, but almost always the results should match the table.
If the indicators are far from normal, cervicometry is performed during pregnancy, which makes it possible to assess the condition, degree of maturity, and others. external os criteria.
Ripening process
What is the normal state of the external pharynx, we found out. Now it is important to understand how he begins to behave before the onset of labor.
A couple of weeks before the baby appears, the throat begins to ripen with lightning speed - it becomes softer, smoother and shorter (the length should be 1 cm).
Also, the internal pharynx ripens gradually, which kept the fetus in the small pelvis for all 9 months.
However, there is another picture: if the body is not yet ready for the onset of labor, the pharynx remains dense and completely closed... In this case, it can be called immature. Basically, this phenomenon is caused by disturbed hormonal levels, which prevents the body from fulfilling natural requirements.
Important! For a normal delivery, a woman is injected with drugs based on prostaglandins, preparing her for childbirth in a natural way.
If the body of the expectant mother is not ready for labor again, a cesarean section is performed.
How to lengthen the neck. If carrying a baby is overshadowed by the physiological characteristics of the body, the doctor may recommend that the woman fix the external pharynx to prevent its early disclosure. For this, special threads or staples are used, which are removed before the onset of labor. study the link.
Useful video: the size of the cervix, the norm
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Instructions
The exit of the cervix into the vagina in a non-pregnant woman remains closed most of the time. Sealed with a special mucous plug, it becomes an obstacle for numerous bacteria that enter the vagina from the outside and can cause various kinds of infections. The external opening of the neck in a nulliparous woman is a solid bulge with a small rounded depression. The length of the neck depends on the individual anatomical characteristics of the woman, her age and the number of deliveries, on average, this value varies around 4-5 cm.
During pregnancy, a woman's uterus undergoes very large changes, which in turn affect the neck, which is significantly reduced in length. The original 5 cm is gradually reduced to 2 or even 1 cm, and by the time of delivery, the neck becomes completely flat. At the time of the start of labor, its disclosure begins, eventually reaching 10 cm in diameter, sufficient to pass the baby's head through itself. After the birth of the baby, the uterus and cervix gradually return to a pre-pregnant state, but they will no longer be exactly the same as before pregnancy. The cervix also continues to be a solid bulge extending into the vagina, but the opening in it becomes much larger and takes on a slit-like shape, moreover, it ceases to be completely closed.
A healthy cervix has a pale pink color, small blotches of red can mean an overgrowth, characterized by doctors as erosion of the cervix. This condition does not always require treatment, it often goes away after the normalization of the hormonal background of the female body. Other pathologies causing a change appearance cervix must be examined by a doctor without fail in order to avoid possible negative consequences.
The uterus is recognized as the main organ of the female reproductive system. The structure determines its functions, the main of which is bearing and subsequent expulsion of the fetus. The uterus plays a direct role in the menstrual cycle, it can change its size, shape and position, depending on the processes occurring in the body.
Anatomy and size of the uterus: photo with a description
The unpaired reproductive organ is characterized by a smooth muscle structure and a pear-shaped shape. What is the uterus, its structure and a description of the individual parts are presented in the picture.
In gynecology, organ departments are distinguished:
- bottom- the area above the fallopian tubes;
- body- middle cone-shaped area;
- neck- the narrowed part, the outer part of which is located in the vagina.
The uterus (in Latin matricis) is covered on the outside by perimetry - a modified peritoneum, from the inside - by the endometrium, which acts as its mucous layer. The muscular membrane of the organ is the myometrium.
The uterus is supplemented by ovaries, which are connected to it through the fallopian tubes. The peculiarity of the physiology of the organ is mobility. The uterus is held in the body by the muscular and ligamentous apparatus.
A detailed and detailed cross-sectional representation of the female reproductive organ is shown in the picture.
The size of the uterus changes throughout the cycle, depending on age and other characteristics.
Determine the parameter for ultrasound examination of the pelvic organs. The norm is 4-5 cm in the period after the completion of menstruation. In a pregnant girl, the diameter of the uterus can reach 26 centimeters, the length is 38 centimeters.
After childbirth, the organ decreases, but remains 1-2 centimeters more than before conception, the weight becomes 100 grams. Normal average sizes of the uterus are shown in the table.
In a newborn girl, the organ length is 4 cm, from the age of 7 it gradually increases. During menopause, the intact uterus decreases, the walls become thinner, the muscular and ligamentous apparatus weaken. 5 years after the completion of menstruation, she becomes the size at birth.
The figure shows the development of an organ throughout life.
The thickness of the walls of the uterus varies from 2 to 4 cm, depending on the day of the cycle. The mass of an organ in a nulliparous woman is about 50 grams; during pregnancy, the weight increases to 1-2 kilograms.
Neck
The lower narrow segment of the uterus is called the cervix (in Latin cervix uteri) and is a continuation of the organ.
This part is covered by connective tissue. The area of the uterus leading to the cervix is called the isthmus. The entrance to the cervical canal from the side of the cavity opens the internal pharynx. The department ends with the vaginal part, where the external pharynx is located.
The detailed structure of the neck is shown in the figure.
In the cervical canal (endocervix), in addition to the folds, there are tubular glands. They and the mucous membrane produce mucus. This section is covered by a columnar epithelium.
In the vaginal part of the cervix (exocervix) there is a stratified squamous epithelium, characteristic of this area. The site where one type of mucosal cell changes to another is called a transition zone (transformation).
Epithelium types are shown large in the picture.
The vaginal part of the organ is accessible by visual inspection.
Regular examination by a doctor allows you to identify and eliminate pathology at an early stage: erosion, dysplasia, cancer and others.
A detailed examination of the organ on the gynecological chair is carried out with a special instrument - a colposcope. The photo shows a close-up of a healthy cervix with pathological changes.
An important indicator is the length of the cervix. The normal value is 3.5-4 centimeters.
Particular attention is paid to the structure of the neck during pregnancy. Narrow or small (short) increases the risk of miscarriage. With isthmic-cervical insufficiency, it becomes difficult for the cervix to withstand the load created by the fetus.
Bottom
The structure of the uterus includes its body and cervix. These 2 parts are connected by an isthmus. The highest region of the body of the reproductive organ is convex in shape, called the bottom. This site extends beyond the entry line of the fallopian tubes.
An important indicator is the height of the fundus of the uterus (VDM) - the distance from the pubic bone to the top point of the organ. It is taken into account when assessing the development of the fetus during pregnancy. The size of the fundus of the uterus indicates the growth of the organ, and normally the value ranges from 10 centimeters at a period of 10 weeks to 35 centimeters at the end of the gestation period. The indicator is determined by the doctor on palpation.
Body
This part is recognized as the main one in the structure of the uterus. The body consists of a triangular cavity and its walls.
The lower segment is connected to the neck at an obtuse angle with a normal structure, the upper one passes into the bottom, directed towards the abdominal cavity.
Fallopian tubes adjoin the lateral regions, wide uterine ligaments are attached to the right and left edges. The anatomical parts of the body also include the anterior or bladder surface, which is presented to the bladder, and the posterior one borders on the rectum.
Ligaments and muscles
The uterus is a relatively mobile organ, since it is retained in the body by muscles and ligaments.
They perform the functions:
- hanging- attachment to the pelvic bones;
- fixing- giving the uterus a stable position;
- supporting- creation of support for internal organs.
Suspension apparatus
The function of attachment of the organ is performed by the ligaments:
- round- 100-120 millimeters long, located from the corners of the uterus to the inguinal canal and tilting the bottom anteriorly;
- broad- resemble a "sail" stretched from the pelvic walls to the lateral sides of the uterus;
- suspension ligaments of the ovaries- originate from the lateral part of the wide ligament between the tube ampulla and the pelvic wall in the area of the sacroiliac joint;
- ownovarian ligaments- the ovary is attached to the side of the uterus.
Fixing device
It includes ligaments:
- cardinal(transverse)- consist of smooth muscle and connective tissue, are reinforced with broad ligaments;
- uterovesical (cervico-vesicular)- directed from the cervix and bend around the bladder, prevent the uterus from deviating back;
- sacro-uterine ligaments- do not allow the organ to move to the pubis, go from the posterior uterine wall, bend around the rectum and are attached to the sacrum.
Muscles and fascia
The supporting apparatus of the organ is represented by the perineum, which includes the urogenital and pelvic diaphragms, which consist of several muscle layers and fascia.
The anatomy of the pelvic floor includes muscles that perform a supporting function for the organs of the genitourinary system:
- sciatic-cavernous;
- bulbous-spongy;
- outdoor;
- superficial transverse;
- deep transverse;
- pubic-coccygeal;
- iliococcygeal;
- ischiococcygeal.
Layers
The structure of the uterine wall includes 3 layers:
- serous membrane (perimetry) - is the peritoneum;
- internal mucous tissue - endometrium;
- muscular layer - myometrium.
Parametrium is also distinguished - a layer of pelvic tissue, which is located at the level of the cervix at the base of the wide ligaments of the uterus, between the sheets of the peritoneum. The location between the organs provides the necessary mobility.
Endometrium
The layer structure is shown in the figure.
The mucous epithelium is rich in glands, is characterized by good blood supply, and is sensitive to damage and inflammation.
The endometrium has 2 layers: basal and functional. The thickness of the inner shell reaches 3 millimeters.
Myometrium
The muscular membrane is represented by smooth muscle cells intertwined with each other. Reduction of sections of the myometrium in different days cycle is regulated by the autonomic nervous system.
Perimetry
The serous outer membrane is located on the front wall of the body of the uterus, completely covering it.
At the border with the neck, the layer bends and is transferred to the bladder, forming the vesicouterine space. In addition to the surface of the body behind, the peritoneum covers a small area of the posterior fornix of the vagina, the rectum, forming the rectal-uterine pocket.
These depressions, the location of the uterus in relation to the peritoneum, are marked in the figure depicting the topography of the female genital organs.
Where is
The uterus is located in the lower abdomen, its longitudinal axis is parallel to the axis of the pelvic bones. At what distance it is from the entrance in the depths of the vagina depends on the structural features, usually it is 8-12 centimeters. The diagram shows the position of the uterus, ovary, tubes in the female body.
Since the organ is mobile, it is easily displaced in relation to others and under their influence. The uterus is located between the bladder in front and the loop of the small intestine, the rectum in the posterior region, it can be determined using an ultrasound scan.
The reproductive organ is somewhat deflected forward and has a curved shape. In this case, the angle between the neck and the body is 70-100 degrees. The adjacent bladder and intestines affect the position of the uterus. The body deviates to the side, depending on the filling of the organs.
If the bladder is empty, the anterior surface of the uterus points forward and slightly downward. In this case, an acute angle is formed between the body and the neck, open anteriorly. This position is called anteverzio.
When the bladder fills with urine, the uterus deviates posteriorly. In this case, the angle between the neck and the body becomes unfolded. This condition is determined by retroversion.
There are also types of organ bends:
- anteflexio - an obtuse angle is formed between the neck and the body, the uterus leans forward;
- retroflexio - the neck is directed forward, the body is directed posteriorly, an acute angle is formed between them, open back;
- lateroflexio - bend to the pelvic wall.
Appendages of the uterus
The appendages of the female reproductive organ are complemented by its appendages. The detailed structure is shown in the figure.
Ovaries
Paired glandular organs are located along the lateral ribs (sides) of the uterus and are connected to it through the fallopian tubes.
The appearance of the ovaries resembles a flattened egg, they are fixed with a suspension ligament and mesentery. The organ consists of the outer cortical layer, where the follicles mature, and the inner granular (medulla), containing the egg, blood vessels and nerves.
How much and the size of the ovary depends on the day menstrual cycle... The average weight is 7-10 grams, length is 25-45 millimeters, width is 20-30 millimeters.
The hormonal function of the organ is the production of estrogens, gestagens, testosterone.
During the cycle, the mature follicle in the ovary bursts and transforms into a corpus luteum. In this case, the egg enters the fallopian tubes into the uterine cavity.
If pregnancy has occurred, the corpus luteum performs intrasecretory functions, in the absence of fertilization, it gradually disappears. How the ovary works, its structure is visible in the picture.
The fallopian tubes
The paired muscular organ connects the uterus with the ovaries. Its length is 100-120 millimeters, the diameter is from 2 to 10 millimeters.
Divisions of the fallopian tube:
- isthmus (isthmic part);
- ampoule;
- funnel - contains a fringe that guides the movement of the egg;
- uterine part - connection with the organ cavity.
The wall of the fallopian tube mainly consists of myocytes and has a contractile ability. This is the reason for its function - transporting the egg into the uterine cavity.
Sometimes there is a complication that is life-threatening for a woman - an ectopic (ectopic) pregnancy. In this case, the fertilized egg remains inside the tube and causes rupture of its wall and bleeding. In this case, it is necessary to urgently operate on the patient.
Features of the structure and function
The structure and location of the uterus are subject to frequent changes. It is influenced by internal organs, the period of bearing the child, the processes that occur each menstrual cycle.
The onset of ovulation is determined by the state of the cervix. During this period, its surface becomes loose, the mucus becomes viscous, it sinks lower than on other days of the cycle.
In the absence of conception, menstruation occurs. At this time, there is a separation of the upper layer of the uterine cavity - the endometrium. In this case, the internal pharynx expands to release blood and part of the mucous membrane.
After the cessation of menstruation, the pharynx narrows, the layer is restored.
The functions for what the uterus is needed:
- reproductive- ensuring the development, bearing and subsequent expulsion of the fetus, participation in the formation of the placenta;
- menstrual- the cleansing function removes part of the unnecessary layer from the body;
- protective- the neck prevents the penetration of pathogenic flora;
- secretory- production of mucus;
- supporting- the uterus acts as a support for other organs (intestines, bladder);
- endocrine- synthesis of prostaglandins, relaxin, sex hormones.
Uterus during pregnancy
The most significant changes are undergoing female organ during the period of bearing a child.
At the initial stage, the appearance of the uterus remains the same, but already in the second month it becomes spherical, the size and mass increase several times. By the end of pregnancy, the average weight is about 1 kilogram.
During this time, the volume of the endometrium and myometrium increases, the blood supply increases, the ligaments stretch during pregnancy and sometimes even hurt.
An indicator of the health and proper development of the fetus is the height of the fundus of the uterus, depending on the period. The rates are given in the table.
Also important indicator is the length of the cervix. It is assessed in order to avoid the development of complications of gestation and premature birth. The norms for the length of the neck by week of pregnancy are shown in the table.
By the end of the gestation period, the uterus stands high, reaches the level of the navel, has the shape of a spherical muscle formation with thin walls, a slight asymmetry is possible - this is not a pathology. However, due to the advancement of the fetus to the birth canal, the organ gradually begins to descend.
Muscular contractions of the uterus are also possible during pregnancy. The reasons are the tone of the organ (hypertonicity with the threat of miscarriage), training contractions.
Strong contractions occur during childbirth to expel the fetus from the uterus. The gradual opening of the cervix releases the baby out. The placenta comes out next. The neck of a woman giving birth after stretching does not return to its original shape.
Circulation
The genitals have an extensive circulatory system. The structure of the blood circulation of the uterus and appendages with a description is shown in the figure.
The main arteries are:
- Uterine- is a branch of the internal iliac artery.
- Ovarian- departs from the aorta on the left side. The right ovarian artery is more often considered a branch of the renal artery.
Venous outflow from the upper parts of the uterus, tubes, ovaries on the right occurs in the inferior vena cava, on the left - in the left renal. Blood from the bottom of the uterus, cervix, vagina enters the internal iliac vein.
The main lymph nodes of the genital organs are the lumbar. The iliac and sacral ones provide lymph drainage from the cervix and lower body. A slight outflow occurs in the inguinal lymph nodes.
Innervation
The genitals are characterized by sensitive autonomic innervation, which is provided by the pudendal nerve, which is a branch of the sacral plexus. This means that uterine activity is not controlled by volitional efforts.
The body of the organ has predominantly sympathetic innervation, the neck - parasympathetic. The contractions are due to the influence of the nerves of the superior hypogastric plexus.
Movements occur under the influence of neuro-vegetative processes. The uterus is characterized by innervation from the uterovaginal plexus, the ovary - from the ovarian, tube - from both types of plexus.
Action nervous system due to severe pain during childbirth. The innervation of the genital organs of a pregnant woman is shown in the figure.
Pathological and abnormal changes
Diseases change the structure of an organ and the structure of its individual components. One of the pathologies why a woman's uterus can be enlarged is myoma - a benign tumor that can grow to impressive size(over 20 centimeters).
With a small volume, such formations are subject to observation, large ones are removed using an operation. The symptom of "dense uterus", in which there is a thickening of its walls, is characteristic of adenomyosis - internal endometriosis, when the endometrium grows into the muscle layer.
Also, the structure of the organ is changed by polyps, cysts, fibromas, cervical pathologies. The latter include erosion, dysplasia, and cancer. Regular examination significantly reduces the risk of their development. With dysplasia of 2-3 degrees, conization of the neck is shown, in which its cone-shaped fragment is removed.
"Rabies" of the uterus (hypersexuality) can also be a symptom of a malfunction in the reproductive system. Pathologies, abnormalities, and characteristics of the body can cause infertility. For example, in a "hostile uterus" (immunoactive), the immune system prevents the fertilization of the egg, destroying the sperm.
In addition to pathological phenomena that change the structure of the organ, there are abnormalities in the structure of the uterus:
- small (for children) - its length is less than 8 centimeters;
- infantile - the neck is elongated, the size of the organ is 3-5 centimeters;
- one-horned and two-horned;
- double;
- saddle and so on.
Doubling
In addition to the presence of 2 uterus, there is a doubling of the vagina. In this case, the development of the fetus is possible in two organs.
Two-horned
Outwardly it resembles a heart, in the region of the bottom the horned uterus is divided in two and joins in the cervical region. One of the horns is underdeveloped.
Saddle (arched)
A variant of the bicornuate uterus, the bifurcation of the bottom is expressed minimally in the form of a depression. Often asymptomatic.
Intrauterine septum
The uterus is completely split in two. With a full septum, the cavities are isolated from each other, with an incomplete septum, they are connected in the neck area.
Omission
Displacement of the uterus below the anatomical border due to muscle and ligament weakness. It is observed after childbirth, during menopause, in old age.
Elevation
The organ is located above the upper pelvic plane. The reasons are adhesions, tumors of the rectum, ovary (as in the photo).
Turn
In this case, a distinction is made between the rotation of the uterus, when the entire organ is rotated with the neck or torsion (twisting), in which the vagina remains in place.
Eversion
An inverted uterus is rare in real gynecological practice and is usually a complication of childbirth.
A completely inverted organ is characterized by the withdrawal of the cervix, the body, the vagina. Partially inversion inside out is manifested by incomplete lowering of the fundus of the uterus beyond the boundaries of the inner opening.
Bias
The anomaly is characterized by displacement of the organ forward, backward, right or left. The figure schematically shows the curve of the uterus, deflected in opposite directions.
Dropping out
Pathology occurs with weakness of muscles and ligaments and is characterized by the displacement of the uterus down to the vagina or going out through the labia.
In the reproductive age, the position of the organ is restored by the method of surgical intervention. If it falls out completely, removal is shown.
Uterus removal
Extirpation of the organ (hysterectomy) is performed for serious indications: with large fibroids, uterine oncology, widespread adenomyosis, profuse bleeding, and so on.
During the operation, it is possible to preserve the ovaries and uterine cervix. In this case, hormone replacement therapy is not prescribed, eggs from the ovaries are suitable for use in surrogacy.
The options for removing the uterus are briefly presented in the photo, after the operation the bladder shifts back, the intestines downward.
The rehabilitation period is characterized by pain in the area of the excised organ, bleeding, which gradually disappear. Not only physical, but also moral discomfort is possible. The negative consequences are associated with the displacement of organs due to the removed uterus
Healthy intrauterine development of a baby is impossible if the expectant mother has any pathologies of the female genital organs. During pregnancy, doctors regularly assess the condition of the cervix. It is especially important to carry out such diagnostics at the most early dates carrying a baby.
Physiology
The cervix is a kind of entrance to the uterus. This organ is a continuation of the cervical canal. The normal size of the cervix is very important. Deviations from the norm can lead to the fact that a woman and her baby will develop various pathologies.
The location of the uterus and cervical canal is determined during an extended gynecological examination, which is held by the expectant mother on the armchair.
The size of the cervix in most healthy women is from 3 to 4.5 cm. A change in this indicator is a very important clinical sign of the development of many pathologies.
Unstable hormonal background contributes to the fact that the size of the cervix can change. This is especially evident in the second half of pregnancy.
If, when carrying a baby in a woman, doctors determine a shortening of the size of the cervix, this is a manifestation of a pathology that requires correction.
Condition before ovulation
The cervix is adjacent in its lower part to the vagina. In non-pregnant women, this zone is hard. Already in the first weeks of pregnancy it becomes loose and softened. The position of the vaginal part of the uterus before menstruation may change somewhat. This condition is usually detected by a gynecologist during a gynecological examination.
V different periods a woman's menstrual cycle, the cervix is different. In the period before ovulation, its hardness is maximum. At the same time, the cervical canal is narrowed as much as possible. This condition is physiological.
Strong narrowing of the cervical canal is necessary at this stage of the female cycle in order to prevent conception.
Into ovulation
During this period of the female cycle, the state of the cervix changes. It becomes looser and softer. If the gynecologist conducts a study during such a period, then he will also detect the closure of the internal os of the uterus. Doctors call this emerging condition a symptom or sign of the pupil.
The cervix also rises slightly during this period. If the location of the genital organ is non-physiological, then this situation can lead to the fact that the woman will develop adverse symptoms. Usually, in this case, a pulling soreness appears, and white discharge from the genital tract begins to appear.
During this period of the female cycle, the secretion of cervical mucus increases. It is necessary for successful conception to occur. It is thanks to this secret that sperm can penetrate into the uterus and to the egg.
If the fusion of the sex cells of a man and a woman does not occur, then the next stage of the menstrual cycle begins.
After ovulation
During this period of the female cycle, the position of the cervix changes. This organ begins to shift downward. During a gynecological examination, the doctor determines that the cervix becomes dry and somewhat dense to the touch. The diameter of the cervical canal is insignificant.
This period is characterized by the fact that the cervix is not ready for sperm penetration... The changing hormonal background contributes to the appearance of such changes. Female sex hormones affect epithelial cells, which leads to the development of their specific changes.
Early pregnancy
During the gynecological examination, the doctor evaluates several clinical parameters. It determines the location, tone, color, shape and density of the cervix.
In the first weeks of pregnancy, the color of the mucous membranes of this organ changes. This zone changes its color from pale pink to maroon. The density of the cervix before the missed period is also different. All clinical indicators change with the course of pregnancy.
During a gynecological examination, doctors already in the first days of pregnancy reveal plethora of blood vessels. During this period, the tone of the uterus also changes.
If it is too pronounced, then this situation is already a manifestation of pathology - hypertonicity. In this case, more careful monitoring of the expectant mother is required during the entire pregnancy.
Typical changes in the cervix begin to occur in the first half of pregnancy. Even in the earliest periods after conception the density of the organ changes. The cervix becomes softer.
The lumen of this body is also changing. At first, the cervix is ajar. As pregnancy progresses, the diameter of the cervical canal gradually decreases.
This physiological response is necessary to prevent a woman from having a premature birth.
The location of the uterus in the small pelvis is very important clinical sign... It may be tilted too far forward or off to the side. In this case, the course of pregnancy can be pathological. In such a situation, a woman needs more careful observation throughout the entire period of bearing her baby.
In the early weeks of pregnancy, the lining of the cervix looks smooth. This is due big amount cervical mucus, which is produced by epithelial cells of the cervical canal. Such a biological secret is necessary in order to protect the organs of the small pelvis and the developing baby from infection.
As pregnancy progresses, the mucous membranes of the cervix become looser. Usually this situation develops by the third trimester of pregnancy. If the cervix becomes too soft or loose, the expectant mother may even need to be hospitalized.
Many women try to palpate the cervix on their own. It should be noted right away that you shouldn't do that. It is impossible to identify signs of pregnancy with this method on your own. In this case, only the risk of a secondary infection is high.
If a woman has a delay in menstruation after unprotected intercourse, then she should immediately seek advice from a gynecologist.
How to determine the condition of the cervix in the early stages?
To identify pathologies of the cervix, it is not always necessary to conduct a gynecological examination. Usually, the doctor conducts such studies only according to indications. More often, doctors resort to prescribing transvaginal ultrasound to monitor developing disorders.
If a woman has a long cervix and no shortening, frequent gynecological examinations are not required. It should be noted that the appearance of pathologies of the cervix occurs at the earliest stages of pregnancy.
It is no coincidence that several clinical examinations are carried out during pregnancy. Until 20 weeks, the cervix should be the same as before in the first days after conception of the baby. At the same time, no significant changes in this organ are observed. This is due to a gradual change in hormonal levels.
In this case, both cervical os remain completely closed. At the same time, the dimensions of this organ are from 4 to 4.5 cm. If in a woman this indicator decreases to 2 cm, then in this case, doctors talk about shortening.
Normally, the length of the uterus should be within the normal range. Only after 20 weeks does a slight physiological shortening of this organ begin to occur. This condition develops almost until the 28th week of pregnancy.
In the future, the size of the cervix continues to decrease. This situation is necessary for natural childbirth.
How do pathologies manifest?
Doctors identify several risk groups, which include women with certain pathologies. In order to assess this risk, the history is very important. If a woman had abortions, especially complicated ones, before the previous conception of the baby, then in this case, more careful monitoring of her pregnancy is required.
The use of forceps and other ancillary medical instruments during a previous pregnancy may cause damage to the cervix.
Hormonal imbalance only contributes to the fact that the woman's progesterone level is significantly reduced. In this situation, doctors usually prescribe special hormonal drugs for pregnant women.
Expectant mothers carrying twins or triplets also have a higher risk of developing various pathologies of the cervix. Such pathological conditions are manifested in multiple pregnancies already at its earliest stages.
Low placenta previa very often leads to the development of various pathologies of the cervix. Usually, such a pathology is formed by the end of the first trimester of pregnancy.
The lack of full-fledged medical control over the development of this condition can contribute to the development of extremely dangerous pathologies for both the expectant mother and her baby.
Women who have been diagnosed with cervical erosion by doctors even before the onset or in the early stages of pregnancy are at an increased risk for the development of various pathologies. In this case, careful monitoring and selection of tactics for monitoring the expectant mother is required.
If, by the end of the first trimester, doctors suspected a woman's isthmic-cervical insufficiency, then she is referred for additional examination. For this she undergoes an ultrasound examination. In some cases, this can lead a doctor to refer a woman for hospitalization in a hospital.
It is possible to suspect isthmic-cervical insufficiency in the very early stages of pregnancy. In this case, the cervix opens too early. Usually it opens up significantly by 8-12 weeks of pregnancy. Such a pathology is fraught with the fact that a spontaneous miscarriage may occur.
Isthmico-cervical insufficiency can also lead to infection of the fetus and internal female genital organs. If this pathology manifests itself in the early stages of pregnancy, as a rule, it is prescribed hormone therapy. The use of more invasive procedures is carried out somewhat later.
If the pathological condition is significantly expressed, then in this case suturing may be required. This procedure is carried out already in a hospital setting. In this case, the stitches are placed on the cervix. They are removed closer to childbirth.
It is important to note that ischemic-cervical insufficiency is not an absolute contraindication for natural childbirth. If the stitches are applied on time, and the treatment tactics are selected correctly, then a woman can independently give birth to a baby without using a cesarean section.
Even pathologies of the cervix that occurred at the beginning of pregnancy and detected in a timely manner can be controlled and effectively prevented.
Examination by a gynecologist for most women is carried out once a year, if there are no abnormalities in well-being. If you suspect pregnancy, you should consult a doctor. This must be done after the delay has occurred. Until this moment, many ladies are worried, wondering if conception has occurred.
The cervix looks different before menstruation and during pregnancy. A woman will not be able to see the changes on her own, but it is quite possible to grope for them. How this diagnostic method is used, its advantages and disadvantages should be considered in more detail.
Cervix and its condition
The lower part of the uterus is called a ganglion. It looks like a tube that connects the vagina and the cavity of the genital organ. The average length of this section is 4 cm, and the length is 2.5 cm.
Changes in this organ make it possible to diagnose early pregnancy, as well as the period of ovulation or the next menstruation. The gynecologist can observe its changes, determine the consistency: there is a hard and soft neck.
Also, this organ makes it possible to determine if there are any pathologies in the functioning of the female reproductive system.
An experienced gynecologist will be able to assess various conditions of the cervix.
If it is not possible to visit the doctor often, the girl has the opportunity to determine some conditions on her own. This must be done correctly.
How the cervix looks at different periods, a woman can only evaluate by comparison, as well as knowing its parameters theoretically.
Cervix during menstruation
From the first day of the cycle, the uterus begins to reject the overgrown endometrium. For this, the neck is slightly opened. This happens a few days before the start critical days... The position of the uterus becomes lower.
When the organ is partially opened, infections should be avoided. To do this, you should:
- Observe the rules of personal hygiene.
- Do not use the pool.
- Do not swim in bodies of water.
- Wipe the anus away from the vagina.
- Do not insert foreign objects, fingers into the vagina.
- Don't douche.
Small discharge from the cervical canal that appears at this time is designed to protect the internal environment from infection. But it's not worth the risk.
Cervix after menstruation
A healthy neck in the first phase of the cycle prepares for future conception. Its channel is narrowing. The bleeding stops. The uterus is pulled up high, and the endometrium begins to grow in it.
After the completion of menstruation, the cervix becomes dry and hard. The cervical canal is closed. This position of the organ allows you to avoid getting the infection inside.
The cervix is firm to the touch. To conduct an examination at home, a woman should compare tactile sensations for two, or preferably three cycles.
Ovulation period
A soft cervix is seen on examination when it is time for ovulation. The gynecologist during this period of the cycle can determine that the pharynx of the organ is open. This is called a symptom of the pupil.
You can feel the cervix at home during ovulation, and note its high humidity. During this period, it rises slightly.
If, during the study, the cervical canal is open, mucus is abundantly released from it with a soft surface, it means that the egg is preparing to leave the ovary. The uterus is ready to receive sperm.
After that, either conception occurs, or the body begins to prepare for the next menstruation. If fertilization has not occurred, on the 16-17th day of the cycle, the canal closes, the organ takes on a different position.
The period preceding menstruation
The cervix is low before menstruation. It is dry and firm to the touch. During the examination, the gynecologist will record a tight compression of the cervical canal. This means that the uterus is not ready to receive sperm.
By the last days of the cycle, after the absence of fertilization of the egg, the organ also undergoes a number of changes. The cervical canal is enlarged.
The cervix before menstruation the day before their onset resembles a little its appearance during ovulation. Only this time it opened not to receive sperm, but to reject the endometrial layer.
Cervix during pregnancy
During pregnancy, the uterus undergoes a number of changes. In the early stages, even an experienced gynecologist will not be able to accurately diagnose the conception that has occurred. After examination, the doctor can determine what changes have occurred in the organ.
First, there are hidden changes inside. They cannot be seen so easily. In the early period before the delay, it looks almost like a uterus before menstruation. However, very soon there will be visible changes.
You can feel a dense cervix with a soft uterus. The onset of pregnancy begins to manifest. How many days the body will need for this is difficult to determine. In the early stages of pregnancy, the uterus changes in the following parameters:
- Colour;
- location;
- the size;
- the form;
- density.
When fertilization has occurred, the color of the neck begins to change. It can be described as cyanotic. There are objective reasons for this condition of the mucous membrane. They consist in increasing blood flow.
A loose uterus is a sign of early pregnancy. If during ovulation the cervix is located high, then after fertilization, progesterone changes its position. During the period of the cycle following ovulation, it goes down in the absence of pregnancy.
The size of the genital organ with successful cell implantation increases, and by the end of 4 weeks it is already comparable to a hen's egg. After fertilization and fetal development, you can feel it in the pelvic area.
If the gynecologist makes an examination during this period, he may reveal the mobility of the neck due to the softening of the isthmus. How long it will take for the body to carry out all these changes depends on its characteristics.
A soft cervix during pregnancy is one of the first signs.
Palpation at home
Many women, before going to the doctor, would like to confirm or deny their assumptions about possible pregnancy... Knowing the basic characteristics, there is a chance to determine the presence of the development of a new life at home before the delay. The uterus is soft during pregnancy. But her neck in nulliparous women is tightly closed and is high. Before menstruation, her position is lower.
Even an experienced specialist would not dare to diagnose pregnancy only on the basis of an examination.
Palpation technique
This method is used only if it is impossible to visit a doctor often. It should not be used before menstruation so as not to bring the infection inside. Having decided to use such a technique, you must remember about its shortcomings.
If you want to make an inspection on your own, you must follow a number of recommendations:
- Before palpation, it is necessary to cut the nails on the middle and index fingers.
- Wash hands thoroughly and wear sterile gloves.
- Two fingers are inserted deep inside.
- The tubercle inside should be probed and conclusions should be drawn about the condition of the neck.
Disadvantages of self-palpation
There are a number negative qualities at the presented diagnostics. These include the following facts:
- There is a possibility of infection and various diseases.
- In case of accidental careless movement, there is a risk of injury to the neck, which will cause erosion.
- The inability to determine with a high degree of probability whether a pregnancy has occurred.
- You will still need to go to an appointment with a medical specialist.
Self-diagnosis is considered a rather risky approach. Even having sufficient theoretical and practical experience on this issue, it is almost impossible to draw accurate conclusions about the state of the reproductive system based on palpation at home.
Only a proper examination by a qualified specialist will be an adequate means of determining pregnancy.