Every woman during pregnancy has to make many scheduled visits to the gynecologist and undergo many examinations. But the first examination, when the doctor determines the fact of pregnancy and determines its term usually becomes the most memorable of them. One of the important moments in determining the presence of pregnancy is the cervix, in which pronounced changes begin to occur after the embryo implantation. The woman’s organism is arranged in such a way that cervix during pregnancy changes its shape and condition. Thus, the fetus can develop before the due date. Cervix during pregnancy plays a very important role. Its condition determines the time of the birth.
What Is Cervix?
The cervix is the most important part of the female organ associated with the procreation process. It affects both the course of pregnancy and the birth process. It is a small tube (about 4 cm by 2.5 cm), connecting the uterus and the vagina. The cervix is divided into the upper – the supracervical part located above the vagina, and the lower – the vaginal, which extends into the cavity of the vagina.
What Should Cervix during Pregnancy Be Like?
With the onset of pregnancy, the cervix, like the entire female body, undergoes significant changes.
The uterus itself begins to change from about 4 weeks of pregnancy, when an overgrown fetal egg causes a protrusion of its wall, an increase in the size of the organ and asymmetry. A good specialist is also able to detect it. The condition of the cervix depends on the stage of pregnancy. But the increase in progesterone, which is observed immediately after the fertilization of the ovum, leads to the fact that the organ changes purely visually. This is easy to see at the gynecological examination. An experienced doctor can even determine the period from the moment of conception.
Signs of Changes in the Uterus after Conception
The uterine cervix during pregnancy in the early stages acquires the following differences from the previous condition:
- The color of its mucous membrane becomes cyanotic. Before the conception it was pink. Do not be afraid of these changes. They are caused by the growth of blood vessels and the activation of metabolic processes. This is necessary to improve the blood supply in this area, since the formation of the membranes of the fetus and its nutrition requires a large amount of oxygen;
- Its position varies with respect to the main part of the organ;
- Cervix tissues become different in consistency which a doctor can feel during the examination.
- The newly formed collagen structure, which is very stretchable and elastic, contributes to the stretching of the uterus with its excessive formation. Accordingly, it leads to the shortening of the cervix during pregnancy and the creation of conditions for opening the internal orifice of the uterus.
The organ stays like this throughout the pregnancy. By the end of the pregnancy the physician ascertains the softness of the tissues. It indicates the maturation of the cervix and readiness for the birth. Before the very birth, the cervix tends to shorten sharply to 1-2 cm, fixing strictly in the center of the small pelvis. Next, periodic inspection is required in order not to miss the beginning of the labor activity, which is signaled by the expansion of the internal orifice and the first contractions.
Length of the Cervix During Pregnancy by Weeks
The cervix gradually becomes shorter according to the duration of pregnancy, reaching the shortest length by the end of pregnancy.
Pregnancy Weeks Cervical Length in mm
The pregnancy period imposes on a woman the need to visit a doctor for general examination and, in particular, to examine the condition of the cervix, often enough – at least once a month. This regularity is indicated for quite healthy women who do not have serious health problems. If the pregnancy is aggravated by serious diagnoses, or the risk of miscarriage is high, the doctor sets a more frequent regime for visits to the gynecological office.
Regular examinations of the cervix during pregnancy are of great importance for revealing the pathologies of both the mother and the child. It allows assigning the necessary treatment in time. At each visit, the doctor takes a material to identify a possible inflammatory process, various infections, and to exclude oncological diseases.
The doctor pays special attention to the condition of the cervix, controls its size, shape, location, consistency. Careful routine studies are usually conducted in the first weeks of pregnancy, then at 20th, 28th, 32nd and 36 weeks. In case of abnormalities, the examination is carried out as required. Screening of the cervix during early pregnancy is especially important. Its shortening indicates that the process of spontaneous miscarriage has begun.
Cervix to the Touch during Early Pregnancy
At the very beginning of pregnancy, when there are no pathologies, the uterine cervix is quite thick when viewed and palpated. This is considered to be the norm. The absence of a threat of spontaneous miscarriage is also indicated by the obstruction of the cervical canal (external orifice) for the finger.
And, on the contrary, if such a threat exists, the doctor will notice this by a softened structure, a shortened size and a loosely closed cervical canal.
Friable Cervix during Pregnancy
With the course of pregnancy, the cervical tissues undergo strong changes in the structure.
Being smooth at the beginning of pregnancy, in view of hormonal and physiological reasons it becomes more and more friable. Friable character of the surface of the cervix is considered the norm near the cervical canal. However, large loose areas can indicate the presence of an infection that an inflammatory process causes.
Sources of trouble can be:
- chlamydia and other serious infections requiring urgent treatment.
In addition to increased looseness, ulceration, pulling pains in the lower abdomen and different types of discharge may occur.
Soft Cervix during Pregnancy
With a normal course of pregnancy before the 32-week period, the cervix should be thick with a closed external orifice protecting the uterus from infection. Only later cervix begins to soften. Thus, it is preparing to open during the birth process, but only peripherally. The cervical canal region remains closed.
Closer to 36 weeks, the external orifice can let in the tip of the doctor’s finger.
Beginning with the 37th week of pregnancy, the cervix enters its final “mature” stage and becomes very soft and short. The orifice starts to open. During vaginal examination, it can already let in one or two fingers of the doctor. This is facilitated by the fact that the fetus presses harder on the organ, which accelerates its maturation. Before the very birth the cervix is shortened to 1 cm, becomes soft to the extent that it is easily smoothed out during the delivery, ensuring the passage of the child through the birth canal.
The Danger of a Short Cervix during Pregnancy
Increasing of the softness of the cervix during pregnancy is accompanied by simultaneous and mandatory shortening. Normally, the length of the cervix during pregnancy should not be less than 3 cm. Closer to the birth, it decreases to 1-2 cm. The apparent shortening of the cervix, together with its considerable softening, is a threatening signal indicating the threat of termination of pregnancy.
To determine the length of the cervix more accurately, doctors use ultrasound with a transvaginal sensor. Especially often in the risk zone are those women in the history of which there are already cases of premature birth or miscarriage. Often, due to incompetence of the cervix early miscarriages take place at 6-7 weeks and at 23-26 weeks of pregnancy.
A woman in this case is prescribed treatment in the hospital with progesterone medications, tocolytics, suturing or a special ring – pessary. Drugs that relax the increased tone of the uterus are also useful. What’s more, it is mandatory to eliminate all physical and sexual activity.
It is necessary to be especially attentive to the state of the cervix after 16 weeks of pregnancy, when the fetus begins to gain weight rapidly and provoke softening and shortening of the cervix.
What’s the Danger of the Elongated Cervix of the Uterus?
Elongated cervix during pregnancy can be due to the following reasons:
- congenital features of the structure;
- frequent inflammatory processes of the genital organs;
- trauma in childbirth;
- surgical interventions.
This factor can cause violations of fertilization, childbirth, and pregnancy. With a long cervix, the anatomy of the uterine orifice is violated. It provokes an abnormal attachment of the placenta. The long cervix, which, as a rule, has a firm structure, is not stretched well. This is fraught with its unpreparedness for childbirth. The labor contractions have a protracted character (more than 10-14 hours).It exhausts the woman, leading to weak labor activity. To save the situation, doctors usually resort to stimulation.
In this case, there are also concerns about the normal passage of the child by the birth canal, since the narrowed cervix does not contribute to this, and the baby’s head is at risk of being in the same area for a long time, experiencing hypoxia. A dangerous condition requires the imposition of obstetric forceps.
Ultrasound of the Cervix during Pregnancy
Ultrasound examination is a necessary and the most important method of examining the cervix, its changes in shape and structure. It allows reliably estimate the course of pregnancy and the state of health of a woman. The method is indispensable for the precise determination of the length of the organ, which is the main gestation parameter.
Untimely shortening of the length of the cervix may indicate an ischemic-cervical insufficiency, that is, weakness of the cervix, or the beginning of the process of abortion.