Long cervix

A long cervix is a common pathology that is asymptomatic and therefore is most often diagnosed when complications arise. This pathology does not pose a threat to life, but it can cause complications during childbirth or when conceiving a child. Statistically, this problem is not very common, because it is not always diagnosed. Therefore, you should not be upset if you have been diagnosed with this condition, because it does not pose any danger. You should only remember this condition when planning a pregnancy.

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Causes long cervix

A long cervix as a primary diagnosis is an uncommon pathology, since it is more often a secondary pathology.

The primary causes of this condition in women who have not given birth are congenital anatomical and functional features of the structure of the reproductive system. Often, a long cervix is combined with other congenital anomalies of the uterus, such as a bicornuate uterus, an elongated uterus, and others. But this can also be the only symptom when the length of the cervix is longer than normal. This condition requires correction only in the case of pregnancy planning, unless of course there are concomitant anomalies in the development of the tubes or uterus that prevent pregnancy.

The causes of a long cervix can be varied. The highest risk of developing this condition is in women who have had more than one birth in their medical history. Then the elasticity of the cervix increases, and it is more susceptible to stretching and change by adhesions or trauma.

Frequent inflammatory diseases of the internal genital organs, such as endometritis, cervicitis, adnexitis can contribute to the development of anomalies in the structure and length of the cervix. This occurs due to the development of adhesions after local inflammatory reactions and the deposition of fibrin threads, which subsequently entails the formation of dense adhesions.

Another cause of a long cervix may be birth injuries, which are treated surgically. Sutures placed on the uterus, cervix or vagina may contribute not only to a change in the size of the cervix, but also the shape and structure of the uterus. This can often be an obstacle to the further process of embryo implantation and pregnancy development, as well as the process of sperm passage itself.

Also, the causes of the elongation of the cervix can be frequent surgical interventions, that is, frequent abortions can change the structure of the cervix. If diagnostic curettage of the uterine cavity is performed, then this can also serve as an etiological factor for such a condition. As for surgical interventions, such operations as conization of the cervix can become a direct cause of complications in the form of a long cervix, precisely because of the localization of this intervention. That is, excision of part of the epithelium of the cervix leads to a narrowing of the canal and its compensatory change.

These are the main reasons that can lead to elongation of the cervix. But it should be remembered that any disease of the female reproductive system carries a potential threat to reproductive function.

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Pathogenesis

The pathogenesis of the development of a long cervix is caused by a number of primary changes, such as, for example, the development of adhesions. This contributes to a change in the epithelium and an increase in proliferative processes, under the influence of which the number of cells increases and the basis for changing the structure of the cervix appears. A large number of cells contributes to the lengthening of the cervix on one side, and fibrin threads can stretch or, conversely, reduce the cavity of the cervical canal on the other side, and change the shape of the cervix.

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Symptoms long cervix

Most often, this disease is asymptomatic, which greatly complicates timely diagnosis and treatment. This is due to the fact that there are no signs until serious complications appear.

Sometimes, in women who have not given birth before, the first signs of the disease may be dyspareunia – a disruption of the normal process of sexual intercourse, in which the woman does not receive pleasure and her sexual desire decreases. This may be the only symptom and often no one pays attention to it, since women are not used to complaining about such a condition. This happens because the elongated cervix does not have a sufficient number of receptors and blood supply may be poor, which disrupts normal sexual intercourse. There are no painful sensations, since the internal structure is not changed and there are no obstacles.

Most often, a long cervix, as such a diagnosis, is made during pregnancy, since this concept can complicate both the fertilization process itself and childbirth. This diagnosis can be established for the first time in a woman who is being treated for infertility. That is, a long cervix can lead to complications in conception, since the sperm cannot reach the fallopian tube for a normal fertilization process. Also, a dense mucous plug can form in the elongated cervical canal, which has an acidic environment, which also prevents the passage of sperm.

Symptoms of a long cervix may manifest for the first time during pregnancy or already during labor. During pregnancy, the normal attachment of the placenta may be disrupted, since the anatomical structure of the cervical os is disrupted and the placenta may have a central, lateral or low attachment. A number of complications may also occur during labor. One of the manifestations may be prolonged labor, which lasts more than 12-14 hours in primiparous women and more than 9-12 hours in multiparous women. This occurs because the elongated cervix is not prepared before labor and opens slowly. A long and hard cervix does not smooth out, which leads to unpreparedness of the birth canal. Therefore, contractions last a long time, lead to fatigue and exhaustion of the woman, and this condition can lead to secondary weakness of labor, which requires active tactics in the form of stimulation of pregnancy.

There may also be obstacles to the normal passage of the baby through the birth canal, since the elongated cervix is not sufficiently dilated and the baby's head or presenting part may remain in one plane for a long time, which increases the risk of hypoxia and may require additional methods - the application of obstetric forceps.

Other symptoms are rarely disturbing, since this condition has no specific features. The main symptoms are related to pregnancy and childbirth.

Complications and consequences

Complications of a long cervix develop mainly during pregnancy. This is directly related to the process of the child's passage through the birth canal. Such complications include weak labor, post-term pregnancy, postpartum hemorrhage, and fetal hypoxia. A dense mucous plug may also form in the narrowed cervical canal, which does not come off and delays the onset of labor. These complications arise due to disruption of the normal opening and smoothing of the cervix, which is elongated.

Another important consequence can be infertility, which occurs due to an elementary mechanical barrier to the movement of sperm.

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Diagnostics long cervix

The asymptomatic course of the disease complicates timely diagnostics. Such patients have no complaints, and no special changes are detected during examination. Therefore, pregnancy should be planned with a thorough examination of the expectant mother.

When examining women with such pathology, there are no special changes: no complaints or symptoms are determined during bimanual vaginal examination. Examination in mirrors is also uninformative because only the cervix itself is visible, which is not changed. Thus, using simple methods of special gynecological examination, this diagnosis cannot be established.

The tests do not allow us to suspect this pathology, since general clinical laboratory tests - general blood and urine tests - are normal. The absence of changes in the general blood test only allows us to exclude inflammatory diseases. Special laboratory tests - a smear of the cervical canal for flora and dysplasia - are also unchanged in the absence of concomitant pathology.

Instrumental diagnostics is the "gold standard" in diagnosis. Colposcopy allows for an enlarged image of the cervix with an examination of the structure of the cervical canal epithelium. This can help in differential diagnostics, as it excludes erosions, polyps, dysplasia and other diseases.

The only method that can confirm the diagnosis is ultrasound examination. This method allows not only to establish an accurate diagnosis, but also to conduct differential diagnostics.

Ultrasound diagnostics is a mandatory method of examination for pregnant women and is carried out at least three times during pregnancy as a screening method for identifying the main pathologies of both mother and child. Already at the first ultrasound, which is carried out at 11-13 weeks of pregnancy, in addition to the main indicators, the parameters of the cervix are also measured - cervicometry. At the same time, normal indicators of the length of the cervix should not be less than 35 millimeters, but should not exceed 45 millimeters. In case of an increase in the latter indicator, they say about a long cervix. But this is not a final diagnosis, since by the end of the pregnancy, the cervix gradually smooths out and decreases, so you should look at these indicators in dynamics. The third ultrasound is carried out after the 30th week of pregnancy, when the indicator of the length of the cervix should decrease. So, at 34-36 weeks, the length of the cervix should be 34-36 millimeters, respectively. If this indicator is still more than 40 millimeters, then only then can we talk about a long cervix. This is taken into account in the future during labor management.

Thus, conducting cervicometry allows us to establish this diagnosis and subsequently navigate the management of pregnancy and childbirth.

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Differential diagnosis

Differential diagnostics of a long cervix can be carried out with other pathologies already directly during childbirth, if this condition has not been diagnosed before. Then weakness of labor appears and it is necessary to carry out diagnostics with hormonal disorders or other anomalies of labor.

Also, a long cervix must be differentiated from other conditions that can cause infertility. These are infectious diseases of the genitals, which are excluded by examining a vaginal smear, as well as anomalies in the development and structure of the fallopian tubes and uterus.

Ultrasound examination allows for an accurate diagnosis and differential diagnosis.

Treatment long cervix

Treatment of a long cervix between births or in women of non-reproductive age is not required, as this condition is not dangerous. In cases of infertility, preparation for pregnancy or during pregnancy, measures must be taken, as complications may arise.

Treatment of a long cervix before childbirth includes a complex of massage to improve the outflow of blood and lymph, physical exercises to strengthen the muscles of the pelvis and perineum as a coordinated action of these muscles during childbirth, as well as medication methods.

Medicines are not widely used, as they are harmful during pregnancy and excessive relaxation of the cervix can lead to premature birth or premature or early discharge of amniotic fluid. Therefore, with a long cervix and disruption of the normal opening of the uterine os, labor is stimulated. This can be done using mechanical methods - a Foley catheter or by amniotomy or manual detachment of the placenta over a short distance. Labor can also be stimulated by using laminaria. Laminaria is a seaweed from which special sticks are made that increase in size by 5-6 times in the vagina and stimulate the opening and smoothing of the cervix. Prostaglandins E 2 - misoprostol are also widely used. This drug, called "Mirolyut", is available in tablet form, 4 tablets per pack at a dose of 200 mcg of the active substance, and 4 tablets are used rectally at once. This method of labor stimulation with a long cervix is widely used, as it is affordable and effective. Prostaglandins can be used in the form of vaginal suppositories or ointments. Such stimulation methods are possible only in the absence of scars on the uterus.

Surgical treatment of a long cervix is not widespread, since it is not a serious diagnosis and does not have effective surgical techniques that would allow correcting this condition. It is simply necessary to know about this disease and prevent possible complications during childbirth.

Traditional treatment for a long cervix

Traditional methods of treating a long cervix prevail, since they do not cause harm during pregnancy. Both herbal treatments and traditional methods are used.

A folk method for treating a long cervix is methods that help soften the cervix and open it to a certain level before pregnancy. These include using a large fitball - exercises on it help increase the production of your own prostaglandins, which reduce the long cervix. Having sex also helps relax the cervix.

Among other folk methods of treatment, the main ones are:

• Honey treatment – one tablespoon of honey should be diluted in a liter of boiled water and douched twice a day. This course should be completed over 7-10 days. Honey has a pronounced relaxing effect on the myometrium of the uterus, and also has a bacteriostatic and immunomodulatory effect.
• Using celandine - a tablespoon of dried celandine leaves should be poured with a glass of boiled water and boiled for another five minutes, then allowed to cool and strained. This decoction should be drunk half a glass three times a day for about a week.
• Nettle has healing properties and at the same time helps soften the hard cervix. For treatment, use the juice from the stems of nettle, freshly squeezed, which is used to soak a tampon and insert it into the vagina for 2 hours in the evening for at least five days.
• Sea buckthorn oil also has an anti-inflammatory effect in addition to its relaxing effect. Sea buckthorn oil, which can be purchased at a pharmacy, is soaked in a tampon and inserted into the vagina for 2 hours, which is best done before bedtime. The course is at least ten procedures.
• A soothing and strengthening herbal tea is recommended, which has a hysterotropic effect. To do this, raspberry, strawberry and hawthorn leaves are infused in boiled water and boiled for another five to ten minutes, after which they drink it instead of tea up to four times a day.

Such folk remedies should be used outside of pregnancy, as they can cause excessive dilation of the cervix, so during pregnancy it is necessary to consult a doctor.

Homeopathic treatments are also quite common.

The most famous homeopathic preparation that has an effective effect is Caulophyllum, a plant extract that is produced in the form of homeopathic granules. During pregnancy, two weeks before delivery, it is used for prophylactic purposes for a long cervix, 3 granules twice a day. Already during labor, with discoordination or weakness of labor activity, the preparation is used 3 capsules every half hour.

Another drug used in this case is Pulsatilla. In addition to its pronounced myotropic effect, it also has a relaxing and analgesic effect. This effect contributes to the normalization of the uterine tone and normal dynamics of cervical dilation. The drug is available in homeopathic granules and is used in the same dosage and according to the same principle.

The drug Arnica has the same effect, but in addition to the analgesic and hysterotropic effect, its additional function is revealed - it is the prevention of postpartum bleeding. These three main homeopathic drugs are used as methods of treating a long cervix not only before childbirth, but also during the occurrence of problems already in childbirth.

These are the main methods of treating this pathology and their timely use allows you to avoid complications.

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Prevention

Prevention of this condition is non-specific and includes all methods of prevention of any other diseases of the female genital organs: correct sexual life, avoidance of abortions, injuries, timely treatment of urogenital infections, use of barrier methods of contraception, as well as correct lifestyle and nutrition. These methods strengthen the entire female body and prevent any disruptions of the normal cycle and reproductive function.

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Forecast

The prognosis for this pathology is favorable, both for life and for normal reproductive function, since today there are many methods for correcting this condition, both medicinal and folk.

A long cervix is a common pathology that is diagnosed most often during pregnancy during an ultrasound examination. The results of cervicometry in dynamics allow you to establish this diagnosis and prevent complications during childbirth. But you should not be upset if this diagnosis is established, since this condition has many methods of correction and does not lead to significant complications. It is necessary to remember this condition and in the event of complications with the conception of a child, it is also necessary to take this fact into account. Therefore, you should take care of your health and the health of future children by preserving your health in advance.

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