Treatment of short cervix

Short cervix is not dangerous for a woman, if it's not about bearing a child. In the latter case, the pathology leads to different complications, the main one of which is ismiko-cervical insufficiency. After setting such a diagnosis (depending on the specific situation), a pregnant woman may be prescribed conservative, surgical or preventive treatment. It all depends on the tests, the length of the uterine neck, the timing of pregnancy, and the threat of interruption. It should be noted that for a period of up to 20 weeks the 3 cm length indicator is already a critical parameter. Such patients are enrolled in a risk group and require intensive monitoring. To prevent possible complications, the maximum restriction of physical exertion, the wearing of a bandage, the constant control of a gynecologist, helps.

If the cause of the pathology lies in the excess of hormones (androgens), then hormone therapy is needed to correct the condition, i.e. The patient is prescribed glucocorticoid drugs such as Dexamethasone. At the end of the course of therapy, the status of the uterine neck is assessed, and if no improvement is observed, then there is a need for surgical correction - so called. "Cervical cerclage." The procedure is performed for 17-21 weeks under anesthesia and consists of suturing the neck to retain the growing fetus in the uterine cavity. After such an operation, a woman for some time (7 to 20 days) is under medical supervision in the hospital. To prevent an increased tone of the uterus, therapy with the use of spasmolytic drugs - Papaverine, No-shpy, etc., is prescribed. The use of antibacterial drugs is necessary if pathogenic microflora is detected or infection is attached. After discharge from the hospital, a woman must visit a gynecologist twice a week for careful monitoring of the cervix, putting a smear on the flora, and also bacteriological planting. Prenatal hospitalization of the pregnant woman is carried out at a period of 37 weeks (during this period, the seams are removed).

It should be noted that a future mother with a diagnosis of "short cervix" urgently needs bed rest and complete rest. It is important to follow the recommendations of the doctor and wear a bandage. In extreme cases, when the pathology progresses, it becomes necessary to install obstetric pessary - a special device that will help maintain the uterus in a natural position and, thus, reduce the fetal pressure on the cervix.

What if the cervix is short?

Short cervix is not a sentence for a woman, however, when planning pregnancy, such a pathology should not be left without attention. The fact is that because of the shortened neck (the length of which is less than 2.5-2 cm), the process of bearing a child can proceed with very serious complications, the main one of which is ischemic-cervical insufficiency. Such a problem often causes the threat of abortion or premature (transitory) births.

What if the cervix is short? First of all, strictly follow all the recommendations and prescriptions of the doctor, aimed at maintaining the pregnancy. Unfortunately, this pathology is most often found during the period of gestation, during the gynecological examination, and is confirmed by the conclusion of an ultrasound in the course of intravaginal examination.

If there is such a problem, a woman may face an inability to have a normal fetus and delivery without medical intervention. The normal neck has a length of approximately 4 cm. If in I-II trimesters it is shortened to 2-3 cm, we can talk about the development of ischemic-cervical insufficiency. For this condition, the softening and expansion of the sphincter is characteristic, as a result of which the first department of the birth can open, and this is fraught with premature birth.

The congenital form of the NIC is most often associated with a genetic predisposition or individual characteristics of the structure of the female body. The acquired nature of this pathological condition can be a consequence of medical and spontaneous abortions (miscarriages), of previous births, which were complicated by trauma (breaks), as well as surgical interventions in the uterine cavity and other factors that somehow lead to trauma of the cervix and its deformation , scarring, and the like. Thus, a future mother with a diagnosis of "short cervix" should follow the instructions of a gynecologist and, if necessary, undergo treatment in a hospital in order to maintain pregnancy.

Treatment of short cervix

If a pregnant woman is diagnosed with a "short cervix", the doctor prescribes treatment based on the specific situation. It is necessary to take into account the condition of the pregnant woman, the length of the cervix, the accompanying pathologies, the results of the studies and diagnostic measures. To avoid possible consequences, it is important to conduct early prevention of the disease: to visit a gynecologist on time, to use reliable methods of contraception, to plan pregnancy prudently.

Drugs prescribed for therapy will depend on the causes that triggered the pathology. First of all, a pregnant woman needs to take a blood test to determine the level of hormones. If the cause of shortening of the cervix is in hormonal failure, the danger can be eliminated with the help of hormonal therapy. Pregnant women are prescribed glucocorticoid drugs: Microfolline, chorionic gonadotropin, Turinal, Dexamethasone, etc.).

With minor changes in the cervix, a conservative method is used, which is the intravenous administration of Ginipral or Magnesia. These drugs eliminate the tone of the uterus. Of the other drugs, you can note soothing (Leonurus, valerian), multivitamins, as well as drugs that relax the smooth muscles of the uterus. A few weeks of intensive care give a positive result, and the condition of the cervix stabilizes. If the problem persists, surgical correction (suturing) or an obstetric pessary that keeps the uterus in the correct position is used.

If due to a short cervix has developed istmiko-cervical insufficiency, the future mother is prescribed tocolytics - drugs that help to relax the uterus (b-adrenomimetics, Magnesium sulfate, Indomethacin). To prevent placental insufficiency, vasodilator and vasoactive drugs, as well as low molecular weight dextrans, are used. Non-pharmacological methods of therapy include acupuncture, electro-relaxation of the uterus, electroanalgesia, endonasal galvanization.

Utrozhestan

Short cervix during pregnancy is often a factor provoking a threat of miscarriage. If the condition is aggravated against a background of a hormonal failure, the future mother is prescribed drugs whose action is directed at reducing the contractile activity of the uterus.

Utrozhestan is one of these drugs (available in the form of capsules and vaginal suppositories). His appointment is associated with a situation where in the body of a pregnant woman there is insufficient production of the hormone progesterone. The dosage of this medication is selected in each case individually, based on the symptoms of the threat of interruption and the degree of their severity. The usual dose is from 200 to 400 mg / day. Every 12 hours. The drug is contraindicated in liver diseases and varicose veins.

In modern medicine, the use of Utrozhestan is widely practiced with the threat of miscarriage due to a shortage of progesterone. Therefore, a pregnant woman should not worry about the fact that this hormonal drug can harm her health or adversely affect the development of the fetus. On the contrary, this drug is necessary, and if it is taken in accordance with the appointment of a doctor, then there will be no side effects. Moreover, this natural progesterone is obtained from plant raw materials. In the first trimester, intravaginal administration of the drug is recommended, but with vaginal use, the drug is absorbed more quickly and better tolerated by the body.

Ginipral

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

Ginipral is assigned to a future mother in the event that she has hypertension of the uterus. This condition not only increases the threat of miscarriage or premature birth, but also "inhibits" the supply of nutrients and oxygen to the fetus. The drug is available in tablet form or in the form of injections and has a direct effect on the vessels of the uterus, contributing to the "soft" relaxation of the genital organ. It should be noted that in the first trimester this medication is contraindicated. His appointment is possible only after the 16th week, and the dosage and duration of the appointment is determined by the doctor. At the same time, control over arterial pressure and blood sugar level is necessary. If the pregnant woman has a strong tone of the uterus, the dose of Ginipral can reach 500 mcg when taken every 3 hours.

Of the contraindications can also be noted individual intolerance of the components of the drug, hyperthyroidism, glaucoma, bronchial asthma, heart disease, renal and hepatic insufficiency. Of the side effects associated with the use of this drug, you can identify headaches, palpitations, agitation, dizziness. Therefore, along with Ginipral prescribing drugs that are aimed at reducing cardiac activity. To avoid swelling of the pregnant woman, it is recommended to limit the intake of liquid and salt. The drug is withdrawn gradually, the dose is reduced with each admission.

Magnesia

The short cervix is a factor in the development of ischemic-cervical insufficiency, which means that a pregnant woman is threatened with spontaneous miscarriage or the onset of premature birth. When revealing pathology, it is necessary to prescribe medications, the action of which is aimed at eliminating the main problem - hypertension of the uterus.

Magnesia (magnesium sulfate) is an effective drug that helps to prevent various complications in case of the threat of termination of pregnancy. Its action is aimed at relaxing the muscular muscles and walls of blood vessels, normalizing the pressure, accelerating the removal of fluid from the body. The effectiveness of this drug appears only with intramuscular and intravenous administration. Reception in the form of a powder will not give the desired result, because the drug does not enter the bloodstream from the intestinal tract.

Use of the drug is contraindicated before childbirth and in the first trimester of pregnancy. At later terms of gestation, such treatment should be carried out exclusively in a hospital, under the strict supervision of the attending physician. The dosage of magnesia will depend on the situation, i. E. Health status of the pregnant woman, as well as concomitant pathologies. Typically, the usual intake of 25% of the drug is 1-2 times a day, with the second stage of nephropathy - 4 times. It should be noted that the introduction of magnesia is a very painful process, requiring the experience and skill of a medical specialist.

Of the side effects that can occur as a result of taking magnesia, it should be noted weakness, drowsiness, anxiety, headaches, sweating, hypotension, speech impairment. With reduced blood pressure the drug can not be prescribed. In addition, its combination with biological nutritional supplements and calcium preparations is not allowed. Since taking this medicine is associated with some risk, before starting treatment, the doctor will weigh everything "for" and "against", given the specific situation.

Dyufaston with a short cervix of the uterus

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

Dyufaston with a short cervix is used if the pregnant woman has problems with bearing a baby, and she has hypertension of the uterus. This drug - a synthetic analogue of the hormone, but in structure is close to the natural progesterone, produced in the body of a woman. The effectiveness and safety of the drug (especially in the early periods, up to 16 weeks) is proved by its long-term use. A positive property of the drug is a gentle effect on the liver and blood coagulability. Diuphaston's treatment regimen and dosage should be selected by the physician on an individual basis, based on the clinical picture and the patient's condition.

Usually, when a miscarriage threatens, the dosage of the drug is 40 mg once, and then decreases to 10 mg every 8 hours. Therapy continues until the symptoms disappear completely. In the event that, after stopping Dufaston's reception, symptoms are restored, it is necessary to continue therapy, returning to the optimal dosage.

[1], [2]

Alternative treatment

The short neck of the uterus is a pathology that can lead to such a dangerous condition in pregnancy, as iscystic-cervical insufficiency. At the same time, the internal cervical sinus is unable to cope with the "blocking" function, and the uterus is more difficult to retain a growing fetus in its cavity. Under pressure, there is an even more shortening and opening of the cervix, which provokes a threat of miscarriage or premature (most often - rapid) delivery. In addition, due to the deformed neck, favorable conditions for the penetration of infections are created.

Alternative treatment for the threat of termination of pregnancy should be used with extreme caution, only after consultation with the attending physician. In this case, effective means are:

• Decoction from the bark of the viburnum. One teaspoon of the crushed root of the viburnum is poured a glass of steep boiling water, put on a slow fire and after 5 minutes removed. After the broth is consumed, you can start taking: 1-2 tbsp. Spoons of the remedy during the day. You can also use flowers of viburnum, taking about 30 grams of raw material and filling it with 1.5 liters of boiling water. The broth is insisted in the thermos for about 2 hours, then take ¼ cup 3-4 times a day.

• Decoction of dandelion. A pinch of grass (5-10 g) should be poured a glass of boiling water and a little boil. It is recommended to use the ready-made remedy for ¼ cup several times a day. In the same dosages, you can use the dandelion root.

A good remedy is the infusion, prepared from the flowers of marigold and the herb of St. John's wort. Ingredients should be taken in equal proportions and pour 200 g of steep boiling water, then insist in a thermos for half an hour. Ready-made infusion should be consumed throughout the day for 2 cups (you can add honey to taste).

[3], [4], [5], [6]

Herbal Treatment

Such a diagnosis, like a short cervix, if it is established during pregnancy, requires urgent methods of solving the problem, i.e. The appointment of effective therapy aimed at preventing the threat of termination of pregnancy. In addition to drugs, which should appoint a doctor-gynecologist (self-treatment is excluded), often apply herbs that have a beneficial effect on the condition of the cervix and a decrease in the tone of the uterus.

Treatment with herbs should be strictly controlled by the doctor and with his permission, as some plants can have the opposite effect and harm the future mother and her baby. Their herbs, which have proved their positive effect on the cervix, in particular, its preparation for childbirth, it is possible to identify the evening primrose (plant oil). This product is available in capsules and is most often prescribed to pregnant women from the 36th week. The plant promotes the synthesis of estrogen and testosterone, and also stimulates the production of prostaglandins. In addition, it is rich in useful fatty acids (especially gamma-linolenic), which contributes to the elasticity of the neck, as well as the prevention of its ruptures during childbirth. Primrose in the form of capsules is taken in 2 pcs. Per day, but from the 39th week, you can gradually increase the dose to 3 capsules.

Decoctions of herbs (calendula, St. John's wort, viburnum, chamomile, etc.) also exert a general strengthening effect on the pregnant woman's body, and also improve the tone of the uterus and help prevent the threat of miscarriage in combination with medications. A good effect is provided by tea made from raspberry leaves, which is recommended for ½ cup before meals. Infusions of hawthorn and dog rose should be eaten in the morning, on an empty stomach.

No less useful is a decoction of strawberries, for the preparation of which you need to take 100 grams of berries and, together with the crushed dry leaves, pour 1 liter of boiling water. Then the broth is brought to a boil and boiled for 30 minutes, filtered, cooled and taken during the day for half a glass (not less than 1 liter).

Homeopathy

A short neck of the uterus during pregnancy can deliver a lot of troubles to the future mother, one of which is the ICI, which leads to the threat of miscarriage or rapid delivery (late). Along with drug therapy, the use of various homeopathic medicines is used, but their appointment should be carried out under the strict supervision of the doctor and only according to his prescriptions.

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

• Arnica - used in complex treatment for the development of ischemic-cervical insufficiency and the threat of abortion; improves blood circulation of the pelvic organs;
• Aconitum - is usually combined with other means with a sense of fear and anxiety, accelerated pulse accompanying the NIH, has a calming effect on the nervous system;
• Arsenicum album - an effective tool that helps with the inclinations of the body to miscarriage and is used to prevent habitual miscarriage;
• Chininum arsenicosum - this remedy has a good immunomodulatory effect and is prescribed for miscarriage and the threat of miscarriage due to infection of the genital tract, including because of the short neck;
• Sabina - the drug is indicated for the prevention of miscarriage, often in the early stages (8-12 weeks);
• Zincum valerianicum - this remedy is used for hyperestrogenia, because enhances the secretion of the hormone progesterone.

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

Operative treatment of short cervix

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

Operative treatment includes the use of the following methods:

• mechanical narrowing of the internal uterus (more gentle method);
• stitching of the external throat (overlapping of the circular seam);
• narrowing the neck by strengthening its muscles along the side walls.

The main indications for carrying out the above manipulations are cases of premature birth and miscarriages in the anamnesis, as well as progressive failure of the uterine neck, i.e. Its constant softening and shortening.

The main contraindications to the surgical treatment can be:

• increased excitability (not amenable to correction) of the uterine walls;
• various diseases of internal organs (liver, kidneys, heart);
• genetic, mental illness;
• bleeding during pregnancy;
• presence of malformations in the fetus.

Operations are most expedient to conduct in the period from the 13th to the 27th week. In order to prevent the ascent of infection, the intervention can be carried out at the stage from 7 to 13 weeks. If there are contraindications to the pregnant woman, conservative therapy is prescribed (drug reduction of the uterus excitability), bed rest is recommended.

Bandage with a short cervix of the uterus

The short neck of the uterus is not a sentence, however, during the gestation of a baby, it is advisable to prevent the development of ischemic-cervical insufficiency in order to preserve the pregnancy. Many women are wondering if it is possible in this case to wear a bandage.

A bandage with a short cervix is indicated when a future mother has hypertension of the uterus against a background of a shortened neck, which is physiologically unable to maintain the pressure of the uterus with the growing fetus. The fact is that a high tone of the uterine musculature can provoke premature ripening of the cervix. This is fraught with its mitigation and disclosure, as well as an increased risk of premature birth or miscarriage. In such cases, the pregnant woman is recommended complete abstinence from any physical exertion and wearing a special device - a supporting bandage.

You need to wear it correctly, without squeezing the tummy. Thanks to such a proven means, it is possible to prevent early dipping of the fetus, as well as to ensure its correct location in the uterine cavity. In addition, modern bandages help a woman prevent the appearance of stretch marks, relieve physical fatigue, facilitate walking, avoid overwork and heaviness in the body. A competently constructed bandage can remove excess load from the spine and prevents the occurrence of back pain.

There are practically no contraindications to the use of such a device, but it is absolutely necessary to consult a doctor. Usually, the use of a bandage is recommended for expectant mothers at 4-5 months of pregnancy, when the tummy begins to increase in size, and the fetal pressure on the short cervix becomes stronger every day.

[7], [8],

Ring with a short cervix of the uterus

A short cervix can bring a lot of problems to a woman who is carrying a baby. This is due to the constant pressure of the uterus on the neck due to the growing fetus. As a result of softening and further shortening of this organ, there may be an ischemic-cervical insufficiency, i.e. Threat of abortion. In especially severe cases, a special adaptation is used in medical practice - so-called. "Obstetric pessary." In this case, a procedure called "non-surgical cerclage" is performed.

The ring with a short cervix is most often used for a period of 25 weeks, when it is contraindicated for a pregnant woman to stitch the neck to avoid injury to the bladder and infection of the fetus. It is possible to draw an analogy between a pessary and a bandage, since both devices are designed to reduce the pressure of the uterus on the neck and, thus, reduce the risk of infection of the fetus by retaining the sulfur plug.

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

There is also an unloading pessary called the Meyer ring. This device is made of plastic and has a special shape. It is injected into the vagina to support the cervix, as well as the redistribution of the weight of the fetus. This is one of the most effective methods of treatment of ICI, which allows to save pregnancy. The Meyer ring is installed at any time when the condition of the pregnant woman is not aggravated by other pathologies, and the NIH is not started. In the opposite case, this method of treatment can be applied only as an auxiliary method.

Exercises for the short cervix

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

Exercises for the short cervix can be prescribed only by the attending physician, since in such a pathology one needs to be as cautious as possible so as not to provoke premature opening of the cervix. A pregnant woman should definitely consult with a doctor about physical exercises, their types and frequency of implementation.

If the future mother has hypertension of the uterus, low blood pressure, varicose veins, and there is a threat of miscarriage due to a short cervix, gymnastics is contraindicated. In such situations it is desirable to perform breathing exercises. In especially severe cases, when the threat of interruption of pregnancy increases, any physical exertion should be excluded, since they can cause the most dangerous consequences (miscarriage, premature birth).

Today, many pregnant women practice Kegel exercises aimed at physical training of perineal and cervical muscles for labor. These exercises can be performed only with the permission of a gynecologist, who will objectively assess the situation and health of the future mother. The essence of Kegel exercises is the tension of the musculature of the vagina. Technique is simple: sitting on a chair, you need to tilt the body slightly forward, and then squeeze and unclench the muscles of the vagina 10 times. To do such simple, but effective gymnastics should be 2-3 times a day.

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