Treatment of short cervix

A short cervix is not dangerous for a woman, unless she is carrying a child. In the latter case, the pathology leads to various complications, the main one being isthmic-cervical insufficiency. After such a diagnosis is established (depending on the specific situation), the pregnant woman may be prescribed conservative, surgical or preventive treatment. Everything depends on the tests, the length of the cervix, the pregnancy period, and the threat of termination. It should be noted that for a period of up to 20 weeks, a length indicator of 3 cm is already a critical parameter. Such patients are included in the risk group and require intensive monitoring. Maximum limitation of physical activity, wearing a bandage, and constant monitoring by a gynecologist help prevent possible complications.

If the cause of the pathology lies in the excess of hormones (androgens), then hormonal therapy is necessary to correct the condition, i.e. the patient is prescribed glucocorticoid drugs, such as Dexamethasone. At the end of the course of therapy, the condition of the cervix is assessed, and if there is no improvement, then there is a need for surgical correction - the so-called "cervical cerclage". The procedure is carried out at 17-21 weeks under anesthesia and consists of suturing the cervix in order to hold the growing fetus in the uterine cavity. After such an operation, the woman remains under medical supervision in the hospital for some time (from 7 to 20 days). To prevent increased uterine tone, therapy is carried out using antispasmodic drugs - Papaverine, No-shpa, etc. Antibacterial drugs are prescribed if pathogenic microflora is detected or an infection occurs. After discharge from the hospital, the woman is required to visit a gynecologist twice a week for careful monitoring of the condition of the cervix, taking a smear for flora, and bacteriological culture. Prenatal hospitalization of a pregnant woman is carried out at a period of 37 weeks (at this time, stitches are removed).

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

What to do if the cervix is short?

A short cervix is not a death sentence for a woman, but when planning a pregnancy, such a pathology should not be ignored. The fact is that it is precisely because of a shortened cervix (the length of which is less than 2.5-2 cm) that the process of bearing a child can proceed with very serious complications, the main one of which is isthmic-cervical insufficiency. Such a problem often causes a threat of termination of pregnancy or premature (rapid) labor.

What to do if the cervix is short? First of all, strictly follow all the doctor's recommendations and prescriptions aimed at maintaining the pregnancy. Unfortunately, this pathology is most often detected during the period of bearing a child, during a gynecological examination, and is confirmed by an ultrasound examination during an intravaginal examination.

If such a problem occurs, a woman may face the inability to carry a fetus normally and give birth without medical intervention. The normal cervix is approximately 4 cm long. If in the first and second trimesters it shortens to 2-3 cm, we can talk about the development of isthmic-cervical insufficiency. This condition is characterized by softening and widening of the sphincter, as a result of which the first section of the birth canal may open, which is fraught with premature birth.

The congenital form of ICI is most often associated with a genetic predisposition or individual features of the female body structure. The acquired nature of this pathological condition may be a consequence of medical and spontaneous abortions (miscarriages), previous births that were complicated by injuries (ruptures), as well as surgical interventions in the uterine cavity and other factors that in one way or another lead to injury to the cervix and its deformation, scarring, etc. Thus, an expectant mother diagnosed with a "short cervix" must follow the instructions of a gynecologist and, if necessary, undergo in-patient treatment in order to maintain the pregnancy.

Medical 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, concomitant pathologies, the results of studies and diagnostic measures. To avoid possible consequences, it is important to carry out early prevention of the disease: visit a gynecologist in a timely manner, use reliable methods of contraception, and plan pregnancy wisely.

The medications prescribed for therapy will depend on the causes that provoked the pathology. First of all, the pregnant woman needs to take a blood test to determine the level of hormones. If the reason for the shortening of the cervix is a hormonal imbalance, the danger can be eliminated with the help of hormonal therapy. The pregnant woman is prescribed glucocorticoid drugs: Microfollin, chorionic gonadotropin, Turinal, Dexamethasone, etc.).

In case of minor changes in the cervix, a conservative method is used, which consists of intravenous administration of Ginipral or Magnesia. These drugs eliminate the tone of the uterus. Other drugs include sedatives (motherwort, valerian), multivitamins, and drugs that relax the smooth muscles of the uterus. Several weeks of intensive therapy give a positive result, and the condition of the cervix stabilizes. If the problem persists, surgical correction (sutures) or an obstetric pessary is used, which holds the uterus in the correct position.

If isthmic-cervical insufficiency develops due to a short cervix, the expectant mother is prescribed tocolytics - drugs that promote relaxation of the uterus (b-adrenergic agonists, magnesium sulfate, indomethacin). Vasodilators and vasoactive drugs, as well as low-molecular dextrans, are used to prevent placental insufficiency. Non-drug methods of therapy include acupuncture, uterine electrorelaxation, electroanalgesia, and endonasal galvanization.

Utrozhestan

A short cervix during pregnancy is often a factor that provokes the threat of miscarriage. If the condition worsens against the background of hormonal imbalance, the expectant mother is prescribed drugs that are aimed at reducing the contractile activity of the uterus.

Utrozhestan is one of such drugs (available in capsules and vaginal suppositories). Its use is associated with a situation when the pregnant woman's body does not produce enough of the hormone progesterone. The dosage of this drug is selected individually in each case, based on the symptoms of threatened miscarriage and their severity. The usual dose is 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 in cases of threatened miscarriage due to a lack of progesterone. Therefore, a pregnant woman should not worry that this hormonal drug can harm her health or negatively affect the development of the fetus. On the contrary, this drug is necessary, and if it is taken as prescribed by a doctor, there will be no side effects. Moreover, this natural progesterone is obtained from plant materials. In the first trimester, intravaginal use of the drug is recommended, but with vaginal use, the drug is absorbed faster and is better tolerated by the body.

Ginipral

A short cervix often provokes unexpected complications during pregnancy (ICI, increased uterine tone, fetal infection), so it is important to identify the pathology in time and avoid serious problems.

Ginipral is prescribed to the expectant mother if she has hypertonicity of the uterus. This condition not only increases the risk of miscarriage or premature birth, but also "slows down" the flow of nutrients and oxygen to the fetus. The drug is available in tablet form or as an injection and has a direct effect on the vessels of the uterus, promoting "soft" relaxation of the reproductive organ. It should be noted that in the first trimester, taking this drug is contraindicated. It can only be prescribed after the 16th week, and the dosage and duration of administration are determined by the doctor. In this case, it is necessary to monitor blood pressure and blood sugar levels. If the pregnant woman has a strong uterine tone, the dose of Ginipral can reach 500 mcg when taken every 3 hours.

Contraindications also include individual intolerance to the components of the drug, hyperthyroidism, glaucoma, bronchial asthma, heart disease, renal and hepatic insufficiency. Side effects associated with the use of this drug include headaches, rapid heartbeat, agitation, dizziness. Therefore, along with Ginipral, drugs are prescribed that reduce cardiac activity. To avoid swelling, pregnant women are recommended to limit fluid and salt intake. The drug is discontinued gradually, the dose is reduced with each dose.

Magnesia

A short cervix is a factor in the development of isthmic-cervical insufficiency, which means that a pregnant woman is at risk of spontaneous miscarriage or premature birth. If pathology is detected, it is necessary to prescribe medications aimed at eliminating the main problem - uterine hypertonicity.

Magnesia (magnesium sulfate) is an effective drug that helps prevent various complications when there is a threat of miscarriage. Its action is aimed at relaxing the muscles and vascular walls, normalizing blood pressure, and accelerating the removal of fluid from the body. The effectiveness of this drug is only evident when administered intramuscularly and intravenously. Taking it in powder form will not give the desired result, since the drug will not enter the bloodstream from the intestinal tract.

The use of the drug is contraindicated before childbirth and in the first trimester of pregnancy. At later stages 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. the health of the pregnant woman, as well as concomitant pathologies. As a rule, the usual intake of 25% of the drug is 1-2 times a day, in the second stage of nephropathy - 4 times. It should be noted that the introduction of magnesia is a very painful process that requires the experience and skill of a medical specialist.

Side effects that may occur as a result of taking magnesium include weakness, drowsiness, anxiety, headaches, sweating, hypotension, and speech impairment. The drug should not be prescribed for low blood pressure. In addition, it should not be combined with biological food supplements and calcium preparations. Since taking this medication is associated with a certain risk, before starting treatment, the doctor will weigh the pros and cons, taking into account the specific situation.

Duphaston for short cervix

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

Duphaston for a short cervix is used if a pregnant woman has problems with bearing a child and she has hypertonicity of the uterus. This drug is a synthetic analogue of the hormone, but its structure is close to natural progesterone produced in the woman's body. The effectiveness and safety of the drug (especially in the early stages, up to 16 weeks) has been proven by its many years of use. A positive property of the drug is its gentle effect on the liver and blood clotting. The treatment regimen and dosage of Duphaston should be selected by the doctor on an individual basis, based on the clinical picture and the patient's condition.

Usually, in case of a threatened miscarriage, the dosage of the drug is 40 mg once, and then reduced to 10 mg every 8 hours. Therapy continues until the symptoms disappear completely. If, after stopping taking Duphaston, symptoms recur, it is necessary to continue the therapy, returning to the optimal dosage.

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Folk remedies

A short cervix is a pathology that can lead to such a dangerous condition during pregnancy as isthmic-cervical insufficiency. In this case, the internal cervical os is unable to cope with the "locking" function, and it is more difficult for the uterus to hold the growing fetus in its cavity. Under pressure, the cervix shortens and opens even more, which provokes the threat of miscarriage or premature (usually rapid) labor. In addition, due to the deformed cervix, favorable conditions are created for the penetration of infections.

Folk remedies for threatened miscarriage should be used with extreme caution, only after consultation with the attending physician. In this case, effective means are:

• Viburnum bark decoction. Pour one teaspoon of crushed viburnum root with a glass of boiling water, put on low heat and remove after 5 minutes. After the decoction has steeped, you can start taking it: 1-2 tablespoons of the remedy during the day. You can also use viburnum flowers, taking about 30 grams of raw material and pouring 1.5 liters of boiling water over it. Infuse the decoction in a thermos for about 2 hours, then take ¼ glass 3-4 times a day.

• Dandelion decoction. A pinch of grass (5-10 g) should be poured with a glass of boiling water and boiled for a while. It is recommended to use the finished product ¼ glass several times a day. Dandelion root can be used in the same dosages.

A good remedy is an infusion made from calendula flowers and St. John's wort. The ingredients should be taken in equal proportions and poured with 200 g of boiling water, then infused in a thermos for half an hour. The finished infusion should be consumed throughout the day, 2 glasses at a time (you can add honey to taste).

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Herbal treatment

A diagnosis such as a short cervix, if it is established during pregnancy, requires immediate methods of solving the problem, i.e. the appointment of effective therapy aimed at preventing the threat of termination of pregnancy. In addition to medications that should be prescribed by a gynecologist (self-medication is excluded), herbs are often used that have a beneficial effect on the condition of the cervix and a decrease in the tone of the uterus.

Herbal treatment should be carried out strictly under the supervision of a doctor and with his permission, since some plants can have the opposite effect and harm the expectant mother and her child. Of the herbs that have proven their positive effect on the cervix, in particular, its preparation for childbirth, one can single out evening primrose (plant oil). This remedy 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 promotes the elasticity of the cervix, as well as preventing its ruptures during childbirth. Evening primrose in capsules is taken 2 pcs. per day, but from the 39th week, you can gradually increase the dose to 3 capsules.

Herbal infusions (calendula, St. John's wort, viburnum, chamomile, etc.) also have 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 given by tea made from raspberry leaves, it is recommended to take ½ cup before meals. Infusions of hawthorn and rose hips should be consumed 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 pour 1 liter of boiling water together with chopped dry leaves. Then bring the decoction to a boil and cook for 30 minutes, filter, cool and take half a glass (at least 1 liter) during the day.

Homeopathy

A short cervix during pregnancy can cause a lot of trouble for the expectant mother, one of which is ICI, leading to the threat of miscarriage or rapid labor (at a late stage). Along with drug therapy, various homeopathic preparations are used, but their administration should be carried out under strict supervision of a doctor and only according to his instructions.

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

• Arnica – used in complex treatment for the development of isthmic-cervical insufficiency and the threat of termination of pregnancy; improves blood circulation in the pelvic organs;
• Aconitum – usually combined with other remedies for feelings of fear and anxiety, rapid pulse accompanying cervical insufficiency, has a calming effect on the nervous system;
• Arsenicum album is an effective remedy that helps with the body's tendency 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 due to a short cervix;
• Sabina – the drug is indicated for the prevention of miscarriage, more often in the early stages (8-12 weeks);
• Zincum valerianicum – this remedy is used for hyperestrogenism, as it increases the secretion of the hormone progesterone.

In addition to the above homeopathic preparations, a pregnant woman may be prescribed Calcium carbonicum, Sulfur, Silicea (as auxiliary preparations when the therapy is ineffective). When prescribing homeopathy, the anamnesis is taken into account, as well as the characteristics of the patient's constitutional type.

Surgical treatment of short cervix

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

Surgical treatment includes the use of the following methods:

• mechanical narrowing of the internal os of the uterus (a more gentle method);
• suturing the external os (imposition of a circular suture);
• narrowing of the cervix by strengthening its muscles along the lateral walls.

The main indications for the above manipulations are cases of premature birth and miscarriages in the anamnesis, as well as progressive insufficiency of the cervix, i.e. its constant softening and shortening.

The main contraindications for surgical treatment may be:

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

It is most advisable to perform operations in the period from the 13th to the 27th week. In order to prevent the rise of infection, interventions can be performed at the stage from the 7th to the 13th week. If there are contraindications, the pregnant woman is prescribed conservative therapy (medicinal reduction of uterine excitability), bed rest is recommended.

Bandage for a short cervix

A short cervix is not a death sentence, but during pregnancy it is advisable to prevent the development of isthmic-cervical insufficiency in order to maintain the pregnancy. Many women wonder whether it is possible to wear a bandage in this case.

A bandage for a short cervix is indicated when the expectant mother has hypertonicity of the uterus against the background of a shortened cervix, which is physiologically unable to withstand the pressure of the uterus with a growing fetus. The fact is that high tone of the uterine muscles can provoke premature maturation of the cervix. This is fraught with its softening and opening, as well as an increased risk of premature birth or miscarriage. In such cases, the pregnant woman is recommended to completely abstain from any physical activity and wear a special device - a supporting bandage.

It must be worn correctly, without squeezing the tummy. Thanks to such a proven means, it is possible to prevent early descent of the fetus, as well as ensure its correct positioning in the uterine cavity. In addition, modern bandages help a woman prevent stretch marks, relieve physical fatigue, make walking easier, avoid overwork and heaviness in the body. A properly designed bandage can relieve excess stress from the spine and prevent lower back pain.

There are practically no contraindications to the use of such a device, however, a doctor's consultation is mandatory. Usually, the use of a bandage is recommended for expectant mothers in the 4th-5th month of pregnancy, when the tummy begins to increase in size, and the pressure of the fetus on the short cervix increases every day.

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Ring for short cervix

A short cervix can cause many problems for a woman carrying a baby. This is due to the constant pressure of the uterus on the cervix due to the growing fetus. As a result of softening and further shortening of this organ, isthmic-cervical insufficiency may occur, i.e. the threat of termination of pregnancy. In particularly severe cases, a special device is used in medical practice - the so-called "obstetric pessary". In this case, a procedure called "non-surgical cerclage" is performed.

A ring for a short cervix is most often used from 25 weeks, when the pregnant woman is contraindicated to have stitches on the cervix to avoid injury to the amniotic sac and infection of the fetus. An analogy can be drawn between a pessary and a bandage, since both devices are designed to reduce the pressure of the uterus on the cervix and, thus, reduce the risk of infection of the fetus by preserving the sulfur plug.

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

There is also a pessary called the Meyer ring. This device is made of plastic and has a special shape. It is inserted into the vagina to support the cervix and redistribute the weight of the fetus. This is one of the most effective methods of treating ICI, allowing you to maintain pregnancy. The Meyer ring is installed at any time when the pregnant woman's condition is not aggravated by other pathologies, and the ICI is not neglected. Otherwise, this method of treatment can only be used as an auxiliary one.

Exercises for a short cervix

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

Exercises for a short cervix can only be prescribed by the attending physician, since with such a pathology it is necessary to be extremely careful not to provoke premature opening of the cervix. A pregnant woman should definitely consult a doctor on issues related to physical exercises, their types and frequency of performance.

If the expectant mother has hypertonicity 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 advisable to do breathing exercises. In especially severe cases, when the threat of termination of pregnancy increases, any physical activity should be excluded, since it can cause the most dangerous consequences (miscarriage, premature birth).

Today, many pregnant women practice Kegel exercises aimed at physically preparing the perineal and cervical muscles for labor. These exercises can only be performed with the permission of a gynecologist who will objectively assess the situation and health of the expectant mother. The essence of Kegel exercises is to tense the vaginal muscles. The technique is simple: while sitting on a chair, you need to slightly tilt your body forward, and then squeeze and unclench the vaginal muscles 10 times. You should do this simple but effective gymnastics 2-3 times a day.

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