The cervix, better known as the cervix, is a narrow canal located just below the uterus and opening into the vagina. So, in fact, the cervix forms a connection between the uterus and the vagina. The cervix is surrounded by a kind of smart epithelial cells. Thanks to these cells, mucus is produced, the content of which changes throughout the menstrual cycle, while at the same time creating a protection shield during the passage of sperm.
While the mucus produced is sperm-friendly when the egg is released, it takes on a structure that resists sperm at other times.
The cervix is tightly closed in a woman who has not given birth vaginally before, but it is more clearly visible in women who have given birth vaginally. In women who have a normal pregnancy without any health problems, the cervix remains closed towards the end of the last trimester, that is, until close to the time of birth, and as the birth approaches, it softens, shortens and begins to open.
The Cervix. What is Cervical Insufficiency?
Cervical insufficiency is the condition in which the cervix (neck) softens and opens prematurely due to the pressure of the baby growing day by day in the uterus and the amniotic fluid floating in it. Mostly, it occurs between 16-24 days without any symptoms such as bleeding or pain. It is one of the most important causes of premature birth and miscarriage.
While cervical insufficiency is seen in 1 or 2 percent of pregnancies, it occurs in the second trimester of pregnancy, that is, in the 4th-6th months. It is seen as the main cause of a significant portion of all miscarriages that occur between months.
The main causes of cervical insufficiency include genetic (congenital) weakness, multiple pregnancies, excessive stretching or tearing of the cervix in previous births, and cervical cancer.
Who is at Risk?
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If cone biopsy or LEEP procedures have been performed on the cervix,
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If the cervix has been seriously injured in previous births,
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If there has been an unreasonable miscarriage during the second trimester (between the 4th and 6th months),
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If there has been one or more premature births,
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Previous pregnancies If you have had cervical insufficiency in the past,
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If you have a congenital uterine and cervical disorder,
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Your mother used a drug called Diethylstilbestrol while she was pregnant with you. If the patient has taken medication,
cervical insufficiency may occur.
How to Understand Whether There is Cervical Insufficiency?
Cervical insufficiency is generally not noticed in first pregnancies. And there is no accurate way to measure cervical length yet. However, in a pregnant woman, the cervix is in the 4th-6th week. It is understood when a miscarriage occurs, without any contraction or bleeding in the uterus, after it gradually becomes thinner and dilates painlessly over the months.
This disease, which generally does not cause any symptoms, occurs in some pregnant women between the 12th and 20th months. weeks may show the following symptoms;
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Feeling of pressure under the uterus (in the pelvic area),
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Premenstrual cramp-like pain,
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Back and waist pain,
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Increase in vaginal discharge,
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White, Clear or light yellow discharge turning pink or brown,
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Mild vaginal bleeding,
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If you see one or more of the above symptoms between the specified weeks, you should consult your doctor without delay and report your complaints. If there is cervical insufficiency, your doctor will follow you with an ultrasound examination from the 12th to the 23rd week.
And if he deems it necessary (if the cervix is shorter than 25 mm). He applies a stitching procedure called cerclage to ensure that the cervix remains closed until birth (on average, it is taken at the end of the 37th week). Cerclage, usually 12-16 days. It is an easy operation performed through the vagina under local anesthesia, between weeks and weeks. While you can return to your normal life 12 hours after this procedure, sexual intercourse may be prohibited for the remainder of the pregnancy.
Cervical insufficiency and cerclage procedure
The stitches are checked at each subsequent examination and are usually determined by the estimated delivery date. They are taken a few weeks in advance. If cerclage was applied in the first pregnancy, there is no need to apply it again in other pregnancies. However, the doctor may repeat it if he deems it necessary.
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