The successful outcome of normal births depends on the work of the cervix, which in turn depends on the level of hormones in the blood of the parturient woman. During the entire pregnancy, changes take place in the cervix, but before the onset of labor, it should be tightly closed, otherwise the pregnancy can be interrupted before the term.
Cervix before delivery
Before childbirth, under the influence of prostaglandin hormones, there are processes in the cervix of the uterus that are called maturation. There is a certain scale that allows you to evaluate the cervix before giving birth, while assessing the 3 criteria: the consistency, the length of the cervix, the permeability of the cervical canal and its location to the wire axis of the pelvis. Each criterion is evaluated during examination of the cervix from 0 to 2 points:
- an score of 0-2 points corresponds to the immature cervix of the uterus before delivery;
- the score of 3-4 points corresponds to the insufficiently mature cervix of the uterus;
- score 5-6 points - mature cervix.
With a normal course of pregnancy, the cervix should mature by 38-39 weeks. Under the influence of hormones there is a softening of the cervix before delivery, its centering in relation to the wire axis of the pelvis. The length of the cervix before birth is reduced to 10-15 mm and opening of the external throat is 1-2 cm, that is, it becomes passable for 1 finger of the obstetrician.
Cervical dilatation before childbirth
The opening of the cervix before birth occurs gradually and reaches 10 cm (the cervical canal should pass 5 fingers of the obstetrician). Disclosure of the cervix in labor is divided into 2 phases: latent (opening up to 4 cm) and active (from 4 cm to 10 cm). The latent phase in primiparas lasts 6-9 hours, in re-birth 3-5 hours. Since the onset of the active phase, the rate of opening of the cervix becomes 1 cm per hour. The soft cervix of the uterus is easily opened by the pressure of the fetal head on it and the lower pole of the fetal bladder in its channel.
How to help cervical dilatation?
Currently, few modern women can boast of excellent health. Accelerated pace of life, frequent stresses, inefficient nutrition and poor ecology can disrupt the production of prostaglandins in the female body, on which the processes of cervical ripening and its opening directly depend. In order to accelerate the maturation of the cervix and its opening in childbirth, medicinal preparations based on prostaglandins have been developed. A synthetic analogue of prostaglandin E1 (Saitotec) or an analogue of prostaglandin E2 in the form of gel (Prepidil) promotes maturation of the cervix for several hours. But they are used very rarely because of high cost. In childbirth, you can use narcotic and non-narcotic analgesics (promedol, fentanyl, nalbuphine), but they can cause respiratory depression in the fetus after birth and cause the need for an antidote. Efficient and relatively safe method, which helps to open the cervix of the uterus is epidural anesthesia. It is conducted by an anesthesiologist under sterile conditions. It does not adversely affect the fetus, since the drugs administered do not enter the bloodstream, and not only speeds up the opening of the cervix, but also makes the process painless.
Cervical rupture
The better the cervix ripens before birth, the less likely it is to rupture during the birth of the baby. Also the cause of the gap
Thus, the maturation of the cervix is broken for reasons that depend and do not depend on the woman herself. Therefore, the woman herself can help prepare for the birth of her body, observing the regime of the day, eating properly and not thinking about troubles.