Small Cervix During Pregnancy

The cervix is the opening to the womb which is situated between the vagina and the uterus. It is the part of the uterus that allows the outflow of menstrual blood flow and the entry of sperm when a woman is not pregnant. After pregnancy, it is the slippery fluid in the cervical canal that protects the fetus. The cervix of a pregnant woman is supposed to be firm, thick, long, and closed with a mucus plug. As the expectant mother reaches delivery time, the cervix stretches and thins out to up to 10 centimeters so that the baby’s head can come out. However, there are cases wherein the expectant mother’s cervix is smaller than the usual 3 to 5 centimeters.

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This shortness is often caused by the hormonal influx that pregnancy brings along with it. A small cervix means there isn’t enough space for the baby which can lead to an early dilation resulting in an early labor. A small cervix is one of the causes of a woman going into preterm labor. This condition is called incompetent cervix or cervical incompetency. See also friable cervix

After conception, through the process of implantation, the embryo embeds itself in the uterine wall. Hence, the uterus provides the embryo with a protected environment that is safe from the dangers of the external world so that it can grow and develop. As the pregnancy progresses, the uterus expands in order to provide the baby with sufficient room to grow and move around. Because of this, we observe that the uterus grows in proportion to the baby within. Therefore, the size of the uterus can be used to determine if the growth of the baby is suitable as per its gestational age. In most cases, the uterus may appear smaller for the gestational age because of a miscalculation of the gestational age based on a wrong date of the last menstrual period. In simple words, the woman may not be as far into the pregnancy as estimated. A small uterus during pregnancy could be indicative of certain pregnancy complications. The main pregnancy complication associated with a small uterus is an irregular growth rate of the baby. This may be indicative of a genetic disorder in the baby and further medical investigation would be required to check for the same. A leak in the amniotic fluid that cushions the baby could also lead to a smaller than expected uterus size as the fluid would be less than the normal amount. Maternal diabetes or maternal obesity could also influence the size of the baby, resulting in a smaller than normal or larger than normal gestational size.

The placenta is an extremely essential pregnancy organ. Like the uterus, the placenta also grows along with the baby, reaching an approximate weight of half a kilo by the end of the pregnancy term. It not only provides the baby with nourishment and oxygen drawn from the mother’s bloodstream but also helps in boosting the baby’s immune system by carrying IgG antibodies to the baby. It also acts like a sieve minimizing the risk of the passage of dangerous viruses like HIV from the mother to the child. It also maintains a store of blood for the baby in case of an emergency. In addition to these features, the placenta is responsible for the production of pregnancy hormones such as hCG, hPL, progesterone, and estrogen which are needed for the success of the pregnancy as well as the production of maternal milk. A small placenta during pregnancy could therefore hinder the progress of the pregnancy as it would not be able to execute all these functions effectively. Hence, it could lead to low gestational weight, fetal growth retardation and deformities in the developing baby. A small placenta also increases the chances of miscarriage, stillbirths and preterm deliveries.

Problems associated with a small cervix in pregnancy

The cervix plays a crucial role when it comes to pregnancy. Cervical health is not only vital for conception but also essential for the completion of a pregnancy term as well as during the natural process of child birth. There are a number of problems with small cervix in pregnancy. Small cervix pregnancy complications mainly arise as a result of repeated vaginal infections, prior cervical procedures, illnesses and trauma to the cervix. Some women are born with a small cervix. A small cervix and infertility could be linked as a narrowed cervix adversely affects the ability of the sperm to swim through to the mature egg in the fallopian tube. If sperm is not exposed to the eggs released during ovulation, conception cannot take place resulting in natural infertility. A small cervix could also cause complications at the time of childbirth as the baby would not be able to pass through a narrow opening. In such cases, a c-section may be inevitable. In some cases, dilators may be used to temporarily widen the cervix. In most cases, following a natural vaginal delivery, the cervix widens on its own making consecutive pregnancies less complicated as well as reducing the pain experienced during menstruation.

Cervix Changes and Position during Ovulation

The cervix undergoes a number of changes during menstruation as well as ovulation. The cervix changes during ovulation help when checking for the fertile phase of the menstrual cycle so as to have better chances at conception through good timing. This method can also be used as a natural family planning method by avoiding intercourse during this phase. Just after menstruation, the cervix lies low, is hard, and can be felt with ease by inserting a finger in through the vagina. In the case of women who have had a vaginal delivery, a small round opening is palpable. The cervix gradually rises after that and the cervical position during ovulation is the highest and is much softer. At this stage, it is difficult to reach the cervix. The opening of the cervix widens at this point to allow sperm to swim through easily. The proportion between a small cervix and ovulation opening may be linked with a smaller opening felt during ovulation. As mentioned earlier, fertility may be affected by a small cervix and the chance of conception may be reduced.

Treatment for Small Cervix During Pregnancy

The length of the cervix can be measured clinically by a pelvic exam or a transvaginal ultrasound. And, a small cervix during pregnancy cannot be enlarged. If a woman has had an incompetent cervix during an earlier pregnancy, if her cervix is congenitally defective, or if she has suffered a trauma, she is likely to suffer from the problem again. There are also reasons like some kind of infections and radiation treatments that also cause smaller cervixes. If the expectant mother’s cervix is short, the doctor will ask her to off her feet and take bed rest till the pregnancy reaches its term. She must also abstain from sexual intercourse till she has had the baby. This ensures that there is no pressure on the cervix that will make the woman go into an early labor. Or then, she may have to undergo a cervical surgery called cerclage, in which the cervix is stitched to keep it closed till the pregnancy reaches its term. The cervix can also be capped. The stitches or cap is removed when the mother gets ready for labor. These procedures have to be carried out early during the pregnancy. Since the size of the cervix plays an important part in normal delivery, a regular ultrasound is often recommended to women who have had miscarriages or preterm labor and are planning a baby again.

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Small Cervix And Pregnancy
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