A bit of physiology
The uterus is a unique organ, the structure of which is such that it is able to stretch and increase its size tenfold during pregnancy and return to its original state after childbirth. In the uterus, a large part is isolated - the body located on top, and a smaller part - the neck. Between the body and the cervix there is an intermediate area, which is called the isthmus. The highest part of the body of the uterus is called the fundus.
The wall of the uterus consists of three layers: the inner one - the endometrium, the middle one - the myometrium and the outer one - the perimetrium (serous membrane).
endometrium- mucous membrane, which changes depending on the phase of the menstrual cycle. And if pregnancy does not occur, the endometrium is separated and released from the uterus along with the blood during menstruation. In the event of pregnancy, the endometrium thickens and provides the fetal egg with nutrients for early dates pregnancy.
The main part of the uterine wall is the muscular membrane - myometrium. It is due to changes in this membrane that the size of the uterus increases during pregnancy. The myometrium is made up of muscle fibers. During pregnancy, due to the division of muscle cells (myocytes), new muscle fibers are formed, but the main growth of the uterus occurs due to lengthening by 10-12 times and thickening (hypertrophy) of muscle fibers by 4-5 times, which occurs mainly in the first half of pregnancy , by the middle of pregnancy, the thickness of the uterine wall reaches 3-4 cm. After the 20th week of pregnancy, the uterus increases only due to stretching and thinning of the walls, and by the end of pregnancy, the thickness of the uterine walls decreases to 0.5-1 cm.
Outside of pregnancy, the uterus of a woman of reproductive age has the following dimensions: length - 7-8 cm, anteroposterior size (thickness) - 4-5 cm, transverse size (width) - 4-6 cm. The uterus weighs about 50 g (for those giving birth - up to 100 G). By the end of pregnancy, the uterus increases several times, reaching the following dimensions: length - 37-38 cm, anteroposterior size - up to 24 cm, transverse size - 25-26 cm. The weight of the uterus by the end of pregnancy reaches 1000-1200 g without a child and fetal membranes . With polyhydramnios, multiple pregnancy, the size of the uterus can reach even larger sizes. The volume of the uterine cavity by the ninth month of pregnancy increases 500 times.
What is considered normal?
Pregnancy is characterized by an increase in the size of the uterus, a change in its consistency (density), shape.
Enlargement of the uterus begins at 5-6 weeks of pregnancy (with 1-2 weeks of delay), while the body of the uterus increases slightly. First, the uterus increases in anteroposterior size and becomes spherical, and then the transverse size also increases. The longer the gestation period, the more noticeable is the increase in the uterus. In the early stages of pregnancy, asymmetry of the uterus often occurs, with a bimanual examination, a protrusion of one of the corners of the uterus is palpated. The protrusion occurs due to the growth of the fetal egg, as the pregnancy progresses, the fetal egg fills the entire uterine cavity and the asymmetry of the uterus disappears. By 8 weeks of pregnancy, the body of the uterus increases approximately 2 times, by 10 weeks - 3 times. By 12 weeks, the uterus increases by 4 times and the bottom of the uterus reaches the plane of exit from the small pelvis, i.e., the upper edge of the pubic symphysis.
Bimanual examination of the uterus
To assess the position, size, density (consistency) of the uterus, a two-handed (bimanual) examination is performed. When conducting a bimanual examination, the obstetrician-gynecologist inserts the index and middle fingers right hand into the woman's vagina, and with the fingers of the left hand gently presses on the anterior abdominal wall towards the fingers of the right hand. By advancing and bringing together the fingers of both hands, the doctor gropes for the body of the uterus, determines its position, size and consistency.
From the second trimester of pregnancy (from the 13th-14th week of pregnancy), the uterus extends beyond the small pelvis, and it can be felt through the anterior abdominal wall. Therefore, starting from this period, the obstetrician-gynecologist measures the height of the fundus of the uterus (VDM - the distance between the upper edge of the pubic symphysis and the highest point of the uterus) and the circumference of the abdomen. All measurements are recorded in the individual card of the pregnant woman, which allows you to track the dynamics of the growth of the uterus and evaluate the growth rate. WMD is measured with a centimeter tape or a tazometer (a special device for measuring the distance between two points) in the position of a pregnant woman lying on her back. Before measurement and examination, it is necessary to empty the bladder.
For the normal (physiological) course of pregnancy, the following indicators of WDM are characteristic:
- at 16 weeks of pregnancy, the bottom of the uterus is located in the middle of the distance between the navel and the pubic joint, VDM - 6-7 cm; are guided only by the size of the uterus. Other indicators are also taken into account, such as the date of the last menstruation, the date of the first fetal movement, and the results of an ultrasound examination.
How is the state of the uterus assessed?
If in the first trimester of pregnancy the condition of the uterus is assessed during a bimanual examination, then from about the fourth month, to assess the progression of pregnancy and the condition of the uterus, the obstetrician-gynecologist uses four external obstetric examination techniques (Leopold's techniques):
- At the first reception of an external obstetric examination, the doctor places the palms of both hands on the uppermost part of the uterus (bottom), while determining the VDM, the correspondence of this indicator to the gestational age and the part of the fetus located in the bottom of the uterus. it produces alternate palpation of parts of the fetus with the right and left hand. With the longitudinal position of the fetus, the back is felt on one side, on the other, small parts of the fetus (arms and legs). The back is felt in the form of a uniform platform, small parts - in the form of small protrusions that can change their position. The second technique allows you to determine the tone of the uterus and its excitability (uterine contraction in response to palpation), as well as the position of the fetus. In the first position, the back of the fetus is turned to the left, in the second - to the right.
All techniques are carried out very carefully and carefully, as sudden movements can cause reflex tension in the muscles of the anterior abdominal wall and increase the tone of the uterus.
During an external obstetric examination, the doctor assesses the tone of the muscles of the uterus. Normally, the wall of the uterus should be soft, with an increase in the tone of the uterus, the wall of the uterus becomes hard. Increased tone (hypertonicity) of the uterus is one of the signs of a threatened abortion, it can occur at any time, while a woman, as a rule, feels pain in the lower abdomen and lower back. Pain can be slight, sipping or very strong. The severity of the pain symptom depends on the threshold of pain sensitivity, the duration and intensity of uterine hypertonicity. If the increased tone of the uterus occurs for a short time, then the pain or feeling of heaviness in the lower abdomen is most often insignificant. With prolonged hypertonicity of the muscles of the uterus, the pain symptom is usually more pronounced.
What does a woman feel?
It should be emphasized that during physiological pregnancy, a woman most often does not feel the growth of the uterus, since the process of increasing the uterus occurs gradually and smoothly. At the beginning of pregnancy, a woman may notice unusual sensations in the lower abdomen associated with a change in the structure of the uterine ligaments (they “soften”). With the rapid growth of the uterus (for example, with polyhydramnios or multiple pregnancy), with adhesions in the abdominal cavity, with posterior deviation of the uterus (most often the uterus is tilted anteriorly), if there is a scar on the uterus after various operations, pain may occur. It should be remembered that if any pain occurs, it is necessary to consult an obstetrician-gynecologist as soon as possible.
A few weeks before giving birth, many women experience so-called precursor contractions (Brexton-Hicks contractions). They are in the nature of pulling pains in the lower abdomen and in the sacrum, are irregular, short in duration, or represent an increase in the tone of the uterus, which the woman feels as a tension that is not accompanied by painful sensations. Contractions-harbingers do not cause shortening and opening of the cervix and are a kind of "training" before childbirth.
After childbirth
After the birth of the child and the placenta, already in the first hours of the postpartum period, there is a significant reduction (decrease in size) of the uterus. The height of the bottom of the uterus in the first hours after childbirth is 15-20 cm. The restoration of the uterus after childbirth is called involution. During the first two weeks after childbirth, the fundus of the uterus drops by about 1 cm daily.
- On the 1st-2nd day after birth, the bottom of the uterus is at the level of the navel - VDM 12-15 cm; x factors: characteristics of the course of pregnancy and childbirth, breastfeeding, the age of the woman, general condition, the number of births in history. The uterus contracts more slowly in women over 30 years of age, in weakened and multiparous women, after multiple pregnancies and pregnancies complicated by polyhydramnios, with myoma, as well as when inflammation occurs in the uterus (endometritis) during pregnancy, childbirth or the postpartum period. In lactating women, the involution of the uterus occurs faster, since the hormone oxytocin is produced during breastfeeding, which contributes to the contraction of the uterus.
The uterus will become a home for the future person within ten obstetric months. It ensures its formation, provision with everything necessary and a comfortable stay throughout the entire period. Already from the first weeks of pregnancy, the uterus begins its work: it changes in such a way as to adequately fulfill its task. These changes are invisible appearance women, but they can be seen by a doctor during examination, sometimes a woman herself feels that something is changing in her, rebuilding in anticipation of a new life.
What changes the uterus undergoes with, we will consider in more detail in the article.
A little about physiology
Uterus - muscular organ, in fact, a bag capable of multiplying its own size during gestation and returning to its previous boundaries after the work is done.
It consists of larger and smaller parts: the body and neck, respectively. Between them is an isthmus. The highest point of the uterus is called the bottom.
Three layers of the muscular wall of the organ- internal, middle and external - are called endometrium, myometrium and perimetrium or serous membrane:
- Endometrium - internal, mucous layer. During each menstrual cycle, it undergoes changes: it prepares to receive the embryo, as if laying a comfortable “bed” for it, if the “guest” appeared and attached itself, the endometrium, like a hospitable host, provides it with everything necessary at first. If fertilization did not happen in this cycle, the endometrium in the second phase of the cycle is separated and comes out at the right time along with menstrual blood.
- If the endometrium is responsible for supplying the new organism, then the myometrium provides an increase in the size of the dwelling when it becomes necessary. During the first half of pregnancy, he thickens his muscle fibers and builds up new ones so that they can stretch and lengthen, obeying the fetus growing inside. And if by the middle of the term it increases the wall thickness to 3-4 centimeters, then by its end the thickness is already 0.5-1 centimeter, when the uterus increases, stretching to the maximum limits during pregnancy.
- The perimetrium lines the outer surface of the uterus. It is a connective tissue, the outer side of which is covered with a single layer of squamous epithelium. It performs a protective function, protecting the organ from friction, and also supporting its functions.
What modifications in the early stages are considered the norm
Naturally, with the onset of pregnancy, the uterus undergoes significant changes. Its appearance, size, density, shape changes when the uterus starts its main work - bearing a baby. The following changes take place:
- Appearance. Only a doctor can see with his own eyes what the uterus looks like during pregnancy in the early stages, and even then he will not see the entire organ, but only part of the neck, while ordinary “mortals” have access to photos that can be found on the net if desired. But from what you see, you can draw certain conclusions. Yes, usually color pink, entering an "interesting position", the neck changes color to bluish or, as it is called in medicine, cyanotic. This is due to the expansion of the vascular network and the flow of blood to the organ to provide it with enhanced nutrition and oxygen supply, which is very important for the development of the fetus.
- Dimensions and weight. In the normal state, the size of the uterus is 7-8 x 4-5 x 4-6 centimeters, they remain the same in the early stages of pregnancy, doubling by 8 weeks, and by 12 increasing by 4 times. Its weight in nulliparous women is about 50 grams, in those who have at least one child, it is about 100 grams. At the end of pregnancy, it reaches the following dimensions: 37-38 x 24 x 25-26 centimeters. It weighs about a kilogram or a little more, especially if there is polyhydramnios or multiple pregnancy. The volume of the organ increases 500 times at the end of the term. These parameters may vary depending on concomitant conditions, such as multiple pregnancies or heredity-reported small size. Although these variants are considered a variant of the norm, they are subject to careful control in order to avoid possible pathologies.
- The form. In the normal state, the shape of the organ resembles a pear, but, having accepted the embryo, it changes to a spherical one and has a small protrusion on the side where the point of attachment of the embryo to the uterus is located. Some asymmetry, which is called the Piskacek sign, levels off as the embryo grows.
Did you know? In the days after childbirth, when the uterus has not yet contracted and returned to its previous size, sexual intercourse can be dangerous for a woman, and sometimes her life, due to the possibility of blockage of blood vessels by air bubbles.
The uterus during pregnancy to the touch
Not only the appearance of the reproductive organ is changing, its tissues are also undergoing significant mutation to best provide future life with everything necessary.
Her body becomes soft and supple, the ability to contract is significantly reduced in order to avoid rejection of the embryo. The neck, although it also softens somewhat, remains the hardest part and provides protection for the new inhabitant in the most vulnerable place.
There are a number of signs of pregnancy that guide doctors when conducting a gynecological examination:
- Sign of Snegirev. The body of the pregnant uterus weakly contracts, thickens, and soon softens to its previous state.
- Sign of Gubarev and Gauss. Due to the fact that the isthmus softens significantly during pregnancy, the neck acquires some mobility.
- Horvitz-Hegar symptom. During a two-handed or, medically, bimanual examination, the fingers on both hands touch without effort in the area where the isthmus is located.
Examination by a gynecologist
Going to the gynecologist about the alleged pregnancy, it would not be superfluous to find out that the examination will include not only an examination on the armchair, although this is an important event among others. Doctors will also be interested in diseases in the families of future parents, their bad habits, working and living conditions. Of course, physiological parameters will be recorded, such as height, weight, age of the expectant mother.
Important! There are things that the doctor does not ask about, but fixes on his own during the conversation: the hormonal type, which is determined by the appearance of the skin and hair, physique, temperament, and so on.
If pregnancy occurs, then the first gynecological examination will be the last in its normal course. However, it is very important because it allows:
- visually examine the visible organs and fix the signs of the onset condition by their appearance;
- conduct a bimanual examination that provides information about the consistency of tissues;
- take swabs for flora and infections, which are best treated as soon as possible if their presence is confirmed by a laboratory test.
Important! Only a doctor can determine pregnancy at a very early stage, and even then not for everyone; this requires extensive experience and professional talent. The "older" the pregnancy, the easier it is to determine.
From the beginning of the second trimester, the uterus increases so much that the woman is able to feel its boundaries herself. The Web has instructions on how to feel the uterus during pregnancy on your own, as well as how to take measurements, tracking growth dynamics.
Does a woman feel changes in the size of the uterus
A woman almost always feels some kind of change taking place in her body as she prepares to give birth to a new life. But it is the growth of the uterus during the normal course of pregnancy that few people notice. At an early stage, you may feel some heaviness in or associated with:
- attachment of the fetal egg to the endometrium;
- hormonal changes in the body;
- softening of ligaments and other tissues, which will ensure the passage of the baby through the birth canal during childbirth;
- rapid growth if there is more than one embryo;
- the presence of a scar after surgery or adhesive processes.
These sensations are considered a variant of the norm if they are not accompanied by:
- prolonged and / or intensifying;
- bloody or blood-streaked discharge;
- other secretions of a suspicious type;
- heaviness in the region of the uterus, or a feeling that it was as if petrified.
Uterine tone
The relaxed state of the uterine muscles is considered the norm, and, conversely, their overstrain is called increased tone. This process ensures the expulsion of the fetus from the uterus during labor, but in the early stages, the inconvenience caused by tension in the groin is a rather formidable violation that can lead to undesirable consequences.
Important! Undergo uterine muscle contraction during everyday events such as sneezing, coughing, laughing, orgasm, pelvic exam. The psychological state has no less influence, for example, stress.
Minor contractions differ from hypertonicity in that they are short-lived and do not cause pain or discomfort. In the case of a prolonged state of tone, undesirable complications may develop, entailing unexpected and unpleasant consequences up to the termination of pregnancy.
In the very first weeks, tone is quite common.
Sometimes the muscles begin to contract later dates, this phenomenon is called training bouts or and is regarded by doctors as a kind of "rehearsal" before a responsible event.
Did you know? Statistics show that about 10% of pregnancies end in early miscarriage, but doctors believe that the actual figure is somewhat higher, since some miscarriages occur when the woman does not yet have time to know about the pregnancy.
The state of hypertonicity is dangerous in that the muscles during contraction can squeeze the umbilical cord and disrupt the nutrition and blood circulation of the fetus, as a result of which hypoxia or oxygen starvation and other disorders can develop, provoked by a lack of substances needed in this period.
Exist many reasons that can provoke this condition:
- lack of progesterone shortly after conception;
- excess male hormones;
- early toxicosis, provoking constant muscle tension, including uterine;
- pathology of the structures of the organs of the reproductive system, which is important to know about yourself and warn your doctor in time;
- Rhesus conflict that has arisen between the organisms of the future mother and fetus;
- infectious processes of the genitourinary system;
- severe muscle tension, especially with multiple pregnancies or polyhydramnios;
- individual causes such as miscarriages, abortions, severe gas formation;
- emotional and psychological state of the expectant mother.
Did you know? In favor of the argument about the influence of the emotional state on the tone of the uterus is the fact that more than on other days, babies are born on Tuesdays, and fewer on weekends.
Tone is characterized by the following features:- pain localized in the lower abdomen;
- pain sensations similar to those that occur with;
- back pain and sacral departments spine;
- visually discernible muscle tension on the abdomen at a later date;
- possible spotting with blood fragments.
Important! A woman may not experience anything special with tone, but this condition does not become less dangerous.
This condition is diagnosed with visual or. Having identified it, the doctor prescribes the appropriate treatment for the condition, and if hospitalization is indicated, you should not refuse it, especially if the doctor's recommendation is persistent.
There are ways to independently reduce the tension of the muscles of the uterus after normalization of the condition with the help of prescribed drugs.
Exercises, able to cope with the tone:
- exercise "cat": standing on all fours, bend your back and raise your head up, lingering in this position for several seconds, then arch your back and lower your head, repeat three times, after which you should lie down for an hour, relaxing;
- relaxation of the muscles of the face and neck: tilt the head, relax all the muscles on the face and neck, breathe through the mouth, stay in this position for about 10 minutes;
- simply standing on all fours can also be quite effective.
Important! Therapy in combination with gymnastics can be quite effective, but if these activities do not have the desired effect, you should consult a doctor as soon as possible.
Displacement of the uterus to the right or left
Lateroversia - deviation of the uterus to the right or left side. This is a pathological process that occurs due to inflammation localized in the tubes or ovaries, and provokes the formation of adhesions. The uterus involved in what is happening shifts to the side where the focus is located.
Other reasons for this deviation may include:
- myomas, fibromyomas, other unilateral tumors;
- cystic formations on the ovaries.
Determine the cause of the deviation of the body in the direction of the pathological process under the power of the doctor after a series of studies. He also develops a strategy for further behavior by analyzing the available information.
If the uterus hurts during pregnancy
At any moment of the "special position" pain is possible. Most often this is a consequence of contraction of the muscles of the uterus.
Uterine pain during pregnancy for other reasons:
- in the early stages, this may mean the attachment of the fetal egg, in which case the pain passes quickly and is insignificant;
- may mean the growth of the organ, when it increases in size, the pain is quite intense, but also passes quickly;
- a lack of the hormone progesterone can provoke the tone of the uterus - its contractions, painful, aching, quite strong, the condition requires the prompt intervention of medicine;
- the cause of pain and tone can also be a mechanical effect from the side Bladder or intestines, so you need to carefully monitor the timely emptying of both, to prevent.
Did you know? Pregnancy lasts forty weeks, everyone knows that. Otherwise, it is considered in lunar or obstetric months, of which there are not nine, but ten. It is customary to count the gestational age from the first day of the cycle, when it has not actually arrived, and not from the day, which is not known to everyone.
The uterus is designed to carry and give birth to a baby with comfort and without stress, providing it with everything necessary for growth, development and a safe exit into the world. She does not always cope with the task assigned to her, but with the prudent approach of the expectant mother and the experience gained modern medicine, it is really possible to cope with most problems, unlike the times even half a century ago, when pregnancy issues were relevant for our grandmothers.
The uterus is a unique organ, the structure of which is such that it is able to stretch and increase its size tenfold during pregnancy and return to its original state after childbirth. In the uterus, a large part is isolated - the body located on top, and a smaller part - the neck. Between the body and the cervix there is an intermediate area, which is called the isthmus. The highest part of the body of the uterus is called the fundus.
The wall of the uterus consists of three layers: the inner - the endometrium, the middle - the myometrium and the outer - the perimetry (serous membrane).
endometrium- mucous membrane, which changes depending on the phase. And if pregnancy does not occur, the endometrium is separated and released from the uterus along with the blood during menstruation. In the event of pregnancy, the endometrium thickens and provides the fertilized egg with nutrients in the early stages of pregnancy.
The main part of the wall of the uterus is the muscular membrane - myometrium. It is due to changes in this membrane that the size of the uterus increases during pregnancy. The myometrium is made up of muscle fibers. During pregnancy, due to the division of muscle cells (myocytes), new muscle fibers are formed, but the main growth of the uterus occurs due to lengthening by 10-12 times and thickening (hypertrophy) of muscle fibers by 4-5 times, which occurs mainly in the first half of pregnancy , by the middle of pregnancy, the thickness of the uterine wall reaches 3-4 cm. After the uterus increases only due to stretching and thinning of the walls, and by the end of pregnancy, the thickness of the uterine walls decreases to 0.5-1 cm.
Outside of pregnancy, the uterus of a woman of reproductive age has the following dimensions: length - 7-8 cm, anteroposterior size (thickness) - 4-5 cm, transverse size (width) - 4-6 cm. The uterus weighs about 50 g (for those giving birth - up to 100 G). By the end of pregnancy, the uterus increases several times, reaching the following dimensions: length - 37-38 cm, anteroposterior size - up to 24 cm, transverse size - 25-26 cm. The weight of the uterus by the end of pregnancy reaches 1000-1200 g without a child and fetal membranes . With polyhydramnios, multiple pregnancy, the size of the uterus can reach even larger sizes. The volume of the uterine cavity by the ninth month of pregnancy increases 500 times.
Enlargement of the uterus during pregnancy. What is considered normal?
Pregnancy is characterized by an increase in the size of the uterus, a change in its consistency (density), shape.
Enlargement of the uterus begins in (with 1-2 weeks of delay), while the body of the uterus increases slightly. First, the uterus increases in anteroposterior size and becomes spherical, and then the transverse size also increases. The longer the gestation period, the more noticeable is the increase in the uterus. In the early stages of pregnancy, asymmetry of the uterus often occurs, with a bimanual examination, a protrusion of one of the corners of the uterus is palpated. The protrusion occurs due to the growth of the fetal egg, as the pregnancy progresses, the fetal egg fills the entire uterine cavity and the asymmetry of the uterus disappears. To the body of the uterus increases approximately 2 times, to - 3 times. To the uterus increases 4 times and the bottom of the uterus reaches the plane of the exit from the small pelvis, i.e., the upper edge of the pubic joint.
Bimanual examination of the uterus
To assess the position, size, density (consistency) of the uterus, a two-handed (bimanual) examination is performed. When conducting a bimanual examination, the obstetrician-gynecologist inserts the index and middle fingers of the right hand into the woman's vagina, and with the fingers of the left hand gently presses on the anterior abdominal wall towards the fingers of the right hand. By advancing and bringing together the fingers of both hands, the doctor gropes for the body of the uterus, determines its position, size and consistency.
How is the state of the uterus assessed?
If in the first trimester of pregnancy the condition of the uterus is assessed during a bimanual examination, then from about the fourth month, to assess the progression of pregnancy and the condition of the uterus, the obstetrician-gynecologist uses four external obstetric examination techniques (Leopold's techniques):
- At the first reception of an external obstetric examination, the doctor places the palms of both hands on the uppermost part of the uterus (bottom), while determining the VDM, the correspondence of this indicator to the gestational age and the part of the fetus located in the bottom of the uterus.
- At the second external obstetric examination, the doctor moves both hands from the bottom of the uterus down to the level of the navel and places it on the lateral surfaces of the uterus, after which he alternately palpates the parts of the fetus with his right and left hands. With the longitudinal position of the fetus, the back is palpated on one side, and small parts of the fetus (arms and legs) on the other. The back is felt in the form of a uniform platform, small parts - in the form of small protrusions that can change their position. The second technique allows you to determine both its excitability (uterine contraction in response to palpation), as well as the position of the fetus. In the first position, the back of the fetus is turned to the left, in the second - to the right.
- At the third appointment, the obstetrician-gynecologist determines the presenting part of the fetus - this is the part of the fetus that faces the entrance to the small pelvis and passes through the birth canal first (more often it is the head of the fetus). The doctor stands on the right, face to face with the pregnant woman. With one hand (usually the right hand), palpation is carried out slightly above the pubic joint, so that the thumb is on one side, and the other four are on the other side of the lower part of the uterus. The head is palpable in the form of a dense rounded part with clear contours, the pelvic end is in the form of a voluminous softish part that does not have a rounded shape. With a transverse or oblique position of the fetus, the presenting part is not determined.
- At the fourth appointment, palpation (palpation) of the uterus is carried out with both hands, while the doctor becomes face to the legs of the pregnant woman. The palms of both hands are placed on the lower segment of the uterus on the right and left, with outstretched fingers carefully palpate the height of its standing and the presenting part of the fetus. This technique allows you to determine the location of the presenting part of the fetus relative to the entrance to the mother's small pelvis (the presenting part is above the entrance to the small pelvis, pressed against the entrance, descended into the pelvic cavity). If the head is present, then the obstetrician determines its size, the density of its bones and the gradual lowering into the small pelvis during childbirth.
All techniques are carried out very carefully and carefully, as sudden movements can cause reflex tension in the muscles of the anterior abdominal wall and increase the tone of the uterus.
During an external obstetric examination, the doctor assesses the tone of the muscles of the uterus. Normally, the wall of the uterus should be soft, with an increase in the tone of the uterus, the wall of the uterus becomes hard. Increased tone (hypertonicity) of the uterus is one of the signs of pregnancy, it can occur at any time, while a woman, as a rule, feels pain in the lower abdomen and lower back. Pain can be slight, sipping or very strong. The severity of the pain symptom depends on the threshold of pain sensitivity, duration and intensity. If the increased tone of the uterus occurs for a short time, then the pain or feeling of heaviness in the lower abdomen is most often insignificant. With prolonged hypertonicity of the muscles of the uterus, the pain symptom is usually more pronounced.
How does a pregnant woman feel?
It should be emphasized that during a physiological pregnancy, a woman most often does not feel the growth of the uterus, since the process of increasing the uterus occurs gradually and smoothly. At the beginning of pregnancy, a woman may notice unusual sensations in the lower abdomen associated with a change in the structure of the uterine ligaments (they "soften"). With the rapid growth of the uterus (for example, with polyhydramnios or multiple pregnancy), with adhesions in the abdominal cavity, with posterior deviation of the uterus (most often the uterus is tilted anteriorly), if there is a scar on the uterus after various operations, pain may occur. It should be remembered that if any pain occurs, it is necessary to consult an obstetrician-gynecologist as soon as possible.
A few weeks before giving birth, many women experience so-called precursor contractions (Brexton-Hicks contractions). They are in the nature of pulling pains in the lower abdomen and in the sacrum, are irregular, short in duration, or represent an increase in the tone of the uterus, which the woman feels as a tension that is not accompanied by painful sensations. Precursor contractions do not cause shortening and opening of the cervix and are a kind of "training" before childbirth.
This project was led by a 25-year-old woman. She has never given birth and has no history of STDs. Each photo was taken at approximately 10:00 pm, starting on the first day of the menstrual cycle. Throughout this project, she used condoms as a method of contraception, and also to ensure that there was no seminal fluid at the time of the photo shoot. She did not use tampons during her period.
This cycle is 33 days, which is the norm. The follicular phase of her cycle lasts until about 20–21 days. auspicious days for fertilization last several days from the 13th to the 21st day with ovulation on the 20th day. The luteal phase is 13 days (12-16 days is normal).
The above is for this cycle. As you can see, after ovulating around the 20th day, her temperature began to rise due to increased progesterone, which in turn is produced by the corpus luteum. This temperature shift means that ovulation has already occurred.
She also monitored the position of the cervix throughout the cycle. Since the photo does not show a hard or soft, high or low cervix. All this is clearly visible with independent probing. The uterus is tilted back (retroflexion), you can see in a few photos that the cervix is pointing up. These are anatomical changes that are present in 20-30% of women and are most often a genetic trait.
The first day
The blood is red, there are small cramps in the lower abdomen.
Chest slightly swollen.
Feelings are very sexual.
Second day
Blood is dark red.
The chest is normal.
Day Three
Blood - brown, sometimes watery dark red.
Day four
Notice the fresh blood.
Day five
Brown colour.
Tired state.
Day six
Very light brown discharge.
Day seven
Neck in a low, closed position.
There is a sticky liquid on the neck.
Day eight
The cervix is low and closed.
Cervical fluid is white and sticky.
Day nine
The cervix is low and closed.
Feeling dry.
Day ten
The cervix is low and closed.
Note the drop of blood and the brown lump near the cervix (right). Perhaps from stormy communication on the same day, but later an endometrial polyp was diagnosed.
Day Eleven
Creamy cervical fluid.
Day twelve
Cervical fluid is milky white. Wet feeling.
I feel very sexy.
Day thirteen
Profuse watery discharge.
The neck, softened and move up.
Day fourteen
White, clear, watery cervical fluid that stains linen.
Day fifteen
Cervical fluid changes to discharge resembling egg white.
The neck is soft, open and high.
Day Sixteen
Cervical fluid like egg white, very wet.
The neck is soft and high.
Day seventeen
Cervical fluid is very thin, with whitish-yellow streaks. Sensual breasts, but not painful.
Liquid stretches between fingers.
Day eighteen
Egg white.
Day nineteen
Egg white with a white tint.
Day Twentieth
Slight pain in the back and cramps on the left side.
Suspicion of ovulation.
Feeling of intense sexuality.
Cervical fluid like gelatinous egg white.
twenty first day
Cervical fluid is like glue.
Nipples are very sensitive and painful.
Day twenty two
Painful nipples.
Neck in middle position and slightly open.
Basal body temperature begins to rise.
Day twenty three
Very sensitive nipples.
Feeling dry.
Day twenty four
Very sensitive nipples.
Dry.
The neck is firm and high.
Day twenty five
Headache and fatigue.
Cervical fluid is dry/sticky.
Day twenty six
Breasts swollen.
Basal body temperature is now noticeably higher, by about 1 degree.
Day twenty seven
Painful nipples, swollen breasts.
The cervical fluid is sticky.
Day twenty eight
Feeling dry.
Day twenty nine
Feeling dry.
Day thirtieth
Feeling dry.
The chest is heavy.
Day thirty one
Feeling bloated.
Dry, (note fresh blood, a sign of impending menstruation).
Feeling of emotional instability.
Day thirty two
Light brown spots.
The neck is low and open.
Feeling tired.
Day thirty three
Pink spots.
Pain in the lower back.
Menstruation will start tomorrow after waking up, 13 days after ovulation.
Article taken from the Internet! Who is not interested in not fu ... kat!
Pregnancy shows signs of the presence of a fetal egg from the very beginning. The changes concern primarily the reproductive organs. Therefore, it is natural that in the early stages of pregnancy the cervix becomes different than before. So the changes taking place with her are one of the many symptoms of an event awaiting a woman.
Read in this article
Cervix: where is it?
Not all women will be able to explain, if necessary, what kind of segment of the reproductive system it is, where it is located and what significance it has. This is logical, it is impossible to keep track of the health or dysfunction of the cervix on your own. Its examination and evaluation is the responsibility of the examining gynecologist.
The cervix is the part of this organ that is visible during visual examination, which is transitional to the vagina and connects them to each other. It produces mucus at all stages of the menstrual cycle. The role of the cervix during gestation cannot be underestimated, it is it that largely ensures the retention of the fetal egg in its proper place. During examination, only its vaginal part can be detected, but this is enough to assess the state of gynecological health. On examination, it looks like a round, protruding formation, covered with a mucous membrane and having a small hole in the middle.
The usual size of the organ is 4 cm in length and 2.5 in circumference, the consistency is firm, the pharynx is closed, it becomes slightly wider on critical days for the release of secretions.
A change in the cervix in early pregnancy is quite noticeable to a specialist, which makes it possible to detect this condition. It is considered one of the important signs, along with the cessation of menstruation.
Signs of changes in the uterus after conception
The uterus itself begins to noticeably change from about the 4th week of pregnancy, when the grown fetal egg causes protrusion of its wall, an increase in the size of the organ and asymmetry. This is also able to detect a specialist. Which cervix in early pregnancy depends on the length of time from its onset. But the increase in progesterone, which is observed immediately after the fertilization of the egg, leads to the fact that the organ changes purely visually. This is easy to see during a gynecological examination. An experienced doctor can accurately determine the period from the moment of conception.
The cervix during early pregnancy acquires the following differences from the previous state:
- The color of her mucous membrane becomes cyanotic, and before fertilization it was pink. Do not be afraid of these changes, they are caused by the growth of blood vessels, the activation of metabolic processes. This is necessary to improve blood supply in this area, since the formation of the membranes of the fetus, its nutrition requires a large amount of oxygen;
- Its position changes relative to the main part of the organ;
- When touched during inspection, tissues become different in consistency.
How does the location of the vaginal part of the cervix change?
The reproductive organs, when an embryo appears, adapt to it in such a way as to ensure normal development, comfort and protect against possible dangers. This dictated the new position of the cervix in early pregnancy. It is impermanent and before it, it changes at different stages of the cycle. But in general, this part of the body is relatively high relative to the vagina. This is especially noticeable during ovulation, when the body seeks to facilitate the penetration of spermatozoa to the female reproductive cell as much as possible.
The location of the cervix in early pregnancy becomes lower than usual. It falls under the influence of progesterone, preventing the fetal egg from slipping out. The course of the process depends on the level of the cervix in early pregnancy, high or low.
If the cervix is high, this may mean an increased tone of the organ itself, which creates the danger of interruption. Some women, because of this circumstance, have to spend almost the entire period in a horizontal position. But the doctor will also take into account and evaluate other existing signs. Perhaps the high position of the neck is a feature of a particular organism that does not threaten the fetus in any way.
Neck consistency
The cervix to the touch early pregnancy quite soft compared to the previous state. This is due to the expansion of its vessels, swelling and more active work of the glands. Progesterone, an indispensable companion of pregnancy, also plays its role, making the uterus itself and the endometrium lining it also looser and thicker. But in comparison with the consistency of the walls of the organ, the neck is denser. It is, as it were, a castle that guards the approaches to the fetus. That does not prevent her from being more mobile than before conception.
Many are afraid that if the cervix is soft to the touch during early pregnancy, it will not hold the fertilized egg. There are no grounds for fears, since its channel is significantly narrowed, and the tissues normally still remain elastic and difficult to stretch until a certain time. The glands begin to actively produce mucus, which becomes thicker and more viscous. A large clot of secretions forms in the cervical canal, called a plug. It performs several functions at once:
- does not allow foreign bacteria to enter the uterine cavity;
- helps to maintain the balance of microorganisms in the vagina;
- creates comfortable conditions for the functioning of the reproductive organs.
If the cervix in the early stages of pregnancy is too hard to the touch, this may signal an excessive tension of the organ itself, called. This condition threatens the rejection of the fetal egg. It is unrealistic to assess the consistency of the cervix on your own, without being a specialist.
Therefore, you should not "wind" yourself if it seems too soft or hard during self-examination. Regular visits to the gynecologist are a guarantee that the pathology will be detected before it is too late to correct it.
What is a short neck
Not many women get pregnant without any problems. And one of the most serious is the threat of interruption, which is caused by various reasons.
The development of the fetus and its weight gain increase the pressure on the cervix. In extreme cases, it shrinks in size and can no longer serve as a full-fledged protection for the fetus. This condition of the cervix in early pregnancy is most often caused hormonal reasons, but it happens with injuries received by the body in the past, multiple pregnancy and polyhydramnios. This phenomenon is referred to as isthmic-cervical insufficiency and requires constant medical supervision and subsequent treatment. Symptoms of shortening of the cervix during pregnancy, detected by a specialist:
- Too soft texture of its tissues;
- Excessive mobility of this part of the organ;
- Expanded lumen of the cervical canal.
In some women, these signs are mild, but in any case, she herself will not notice the problem, especially in the first weeks. It is important that the doctor has the opportunity to see the anomaly, both visually and with the help of ultrasound. This requires timely registration and a lot of surveys.
What is the danger of shortening the neck
In early pregnancy, shortening the cervix is dangerous by increasing the likelihood of miscarriage. Instead of a dense ring that protects the embryo from falling out of the cavity, isthmic-cervical insufficiency leads to the appearance of an element that provokes bleeding next to it. This part of the body is not able to contain the increasing pressure, which leads to the tone of the uterus. She becomes hard, tense, her muscles at any moment can begin to actively contract and decompress, trying to reject the fetal egg.
At an early stage, this is dangerous because the symptoms of cervical contraction during pregnancy are not always noticeable to the woman herself. Shortening of a section of an organ is also detected using transvaginal ultrasound, which is prescribed at different times. Some women experience:
- Appearance of watery discharge. They are in this state and are normal, but usually thick and not in such a large amount;
- Mixing blood drops to transparent mucus;
- Increased need to urinate;
- Pulling pain in the lower abdomen, lower back, discomfort in the form of tingling in the vagina.
Sometimes the short length of this part of the organ is congenital, in more common cases it is an acquisition. But in order not to provoke a shortening of the cervix herself and not pose a threat to the child, a woman needs to take care of this even before pregnancy, that is:
In addition to a gynecological examination using mirrors and a two-handed examination, the doctor will refer the woman for microflora analysis. It is necessary to make sure that there are no venereal infections and a fungus in the body that can harm the fetus. We are talking about the microflora of the vagina, but it affects the state of the cervix in the most direct way.
Another study on cytology studies the structure of the cells of this part of the organ. The cervix during pregnancy in the early stages is not at all immune from their degeneration into malignant ones. Two more problems that are sometimes found at the beginning:
- Endocervicitis. Infectious inflammation of the cervix can lead to the penetration of bacteria into the organ cavity, infection of the fetus, weakening of the muscles and, as a result, miscarriage. Therefore, treatment should be carried out immediately. The disease is manifested by the fact that in the early stages of pregnancy, the infected cervix produces purulent instead of mucous secretions;
- . Its formation can be caused by pregnancy, and provoked by other reasons. But in any case, treatment is carried out after childbirth, and before them, the state of the epithelium is monitored. Erosion looks like redness or sore on the surface of the mucosa.
In early pregnancy, an altered cervix is not only one of the symptoms " interesting position". In addition to protective functions for the fetus, it informs about possible problems which, if not taken adequate measures, can lead to the worst. Therefore, women should not be afraid and avoid gynecological examination and intravaginal ultrasound, especially if there is a history of abortion, miscarriage, and premature birth.
