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November 2017.Work Cited Thefunction of the cervix plays a primary role during pregnancy keeping the fetusin the uterus until it is mature enough to be delivered and preventing it fromvaginal infections that can enter the uterus via the cervix. Cervicalincompetence and vaginal infections are main contributors to preterm births. By controlling the cervix, the embryo will besafe and healthy inside the uterus until the end of gravidity which is the goalof every pregnancy. Because the preterm birth is the main cause of perinatalmorbidity and mortality worldwide prevention of preterm birth is probably themost important challenge in modern obstetrics. Notonly does the cervix keeps the fetus in the uterus during pregnancy but it canprevent form other risk factors such as infection. The cervix acts as a barrierbetween the fetus and vaginal infections that can lead to early labor since someinfections are very risky if they pass the barrier and enter the uterus.
Considering that, vaginal infections are very common in pregnant women howeverthe amniotic fluid is sterile and the uterus likewise growing fetus is protected from all infections such as bacteriaand viruses by the cervix. Thus, the cervix is considered as a controller andlimits all microbial access by producing the mucus, which plays a role as ananti-microbial. If this blockage is compromised, bacteria may go into theuterine cavity leading to preterm birth (Racicot).Tobe considered normal, the cervical length should be at least 30 mm, if cervixmeasures less than 25 mm then is considered as a risk for the gravidity (Dawes). As the pregnancy continuesin the second trimester, weeks 14 to 27, the pressure will rise in the cervixdue to its position with the fetus. As a result, the cervix may shorten due tothis pressure risking the fetus to be delivered before maturity. This can becalled also as an incompetent cervix when the cervix is shortened, or weakenedcervix, when the cervix is not firm as much as it should be.
Both theseconditions can lead to miscarriage or preterm delivery, even though based on thestatistics this can happen only 1 in 100 pregnant women (americanpregnancy.org). Not only weakenedcervix due to the softness of the muscles can be open and risks the fetus fromreaching full term but also can lead to premature rupture of the membrane,condition in which the bag of water breaks before the 37th week of pregnancy and beforethe onset of contractions. Incompetent cervix usually does not have any symptoms;this is the reason that the risk for miscarriage or preterm birth may be higherthan in other problems that can be identified before is too late (americanpregnancy.org)In the second trimester of pregnancy, in addition tosupplemental screening for anatomic anomalies of the fetus, it is necessary tocarry out an adequate overview of the cervical segment. In the world, nowadays,the importance of ultrasound diagnostics in assessing the cervical segment ismuch more important than a clinical examination. In this way, an endovaginalprobe, as well as transabdominally, is more precisely estimating the length (inmillimeters), as opposed to the manual examination, in which the vaginal partof the cervix is assessed.
The cervical measurements in the first trimester areclosely related to preterm birth even though between 11th and 14thweek of gestation prediction for preterm birth is not well defined yet.Importance of cervical length in the previous studies did not appear to haveany relations to preterm birth and only limited number ofdata showed the association between preterm births and cervical length. Twostudies were done to compare the length of the cervix in the first and secondtrimester of pregnancy which they did not show that cervical length and pretermbirth to have been linked between 10 and 14 weeks of pregnancy. If we take to account difficulties to measurethe cervical length before 14 weeks as it cannot be distinguished from theuterine segment because the gestational sac did not reach the size to expandlover part lead us to an explanation why the data did no show the closerelation between cervical length and preterm birth. (P.
Antsaklis). But how cervix can be measured then?The new method was proposed to measured cervix length by distinguishingendocervix and isthmus, moreover, look for the myometrial thickening betweenendocervix and the gestational sac. This method suggests that first should bemeasured the lineardistance between the two ends of the glandular area around the endocervicalcanal and second the shortest distance between the glandular area and thegestational sac (isthmic length), distinguishing between the endocervix and theisthmus.Using this method to measure the cervix, one study done to show that when thecervix is shorter in the first trimester chances for spontaneous deliverybefore 34 week is high than in women with normal cervix length. However limitedare the studies that suggest further examinations which can provide moreinformation about the importance of the cervix length at this stage ofpregnancy (P. Antsaklis). As the most important parameter, which is controlledthroughout the entire period of pregnancy is the size of the cervix, or rather,its length.
In many ways, this figure depends on the possibility of asuccessful pregnancy. One of the most important checkups in pregnancy is acervical examination – the opening in the vagina. The cervix is the one responsiblefor the safety of the fetus to the very birth that is why it is controlledthroughout the entire period of pregnancy.
Otherwise, the cervix is always openin women, for sperm entry and swelling of menstrual blood, but in pregnancy,the cervix closes and becomes a special protective barrier. In a normalpregnancy, the cervix is ??firm, long and closed until before giving birth,however, a week or two before delivery it softens, becomes shorter and opens.Before the act of giving birth, the cervix is usually open about 10 cm. Nevertheless,in some women, the cervix is ??not so “reliable”.
In pregnant womenwith cervical insufficiency, the cervix sometimes opens and widens well beforethe term itself even in the first trimester. Inmodern postpartum, where premature birth is still predominantly responsible forperinatal mortality and morbidity; any method of screening to more preciselydefine a risk group of pregnant women would be welcome. According to “Miscarriage:Signs, Symptoms, Treatment, and Prevention”, in childbearing years 10-25% ofclinically recognized pregnancies will end with miscarriage (American Pregnancy Association).
Pregnancy is a special condition of the female body when it shifts to a newmode of operation and what is happening in it, it is aimed at the preservationand development of an unborn child. This applies to all internal organs beingclosely linked, including the cervical canal whichcontributes the pregnancy by keeping the fetus in the uterus and controllingand limiting bacteria that can enter the uterus through the cervix.TheRole of the Cervix in Pregnancy.December 6, 2017SON 215-01Professor: C. SeibertSanije Bytyqi December 6, 2017Professor: C. SeibertSON-219Sanije Bytyqi The Role of the Cervix in PregnancyResearch Paper Bunker Hill Community College