The internal pharynx acts as a hole in the lower region of the main female genital organ - the uterus, which connects its cavity with the cervical canal. Thus, the uterus ends with this very pharynx. It is simply impossible to see it with the eye, and it is not felt by the woman herself. True, it closes the entrance from the cervical canal, that is, it serves as its edge. Often the cervical element is identified with the internal os of the uterus, whose width is from seven to eight millimeters, such are the dimensions of the internal os.
Role in a woman's body
The main function of a structure such as the internal os is to prevent foreign substances from entering the uterus. It also prevents the fetus from being born prematurely. After the fertilized egg enters the uterine cavity and pregnancy occurs, the pharynx closes tightly, taking on a bluish color. It will thus be closed until the onset of childbirth. Between the vagina and it during pregnancy, a mucous plug is formed, which is required to protect the placenta and fetus frommicroscopic organisms that are able to penetrate. This element departs shortly before childbirth.
They begin when the internal os of the uterus opens, and the woman feels cramping pain, which indicates the onset of labor. When this pharynx reaches ten centimeters in diameter, the fetus is given the opportunity to exit the uterus by passing through the genital tract. With a rapid resolution from a burden or for other reasons, as well as with various pathologies, a rupture of the neck (internal os) occurs.
Placenta on the internal os of the uterus
Previa is the attachment of the placenta in the lower region of the uterus in the cervical region. It is marginal when part of it is located at the level of the internal pharynx.
In early pregnancy, presentation is quite common (up to thirty percent of all pregnancies). Chorion is called the placenta at the initial stage of its development. But by the time the pregnancy is completed, in almost all patients, it rises on its own. The likelihood that the chorion will rise, as a rule, remains until the end of gestation.
One of the external manifestations of such a problem as the location on the internal pharynx is the occurrence of sudden painless bleeding from the genital ducts, which in most situations stop on their own. But most often, placenta previa can be completely asymptomatic.
Why is the placenta on the internal os dangerous for the baby?
Children in this case also develop normally(as during normal pregnancy). True, against the background of placenta previa, the risk of heavy bleeding from the genital canals is somewhat higher, and therefore the onset of premature birth is possible. In this case, it is advisable to use an emergency caesarean section.
Treatment
To influence the position of the placenta relative to the internal os of the uterus during pregnancy with the help of drugs or other methods, unfortunately, is impossible. With the localization of the placenta on the internal pharynx (when this structure is closer than two centimeters), a restriction in physical activity is recommended along with abstinence from sexual activity. The occurrence of bleeding is the reason for the emergency hospitalization of a woman.
Placenta on the internal os during pregnancy and childbirth
In the event that by the end of gestation, according to the results of ultrasound, the placenta in the uterus overlaps the internal os, then this is an indication for a caesarean section at the thirty-eighth to thirty-ninth week. If there is a low placentation, you can wait another seven days, but when at the thirty-ninth or fortieth it is closer than two centimeters to the internal pharynx, then this is also an indication for a caesarean section.
If it lies two centimeters higher from the pharynx, then you should wait for the independent start of childbirth. They run normally. As practice shows, the risks of bleeding in this case will not be significantly higher than in the presence of a conventional location.
What does it say when the internal cervical os is closed or open?
The cervix is a dynamic organ, it changes throughout the cycle in non-pregnant women. Its disclosure occurs during periods of ovulation and during menstruation, as well as at the beginning of the next cycle, it closes, after which it rises. In the event that fertilization occurs, then first of all the appearance changes with the location of the neck. The fact is that it lengthens, acquiring a bluish tint due to increased blood circulation, and also becomes dense and tight.
During a medical examination, a specialist can accurately determine whether there is no threat of miscarriage. For example, if the internal os of the uterus is tightly closed, the finger does not pass and is slightly deflected, then there is definitely no threat. But in the case of partial disclosure or friability, the woman needs hospitalization in order to avoid premature birth. Normally, its length changes throughout pregnancy within the following parameters:
- Until the fourteenth week of pregnancy, the length is usually between thirty-five and thirty-six millimeters.
- From the tenth to the fourteenth - up to thirty-nine.
- From the twentieth to the twenty-fourth week - forty millimeters.
- Twenty-fifth to twenty-ninth is forty-two.
- From the thirtieth to the thirty-fourth week decreases to thirty-seven millimeters.
- From the thirty-fifth, the length is twenty-nine.
The internal os of the cervix during pregnancy in the closed state is extremelyimportant for the safe and proper development of the child, as it performs the following functions:
- Helps to keep the fetus directly in the uterus until the onset of timely delivery.
- Protection against infection of the amniotic sac.
- Exclusion of infection.
Under the condition of the normal functioning of the body, the neck begins to expand and shorten, and then changes its structure to soft and loose. This allows the fetus to descend in preparation for its birth.
How can I close the internal os?
In the event that the internal os of the cervix is open, shortened and its partial opening is observed, doctors perform a procedure that promotes the closure of the internal os. There are several following methods that allow this: therapeutic, conservative and surgical.
Medicated treatment
Therapy consists of taking hormonal drugs based on progesterone, which help to stabilize the condition, and at the same time, the possible closing of the channel. Such means include "Duphaston" along with "Utrozhestan". Two weeks after the drug appointment, it is necessary to diagnose the cervical canal in order to determine the overall effectiveness of the method. In the event that everything goes well and the internal os of the uterus is closed, then the drug is prescribed to the patient for a long time.
Conservative method
This can become an auxiliary in the framework of drug treatment. This technique inincludes the installation of a gynecological ring. It is put on the neck so that it can rest against the walls of the vagina. This makes it possible to remove the main load from the internal pharynx. This technique allows you to close the cervix with the closure of the internal os, respectively. It is carried out at any time, the use of anesthesia and inpatient observation is not required, this technique is applicable if women have multiple pregnancies. The ring is used exclusively at an early stage when the cervical canal is closed.
Surgical method within the closure of the internal os
This technology lies in the fact that the cervix is sutured and thus the cervical canal is compressed. The method is used if there is a serious threat of interruption of gestation, and alternative methods are not effective. The operation is carried out in the early stages and no later than the twenty-eighth week. It is extremely important that the amniotic membranes are not broken and that they do not fall into the cervix, otherwise infection is possible. Contraindications for sutures are as follows:
- There are infectious diseases of the genitourinary system.
- The occurrence of pathologies in the development of the fetus.
- Severely ill mother.
Before the procedure, it is necessary to carry out therapy aimed at reducing the tone of the uterus along with an ultrasound examination, which determines the condition of the fetus with the location of the placenta. Given the fact thatImposition is a surgical procedure using anesthesia, inpatient preparation before surgery and follow-up after it will be required.
It is important to have a weekly examination with a doctor, and at the same time to carry out periodic vaginal sanitation. Since the suture can provoke an increased uterine tone, the use of drugs such as Ginipral or Magnesia is strongly recommended along with the antispasmodic Papaverine. Suture removal is carried out at the thirty-eighth week directly in the gynecologist's office. This procedure allows the fetus to descend for subsequent birth resolution.
