cervix

synonym

Cervix

Definition of the cervix

The cervix or cervix is ​​the area between the cervix (Portio) and the actual uterus (uterus). It protrudes into the vagina and serves as a connecting passage. During fertilization, the sperm pass through the cervix and in this way reach the actual uterus. At birth, the child leaves the uterus through the cervix. During the monthly menstrual bleeding, the bleeding lining of the uterus also enters the vagina through the cervix.

anatomy

Localization of the cervix in the body

1. uterus
2. Scabbard
3. cervix
4. Tube / fallopian tube
5. Ovary / ovary

The cervix is ​​connected to the vagina through the outer cervix (Portio vaginalis uteri) and is locked in the non-pregnant woman. The cervix is ​​connected to the uterus through the inner cervix (Ostium uteri internum) completed. The outer cervix is ​​an oval opening and a dimple in the woman who has not yet given birth. The length between the outer and inner cervix is ​​individual and varies from woman to woman. On average, however, depending on the age of the woman and the anatomy, the length is approx. 5 cm.

Histologically, the cervix consists of so-called Squamous epithelium as well as from Columnar epithelium. More precisely, the outer cervix consists of squamous epithelium and the actual cervix consists of columnar epithelium. But it can also happen that squamous epithelium was forced into the cervix from outside during development. The boundary between the two microscopic cell types is not rigid and shifts towards the cervix over time. Influencing factors are next to that Age of the woman also the number of Pregnancies. The older a woman is and the more children she has given birth, the higher the squamous epithelium extends into the cervix and the further the columnar epithelium is displaced.

Illustration of the cervix

cervix

1. Cervix - Cervix uteri
2. Inner cervix -
   Ostium uteri internum
3. External cervix -
   Ostium uteri externum
4. Uterine cavity -
   Cavitas uteri
5. Columnar epithelium
6. Cervical canal
   with fan-shaped folds -
   Canalis cervicis uteri
7. Squamous epithelium
8. Scabbard - vagina
9. Uterine body -
   Corpus uteri
10. Cervical canal
    (with mucus plug) -
    Canalis cervicis uteri
11. Hardened muscle tissue
    Elapse
    (Stretching and thinning)
    of the cervix -
    schematic representation:
    A - Closed
    (Length of the cervix is ​​approx. 5 cm)
    B - Half open, elapsed -
    Length of the cervix should be up just before
    should not be less than 2.5 cm at birth
    (Risk of cervical weakness -
    Zvascular insufficiency)
    C - Fully open and complete
    elapsed cervix

You can find an overview of all Dr-Gumpert images at: medical illustrations

Function of the cervix

In the fertilization will that sperm in the vagina given to the woman and approaches the external cervix. The cervix moves forward and takes in the semen given off by the man. The sperm pass through the cervix uterus and nest.

More about this topic can be found: Fertilization of the egg

In the pregnancy As the child grows, so does a woman's uterus. As a result, the cervix is ​​stretched and shortened in length. The original length of the cervical canal of approx. 5 cm increases in the course up to 2 cm or 1 cm from and is just before the birth of the child can no longer be measured. The length of the cervix is ​​an indicator of the pregnancy and the normal course and is measured regularly by the gynecologist during the pregnancy examination. Before the birth, the length should be approx. 2.5 cm be. If it is already shorter, there is a risk of one Premature birth or Miscarriage.

A slimy secretion is released into the vagina via the cervix, the consistency of which is characteristic of the current state of the Menstrual cycle is. On infertile days it is viscous, on the days shortly before the woman ovulates, the mucus becomes liquid and permeable. To a certain extent, the investigation also presents an, albeit uncertain, Contraceptive method represent.

Dreaded diseases of the uterus and the cervix are the cervical cancer as well as dysplasias of the epithelium of the cervix, which are a precursor of cervical cancer. Inflammation and increased bleeding of the cervix can also lead to sometimes serious symptoms.

You might also be interested in this topic: cervical cancer

The cervix during pregnancy

In order to ensure that the pregnancy runs as smoothly as possible, preventive examinations take place about every four weeks during this period. Among other things, the Weight and the Blood pressure the expectant mother controlled and documented, as well Urine tests carried out. During these preventive examinations, however, the examination of the uterus is of particular importance.
In particular the cervix (Cervix uteri) with its opening, the cervix, is of interest. This is usually during pregnancy tightly closed by a mucous plugto prevent pathogens from rising into the uterus. To provide a strong base for the uterus with the child growing in it, this is Muscle tissue of the cervix as well hardened.
From about the 36th week of pregnancy however, under the influence of the hormone prostaglandin F2a, it begins to become more pliable and softer. At the same time there is a Shorten the cervix uteri and ultimately an erection of the uterus through the so-called Maturation pains instead of. All of these are signs that the uterus is preparing for the approaching birth.
For this reason, special attention is paid to the length of the cervix during prenatal care. He should until shortly before birth no less than 25 mm be. A Excessive shortening of the cervix before birth carries the risk of one Cervical weakness ("Cervical insufficiency"), i.e. the premature opening of the cervix. The softening of the uterine tissue that takes place here can be felt by the doctor. If a cervical weakness is actually found, it can then be treated to a certain extent depending on the cause.

Shortened cervix

The nature of the cervix ("Cervix uteri"), as well as its length and its external appearance provide the examiner with valuable information on the progress and course of a pregnancy. The cervix should be included until shortly before the birth a relative constant length and Compressive strength maintained. Are considered harmless 25 mm or longer. This length can be recorded with millimeter precision during every preventive examination and then documented in the maternity record, either by palpation or by means of vaginal ultrasound. Measuring the length of the cervix is ​​essential because a shortened cervix results in a weak cervix ("Cervical insufficiency"). This ultimately has the consequence that the base of the uterus can no longer withstand the weight of the child, so that a early opening of the cervix threatens. Any untreated cervical insufficiency therefore carries the risk of Premature birth.

A shortened cervix can have many causes. Psychological stress can play a role as well as physical overexertion or one increased production of amniotic fluid (which in turn can be based on a number of possible causes). Ultimately, however, the most common reason for a shortening of the cervix is ​​an unrecognized ascending one infection and resulting premature labor.
In particular, mothers with multiple pregnancies are affected by premature shortening of the cervix. Primiparous women, however, are rarely affected by cervical insufficiency.
Despite the potentially serious consequences for pregnancy, a shortening of the cervix takes place without major discomfort or other symptoms.
For this reason, it is essential that the pregnant woman attend the preventive medical check-ups. If a cervical shortening was detected early on, there are various therapy options with usually good treatment prospects, so that the birth can be postponed until shortly before the originally planned appointment if these measures are followed consistently.

The most important measure always remains the physical conservation and the best possible Avoiding stress. The degree of rest required can range up to strict bed rest, depending on the extent of the shortening of the cervix. In any case, the pregnant woman concerned should make sure to take a lot of breaks and consciously allow herself a lot of time in her everyday activities. Some therapists also provide a supportive therapy Magnesium therapy arranged, which is intended to cause relaxation of the muscle tissue of the uterus.
Is a infection proven to be the cause of a shortened cervix Antibiotics the therapy of choice. Cracks in the tissues of the cervix, the Scabbard or des Dams can also treated surgically become.

Another treatment option is the placement of a so-called cerclage. In medicine, this is generally understood as the wrapping of an organ or structure with a ribbon.In the case of cervical cerclage, the cervix is ​​wrapped with a band to give it more support and resistance to the weight of the child. For some years, however, this method has been viewed as critical, as it only appears to be an effective therapy for preventing premature birth in exceptional cases and at the same time brings with it the risk of stimulating additional uterine contractions.

In case of a severe cervical insufficiency is a inpatient briefing strongly recommended. A contractions that start prematurely can be medicated here Tocolytics inhibited, which can save valuable days to prepare mother and child for the birth.

Also read our topics: Premature labor and Premature birth

Passing of the cervix

The uterine cervix is ​​a few inches long for most of pregnancy. 25 mm are considered safe and healthy. Just before the birth however, the cervix begins to close in preparation for childbirth shorten. This is often referred to as "using up" the cervix.
The inner (located in the uterus) and outer (located in the vagina) cervix increasingly approach each other during this process, until the cervix, which originally protruded into the vagina, is barely palpable and has finally completely disappeared. Simultaneously the entire uterus descends slightly. This process is to be seen as a sign of an approaching birth. At the same time, the mere fact that the cervix has passed does not mean that an exact due date can be predicted. The birth remains a very individual process. The length of time from the passage of the cervix up to the actual opening of the cervix can from a few days to a few weeks pass. Overall, however, it can be said that the elapse of the cervix in primiparous women is much closer to birth than in multiparous women. In these cases, the cervix can actually be slightly open a few weeks before the birth.

Summary

The cervix (Cervix) represents the connecting passage between Scabbard (vagina) and uterus (uterus) and extends between the outer cervix as an entry point and the inner cervix. Histologically, the cervix is ​​off Columnar epithelium built up, the cervix consists of Squamous epithelium. Both cell types are not sharply separated from one another and migrate to the uterus over time, i.e. squamous epithelium displaces columnar epithelium.
The cervix is ​​supported by both the Sperm in the fertilization as well as from the shed epithelium of the uterus at the monthly Menstruation crossed. The length of the neck averages about 5 cm and is an important indicator of an existing one pregnancy. The further a pregnancy has progressed, the further the neck will shorten. Until shortly before birth, it should not be less than 2.5 cm.
These are diseases that can affect the cervix Cervical cancer as well as fabric conversions (Dysplasia), which can represent a precursor of carcinoma. Furthermore, increased bleeding in the area of ​​the cervix and inflammation can develop and cause discomfort.