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Istmiko-tservikalnaya insufficiency


This state when the isthmus (in Latin "истмус") and a neck ("цервекс") of a uterus does not cope with the increasing loading (the growing fruit, amniotic waters) and begins to reveal prematurely.

Symptoms Istmiko-tservikalnoy of insufficiency:

Symptoms of ITsN are, as a rule, poor and are not specific because the disclosure of a neck of uterus proceeding without pain, bleeding and anomalies of a fruit is its cornerstone. The pregnant woman can be disturbed discomfort in a vagina, the speeded-up urination, weight in the bottom of a stomach or insignificant sanious allocations from a vagina – symptoms of threat of abortion and the begun abortion.

As the provocative moment for abortion at ITsN only sneezing, cough, rise in weight or even the movement of a fruit can serve.

Reasons Istmiko-tservikalnoy of insufficiency:

Istmiko-tservikalnaya insufficiency is subdivided on anatomic and functional.

Anatomic is a consequence of various injuries of a neck of uterus at the time of delivery (use of nippers, a large fruit, manual department of a placenta, the wrong suture with formation of rough hems) and abortions.

Functional arises as result of inborn malformations of a uterus, infantility, deficit of sex hormones, the increased maintenance of androgens, the acquired pathology of muscular and connective tissue layers of a uterus or inborn displaziya of fabrics.

Risk on emergence of ITsN is EKO (extracorporal fertilization) as massive hormonal preparation naturally brings to a softening of a neck of uterus. And if the woman has any anatomic anomaly of a neck of uterus, then the probability of development of ITsN increases several times.

Treatment Istmiko-tservikalnoy of insufficiency:

Treatment of ITsN happens surgical and conservative. In some cases according to the decision of the doctor perhaps complex use of various techniques.

Surgical treatment at nonpregnant consists in a tracheloplasty. After operation contraception within six months is recommended.

At pregnant women surgical correction is carried out by suture on a neck of uterus which prevent a pharynx gaping. For achievement of the best results it is desirable to perform operation up to 16-18 weeks of pregnancy. If operation took place successfully and without complications, then seams are removed before childbirth approximately on the 37th week of pregnancy.

At a postoperative stage appoint the drugs reducing a uterus tone, and if necessary carry out hormonal therapy.

The conservative method of treatment of ITsN is a use of obstetric unloading pessaries, peculiar "bandage" which, reducing and distributing loading, helps a neck of uterus to hold the growing fruit.

The obstetric pessary is a silicone or plastic design of a special form, it is located in a vagina on early durations of gestation. The pessary is deleted at duration of gestation of 37-38 weeks.

The method is very effective, atraumatic, absolutely safe for the woman and a fruit.

Treatment of istmiko-cervical insufficiency is an and particular treatment for the woman aiming to keep pregnancy. It is necessary to limit any exercise stresses to a minimum, to avoid emotional shocks, to be under constant observation the obstetrician-gynecologist and to strictly observe drug intake, appointed the doctor. Sexual contacts are excluded for the entire period of pregnancy.

In the presence of anatomic ITsN, delivery by planned kesarevy section is justified that will prevent additional traumatization of a neck of uterus in labor.

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