Cervical Dystocia

Cervical Dystocia

Cervical dystocia is when the birth process is delayed due to insufficient expansion of the cervix. Cervical dystocia is usually triggered by functional disorders. Insufficient opening despite sufficient contractions leads to painful cramps.

What is cervical dystocia?

Cervical dystocia is a complication of childbirth. Normally, the cervix gradually dilates with the onset of labor. During early labour, it should expand to an inch or two in diameter. When the cervix is ​​about eight to nine centimeters open, the contractions begin. When the diameter of the cervix is ​​around ten centimetres, the child’s head can be born. Cervical dystocia is present if the cervix does not open or opens too slowly. For meanings of hangover (alcohol intoxication), please visit polyhobbies.com.

Causes

Cervical dystocia is based on either functional or pathological-anatomical disorders. In most cases, cervical dystocia is caused by functional disorders. These are usually due to spasms of the cervix or the lower part of the uterus. These spasms, in turn, are usually triggered by uncoordinated or excessive labor.

Normally, the opening contractions come about three times in ten minutes with a pressure of 10 to 50 mmHg. Untargeted and uncoordinated contractions do not open the cervix, unlike normal contractions. The spasm of the cervix can also be psychological. Especially first-time mothers from the age of 38 to 40 years are affected by this psychologically caused spasm. In addition, the so-called endogenous prostaglandins respond less well in late first-time mothers than in younger mothers.

Prostaglandins are local hormones that, among other things, play a role in labour. This hormonal imbalance keeps the cervix, including the cervix, rigid. This then leads to a functionally disturbed birth process. Pathological-anatomical causes of cervical dystocia are present when the muscles of the cervix are pathologically altered. These pathological changes are caused, for example, by operations that can lead to scarring of the cervix.

Such scarring occurs, for example, after a conization. During a conization, part of the cervix in the area of ​​the cervix is ​​removed. An Emmet plastic or a cerclage and inflammation can also lead to scarring. In rare cases, the cervix can be stuck together by connective tissue. This condition is called conglutinatio orificii externi uteri.

Symptoms, Ailments & Signs

Cervical dystocia is characterized by insufficient opening of the cervix during childbirth. Labor activity is not affected. During palpation, i.e. during scanning, the cervix feels firm or possibly even spasmodically hardened. The affected women feel each of the painful contractions, but the cervix does not open or only partially. The limit is usually reached at five to eight centimeters, from which the cervix no longer opens any further. However, ten centimeters would be required for the birth. Cervical dystocia can last for hours. The process is very exhausting and completely exhausts the woman giving birth.

Diagnosis & course of disease

Diagnosis is by inspection and palpation of the cervix. On inspection, the small diameter of the cervical opening is evident. On palpation, the cervix and cervix appear firm and hard.

Complications

Cervical dystocia is a serious complication of childbirth. If the cervix does not open wide enough during childbirth, painful labor and sometimes bleeding occur. In general, childbirth with cervical dystocia is very strenuous and exhausting for the mother-to-be.

Babies can bruise and otherwise injure themselves during childbirth, but they are rarely serious. Major complications can occur when the cervix dilates just a few centimeters. A natural birth is then usually not possible and a caesarean section must be initiated.

Such an intervention is always associated with risks for the woman giving birth and the child. It can happen that the unborn child twists unfavorably or is injured by the surgical tools. For the mother, a caesarean section is associated with the risk of infections, injuries and wound healing disorders. The cosmetic blemish can cause psychological problems.

The therapy of cervical dystocia using home remedies can cause complications, depending on the method and preparation. Above all, alternative medical procedures such as acupuncture or homeopathic remedies harbor certain risks. Conservative medicines can cause side effects.

When should you go to the doctor?

In Europe, a child is usually born under the supervision of a doctor and a midwife. It is less advisable for a woman to give birth to a child without the presence of medically trained personnel. The delivery can take place in an inpatient setting, in a birthing center or at home. It is possible to work with obstetricians or midwives at all locations. Well before the expected date of birth, the pregnant woman should seek appropriate care.

If complications or adversities occur during the birth process, the situation can be reacted to as quickly as possible. In addition, the mother-to-be should inform herself sufficiently about the birth process. At the latest when the contractions start, an obstetrician should be called or a hospital should be visited. If an unplanned and sudden birth occurs, an emergency service must be alerted. To avoid developments that are hazardous to the health of the unborn child and the mother, immediate action should be taken.

Treatment & Therapy

The focus is initially on pain relief. The women affected suffer from severe pain, especially in the case of spasms of the uterine muscles and the cervix. In order to protect the unborn child, the pain is primarily relieved in a conservative way. A relaxing bath in the bathtub can be used for this, for example. The midwife can support you with detailed instructions and tips on how to better cope with the contractions and the pain of the contractions.

The partner can be a valuable support in the delivery room. Alternative medical procedures such as acupuncture, homeopathy or aromatherapy can also bring improvement. If these conservative pain relief measures are unsuccessful, painkillers can be used. Anticonvulsant drugs (spasmolytics) can be administered as suppositories or infusions. They ensure a relaxation of the cervix, which promotes the opening of the same.

Opiates can also be injected into the gluteal muscle. These have a pain-relieving and calming effect. However, they have the disadvantage that the respiratory drive of the woman giving birth and possibly also the respiratory drive of the newborn are suppressed. Epidural anesthesia can be helpful, especially in the case of very severe pain and a long birth. A local anesthetic is administered to the spinal cord through a small tube. If the cervix is ​​very rigid, local administration of prostaglandins can have a supportive effect. The cervix may have to be manually dilated to allow the baby to be born.

Prevention

Above all, the functionally related cervical dystocia can best be prevented by thorough preparation for the birth. A childbirth preparation course can be very helpful. It takes away the fear of childbirth and the pain of labor and also strengthens confidence in one’s own ability to give birth. During the course, the pregnant woman learns breathing exercises that make childbirth easier and reduce pain.

Improper breathing during labor can cause spasms in the cervix. With the help of the relaxation exercises learned in the course, the woman giving birth can draw new strength during the birth. Women who have already given birth naturally need not fear cervical dystocia. This actually occurs almost exclusively in first-time mothers.

Aftercare

In the case of cervical dystocia, those affected usually have only a few and usually only limited follow-up measures available. Therefore, they should see a doctor as soon as the first symptoms of this disease appear, so that there are no complications or other symptoms as the disease progresses. Early diagnosis and subsequent treatment usually have a very positive effect on the further course of the disease.

Most patients require surgery to relieve the symptoms. The time after that should be avoided from physical exertion and stressful activities. Because of cervical dystocia, many of those affected also depend on the help and support of their own families.

Support in everyday life is very important, and psychological help can also prevent the development of depression and other mental health problems. However, the further course of cervical dystocia is strongly dependent on the time of diagnosis and also on the severity of the disease, so that a general prediction is not possible. The focus is therefore on early diagnosis and recognition of the disease.

You can do that yourself

In the case of cervical dystocia, the measures and the possibilities for self-help are clearly limited. In some cases, they are not even available to the patient. Therefore, first and foremost, a quick and, above all, an early diagnosis of the disease is necessary so that it can be treated quickly, since it cannot heal on its own.

In many cases, the support and help of one’s own family is also very important for cervical dystocia. This can prevent or limit depression and other mental illnesses. The partner also often needs support. Contact with other people affected by cervical dystocia often has a positive effect on the further course of the disease and can make everyday life a little easier, as this leads to an exchange of information.

Acupuncture or aromatherapy measures can also alleviate the symptoms, although these therapies cannot replace full medical treatment. Regular check-ups by a doctor should also be carried out to prevent further complications or symptoms.

Cervical Dystocia