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Cervix before (left) and after vaginal birth (right) In front of the upper part of the cervix lies the bladder, separated from it by cellular connective tissue known as parametrium, which also extends over the sides of the cervix. [4]
Cervical dilation may be induced mechanically by placing devices inside the cervix that will expand while in place. A balloon catheter may be used. Other products include osmotic dilators , such as laminaria stick (made of dried seaweed) or synthetic hygroscopic materials, which expand when placed in a moist environment.
The cervix remains soft after birth. The vagina contracts and begins to return to the size before pregnancy. For four to six weeks of the postpartum period the vagina will discharge lochia , a discharge containing blood, mucus, and uterine tissue.
Histologically, the cervix undergoes significant changes towards the end of gestation, allowing the ripening of cervix for the passage of birth delivery. First, there is an increase in the cervical synthesis of glycosaminoglycan hyaluronan (HA), which increases tissue hydration, thereby catalyzing the degradation of collagen and elastin-fibers.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.
Vaginal delivery involves four stages of labour: the shortening and opening of the cervix during the first stage, descent and birth of the baby during the second, the delivery of the placenta during the third, and the 4th stage of recovery which lasts until two hours after the delivery.
Bloody show or show is the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy.It is caused by thinning and dilation of the cervix, leading to detachment of the cervical mucus plug that seals the cervix during pregnancy and tearing of small cervical blood vessels, [1] and is one of the signs that labor may be imminent. [2]
Effacement translates to how 'thin' the cervix is. The cervix is normally approximately three centimetres long, as it prepares for labour and labour continues the cervix will efface until it is 'fully effaced' (paper-thin). Cervical dilation: Closed 1–2 cm 3–4 cm 5+cm Dilation is a measure of how open the cervical os is.