Erosion of the cervix during pregnancy is a violation of the integrity of its mucous membrane, found during the carrying of the child.
When this occurs, the replacement of the normal flat epithelium of the cervical zev by the cylindrical epithelium of the cervical canal. Mostly, erosion is a benign process that does not threaten a woman with serious problems.
The fact that pathology is often diagnosed precisely during the period of gestation is due to the poor symptoms of the disease, so the woman does not go to the doctor for lack of complaints.
A thorough medical examination after conception reveals an erosive process.
Symptoms of cervical erosion during pregnancy
The clinical picture of erosion is hidden. Therefore, if there is no pregnancy, pathology is detected only on a routine examination by a gynecologist or if problems arise in the work of the genitourinary system.
However, statistics show that the symptoms of erosion begin to manifest themselves with greater force after conceiving a child. The reason for this is a change in hormonal levels and an increase in the content of sex hormones in the body. It often happens that when you go to a gynecologist about the disturbing symptoms of erosion, a woman is found to have a pregnancy at the initial time.
The following signs force the alert:
The appearance of blood flow after intercourse,
Discomfort, expressed in the pulling feeling of pain in the lower abdomen,
The presence of abnormal discharge in the intervals between menstruations. Their character can be either slimy or purulent. This is due to the fact that inflammation joins the erosive process,
Itching and burning sensation in the vulva and vagina.
These signs can be observed both in a complex, and separately. However, they usually force a woman to see a doctor.
Causes of cervical erosion during pregnancy
The causes of the erosive process, manifested during pregnancy or before it, must be clarified without fail. This will optimize the therapeutic scheme, as it will make it possible to eradicate the provoking factor.
Among the most common causes of the development of the pathological process in the cervix during gestation are the following:
Hormonal fluctuations in the body of a woman. Moreover, those that occur not smoothly, but sharply,
Sexually transmitted diseases. Among these are chlamydia, ureplazmoz, gonorrhea, papillomatosis, trichomoniasis and genital herpes. In the event that microorganisms penetrate inside epithelial cells, this greatly complicates the erosive process. In addition, the introduction of human papilloma viruses into the damaged layers of the cervix can lead to the development of malignant tumors,
Long-term use of oral contraceptives or other hormonal drugs used before the onset of pregnancy,
Early age of sexual intercourse
Artificial abortion. Repeated abortions are especially dangerous,
Inflammatory diseases of the genital organs that are not infectious,
Decrease in the body's immune forces
Sexual abuse, or abusive sex, resulting in cervical injuries,
Damage to the mucous membrane of the uterine zyva as a result of improper douching, or due to the installation of an intrauterine device, etc.
Frequent stress loads on the body.
In addition, the combination of two factors, such as the presence of an inflammatory process and hormonal disruption in the body, often leads to the fact that the disease is formed in women who have not given birth before and in those who have not had any injuries to the genitals.
What is dangerous cervical erosion during pregnancy?
Pregnancy planning must necessarily include a gynecological examination stage. In this way, most often it is possible to find out whether there is an erosive area on the cervix. Inspection needs to be done, because during gestation of the fetus, erosion can pose a certain danger. Mostly the threat is reduced to the fact that the ulcerated surface is an excellent environment for the development of pathogens that cause inflammation.
Among the most dangerous consequences that erosion can cause during pregnancy are the following:
The manifestation of inflammatory diseases whose therapy is complicated by the position of a woman
Spontaneous abortion, especially in the first trimester,
The onset of preterm labor at later periods of gestation,
Transformation of erosion into a malignant cancer process,
Premature rupture of the fetal bladder, infection and death of the fetus.
That is why doctors strongly recommend to undergo erosion treatment before the onset of pregnancy, if not by surgery, then by conservative means. The risk of increased growth of cervical erosion and the malignancy of the process during childbearing increases due to the dramatically changing hormonal background. In addition, the load and stress on the woman’s body has a negative effect on the disease.
Compulsory treatment during pregnancy is subject to the erosion, the size of which is large and there are already signs of inflammation. However, in medical practice there are also such cases when erosion takes place independently in the process of carrying a child.
Is pregnancy possible with cervical erosion?
The woman with erosion will not experience difficulties in conceiving a child. The disease does not affect the process of maturation or fertilization of the egg. However, if the pathology was identified before the onset of pregnancy, it is first necessary to cure erosion. The subsequent conception can be planned after a month, but only on condition that the healing process proceeds normally and without any complications.
When erosion was of impressive size, and the restoration of tissues after its removal is slow, it is necessary to delay the planning of pregnancy. In this case, the woman should not despair. As a rule, even the most complex process of regeneration takes no more than half a year.
Diagnosis of cervical erosion during pregnancy
The process of treatment can not be started without establishing an accurate diagnosis. Research methods are determined by the doctor. One of the most common procedures is the detection of erosion during a gynecological examination using mirrors. At the same time a clear epithelial defect is found. As a rule, a clearly defined area with a red color is observed on the surface of the uterine zev. The area of erosion can occupy different.
Another method of studying the eroded area to determine the density of the affected tissue in cases of suspected malignancy is the Hroback test, which consists of probing the affected area.
In addition, the doctor sends biological material (smear from the erosion surface) to the laboratory for the study. It consists in performing bacteriological and cytological analysis.
If there are any doubts, and additional confirmation of the diagnosis is required, the patient is referred for colposcopic examination. In the presence of erosion on the cervix of the uterus, the doctor finds visible damage to the epithelial tissue with the stroma area. At the same time, the bottom of true erosion is at a low level in the layer of cylindrical epithelium (or in flat multi-layer epithelium).
If there is a suspicion that the process is of a malignant nature, biopsy tissue is taken. This will make it possible to detect existing atypical cells. Only a comprehensive study will provide an opportunity to choose the most effective treatment regimen for a pregnant woman with erosion.
How to treat cervical erosion in pregnant women?
The therapeutic effect on the patient bearing the child should be different from the treatment of a non-pregnant woman. All the most popular techniques, including laser, cryodestruction or diathermocoagulation, can be used only after the child is born. Pregnancy is that period during which only the most benign techniques in combination with supportive therapy can be applied to eliminate the erosive process.
The primary goal is to stop the progression of the erosive process, preventing the development of inflammation. However, most experts are of the opinion that erosion is simply necessary to observe. If it does not threaten the development of complications, then there is no point in treating it with drugs.
In the case when a pregnant woman complains of intermittent burning sensation and the appearance of bleeding, it is possible to use methyluracil in the form of vaginal suppositories. They are administered for two weeks, twice a day. The use of candles with sea buckthorn oil is recommended, also for 14 days. This will reduce the symptoms of the disease.
When the erosive process is complicated by inflammation, it is advisable to prescribe antiviral and antibacterial drugs. Their choice will be made by the supervising doctor on the basis of bacteriological seeding and taking into account contraindications.
It is during pregnancy that a competent preventive program is important, as the risk of developing the disease increases due to hormonal changes.
To avoid this, it is important to adhere to the following rules:
Visits to the gynecologist should be strictly on schedule. You can not miss the appointment time. This will allow not only to fully monitor the course of pregnancy, but also to detect in time the development of possible pathological processes,
Important rules of intimate hygiene. To take a shower during pregnancy and change underwear should be regularly, not less than once a day. It is necessary to use only linen from natural fabrics,
If possible, you should not change sexual partners during pregnancy, as well as practice unprotected sexual acts,
If any deviations from the norm occur, you should immediately consult a doctor, without waiting for a pre-arranged visit. We are talking about the emergence of a burning sensation and discomfort, the appearance of pathological discharge.
Due to the fact that erosion in some cases increases the risk of serious complications such as the addition of a purulent or inflammatory process, as well as an early abortion, doctors strongly recommend getting rid of it before conception. A healthy cervix is one of the components of successful gestation and timely delivery.
If suddenly it happened that the pathological process was discovered after conception, then you should not panic and wait for negative consequences. Constant medical supervision, adequate prophylactic treatment with conservative methods and the absence of other diseases of the genital sphere in most cases are a guarantee of a favorable outcome of pregnancy without any consequences. It should be remembered - the erosive process is not a reason to end the pregnancy. Nevertheless, it is highly desirable to have cytology and colposcopy in addition to standard medical examinations every three months.
Most pregnant women with erosion give birth to absolutely healthy babies and do not experience difficulties during their carrying. At the same time, regular medical observation is sufficient.
With regard to the behavior of a woman after she gave birth to a child, she should not neglect to visit the doctor. It is important to come for a gynecological examination two months after the birth of the baby and find out what happened to erosion. If she has not eliminated herself, then it is necessary to carry out therapeutic measures. The choice of a specific technique is better to entrust the doctor.
Education: The diploma “Obstetrics and Gynecology” was obtained at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013, graduate school in NIMU named after. N.I. Pirogov.
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Cervical erosion is an abnormal change in the structure of the mucous membrane (epithelium) of the cervix in its vaginal part. Distinguish true erosion and pseudo-erosion (ectopia). In true erosion, cracks appear in the vaginal part, into which the cells of the cylindrical epithelium that lines the cervical canal fall and grow. When ectopic damage to the surface does not occur. Reddening and thickening of tissues appears in the area of contact between the inner cylindrical epithelium of the canal and the outer flat epithelium of the cervix.
Changes appear both before the onset of pregnancy and during it. Pathology results from diseases of the reproductive and endocrine systems. There are other causes of erosion:
- hormonal shift,
- natural weakening of immunity
- sexually transmitted infections (chlamydia, herpes, trichomoniasis and others),
- increasing the size of the uterus and changing the structure of the epithelium,
- weight gain.
If the cervix was injured during a previous birth or abortion, it also contributes to erosion.
Is erosion dangerous during pregnancy?
After the discovery of the pathology, a mandatory examination of the woman for infectious diseases and cancer is carried out. If the disease is not detected, then erosion of the cervix during pregnancy is not dangerous, and its treatment is carried out after delivery.
If, upon detection of erosion, tests showed the presence of infectious diseases, then the danger is as follows:
- Some infections that are present in the mother’s body (human papillomavirus, gonorrhea, herpes, trichomoniasis, chlamydia) result in impaired fetal development, physical abnormalities and mental retardation in an unborn child.
- In the early stages of the infection causes damage to the endometrium and miscarriage.
- In the later periods, complications may occur during childbirth (too early discharge of amniotic fluid, preterm labor).
- Infection of the birth canal leads to infection of the fetus and the birth of a child with diseases such as conjunctivitis, otitis media, pneumonia.
If the erosion is neglected, there is a strong dysplasia (the epithelium of the cervical canal is turned out), the size of the affected area is large, there is a possibility of malignant transformation, then the erosion is treated without waiting for the birth. During pregnancy, a slight erosion of the cervix may increase in size. If, until now, she didn’t show anything, then during this period a woman may have abundant mucous yellow discharge, pain during intercourse, blood-associated discharge, which is sometimes taken for menstruation.
Diagnosis of the disease
When erosion is detected in a pregnant woman during a visual gynecological examination, clarifying analyzes are made. A vaginal smear is examined to determine the presence of bacteria and viruses.Colposcopy, examination of the vagina and cervix by means of optical zooming of individual sections is performed. This method makes it possible to distinguish erosion from cervical cancer.
If there is a strong dysplasia, which often turns into a malignant tumor, or suspicion of oncology, then a biopsy is taken by plucking a piece of affected tissue. It is examined under a microscope to establish the structure of the cells.
Addition: Biopsy during pregnancy is used only in very serious cases, as plucking of the tissue can cause dangerous bleeding.
The need for treatment of cervical erosion during pregnancy is determined individually on the basis of examination results. The treatment is carried out to prevent the exacerbation of the disease.
In the presence of dangerous for the fetus infections, in the case of malignant degeneration of erosion, pregnancy in the first trimester is interrupted artificially. With later detection, the possible risk to the mother and the child is assessed, the decision is made to preserve the pregnancy or to terminate it.
For the treatment of pathologies caused by inflammatory and infectious diseases, antibiotics and antiviral drugs are prescribed. If the smear shows the absence of infectious diseases of the internal and external genital organs, then erosion does not pose a threat to the course of pregnancy, has no effect on the child, does not affect the course of childbirth. Treatment is delayed and carried out 2 months after delivery.
The gynecologist, leading the pregnancy, periodically examines the affected area, and also takes a smear for infection. If a mild dysplasia is found in a pregnant woman, then once every 3 months a second colposcopy is performed to control the changes.
Cauterization of erosion during pregnancy is not done in any way. This can cause bleeding in women and fetal death. Sometimes, if itching, bleeding, discomfort, worries, the doctor prescribes candles with methyluracil (wound healing) or sea buckthorn.
Note: During pregnancy, you can not do douching. It provokes a miscarriage. In addition, the site of erosion is easily injured, leading to bleeding. During douching, you can carry the infection into the vagina, disrupt the composition of the microflora.
Traditional medicine recommends using decoctions of chamomile, calendula, celandine, St. John's wort, and yarrow for drinking, as well as honey, propolis, mummy, aloe, pumpkin pulp, oak bark, sea buckthorn oil for tampons for treating cervical erosion during pregnancy.
Using traditional methods, it must be remembered that components can cause allergies and other side effects. You must consult your doctor before using such funds.
Diagnosis of erosion during gestation
Erosion can be noticed by any gynecologist during a routine inspection. But in this way, that is clearly, it is impossible to establish an accurate diagnosis, and therefore a pregnant woman should pass all the necessary tests.
Gynecologists take tests on the flora of women, and all of them - even women who are not pregnant. And with erosion, this analysis is indispensable. But if according to the results of such a gynecologist does not observe any violations, then erosion can be performed after the baby is born, and then already engage in detailed studies and procedures.
If flora analysis showed dysplasia, then there is a need for further procedures - analysis of papillomas and calcoscopy.
If everything is in order in this plan, then treatment may also be postponed to the postpartum period. If the fear of cancer is confirmed, the pregnant woman should be biopsy.
When blood appears in the discharge from a woman, they may additionally take tests for infections that lead to inflammation.
Symptoms and consequences for the child
Erosion usually does not cause any discomfort to the woman, and the disease can be detected only on examination by a doctor. Symptoms usually occur if erosion occurs before the state of pregnancy. In this case, there is a chance that it will worsen over time.
And symptoms are considered such manifestations:
- Discharge in the form of pus and mucus.
- Discomfort or even pain during intercourse.
- Discharge at the end of intercourse, resembling ichor.
Erosion of the cervix may well lead to miscarriage of the child. It is also possible the emergence of other diseases that are caused by infection that has spread in erosion, which will affect the development of the child. Therefore, without an accurate diagnosis of doctors safely bypass this danger will not work.
What is dangerous?
When eroded, the cervical epithelium becomes damaged, and therefore female genitals become very vulnerable to infectionsit especially concerns the uterus, fallopian tubes and appendages.
Erosion can even cause the growth of malignant cancer cells. This phenomenon is called dysplasia. Dysplasia can be of varying degrees or stages, the most dangerous of which is preinvasive cancer, the last stage.
But judging by the statistics, this happens extremely rarely, and Doctors believe erosion is not dangerous, and in most cases, its treatment occurs after delivery. But even in the case of favorable test results, a woman needs to be attentive to her health.
It is necessary to pay attention to any unhealthy discharge and immediately report it to the doctors, because the discharge can warn about the appearance of an unfriendly infection in the uterus.
How does gestation affect?
The mere presence of erosion is not capable of affecting the state of pregnancy or the fetus. The main danger can be infections that have penetrated the damaged epithelium, for example, herpes, chlamydia or papillomas - which can directly affect the health of the fetus and subject it to abnormal development or miscarriage.
But fortunately, all pathological infections can be detected on time with the help of tests and timely measures are taken for treatment.
Also appearance of erosion during pregnancy may indicate a woman’s susceptibility to hormonal changes. If erosion was detected before pregnancy, then this may affect its further onset, but not on the pregnancy itself.
Well, after childbirth, the hormonal background of a woman is gradually restored, and together with changes in body tissues, this often leads to an independent cure for cervical erosion.
As a result of the discovery of pathological infections during erosion and treatment with various drugs, the condition of the uterus tissues may deteriorate. it can be a threat to the occurrence of complications during childbirth.
If there is a selection of brown color
During pregnancy, it may bleed from the genital tract. Usually this is not dangerous, since during the period of pregnancy the increased flow of blood enters the uterus, and the damaged mucosa may begin to bleed slightly.
- Minor bleeding may appear after sex. But this for the most part does not cause pain or discomfort, and the bleeding stops quickly.
But bleeding may indicate much more dangerous phenomena, for example, a detachment of the placenta. Therefore, in any case, the appearance of blood in the discharge should notify the doctor and find out the exact cause of their appearance.
The appearance of unhealthy discharge can always be detected. But the difficulty is that sometimes they can simply be overlooked. A woman with cervical erosion needs to closely monitor this, especially since it is practically the only way to monitor the state of health during pregnancy and during the process to decide what to do in a critical situation.
Treat erosion is most favorable after birth. But circumstances can be completely different: sometimes erosion has to be urgently removed before birth, and there are cases when the disease is eliminated by itself after the birth of a child.
There are several treatment options for cervical erosion:
- Diathermocoagulation, or cauterization by electric current.
This is one of the oldest ways to treat erosion, and many doctors today consider it the most traumatic.
The essence of this method is simple: the damaged area of the mucous membrane is cauterized, and after a while the burn scar is tightened, forming a new layer of epithelium. Cryodestruction This method is quite young, and its essence is the opposite of the previous one - erosion is not cauterized, but succumbed to freezing.
But although only the damaged part of the cervix is frozen out, there is no certainty that all the damaged tissues were completely processed, or the healthy tissues of the uterus were not affected.
This is the only drawback of this method. Laser coagulation.
This method involves the treatment of erosion by exposing it to a surgical laser.
This is more effective than in the two previous methods.
That is why the treatment of erosion by laser today is most common.
Pregnancy after burning a current
Doctors believe that for women who have not yet given birth to children can not be used for burning electricity in the treatment cervical erosion. The point is formed after burning cautery scars on the tissues. Although erosion was cured, the scars could not be fully tightened, and subsequently would become a hindrance during pregnancy, and during childbirth caused tissue tears and painful sensations.
Cervical erosion is a fairly common phenomenon among pregnant women. By itself, erosion does not bear any harm on the body of a pregnant mother or child, but can be the basis for serious consequences.
Dangerous infections can penetrate through the damaged epithelium, so erosion should be diagnosed in time with careful monitoring of its condition. A woman should closely monitor the secretions from the birth canal, and in time to respond to the appearance of blood in them.
If everything takes place responsibly by the woman and doctors, then pregnancy and childbirth will take place safely, and erosion will be cured effectively and without any negative consequences.
Medical expert articles
Unfortunately, cervical erosion during pregnancy is often detected. This happens because the latent course of erosion does not allow a woman to suspect that something was wrong and to see a doctor before pregnancy. A thorough examination by a gynecologist of a pregnant woman leads to the fact that various pathologies of the cervix and other parts of the sexual sphere can be detected.
What to do in this situation? How does erosion affect pregnancy? Do I need to treat it now or wait for the birth of a child? A lot of questions, isn't it? We will try to answer some of them today.
Treatment of cervical erosion during pregnancy
Treatment of cervical erosion during pregnancy requires a special approach. Such common methods of erosion therapy as cryodestruction, laser therapy and diathermocoagulation can be carried out after birth. And during gestation, only gentle and supportive therapy is used.
Treatment should be as cautious as possible, aimed primarily at inhibiting the erosive process and preventing the development of an inflammatory response.
The use of drug treatment is complicated by the fact that not all medications can be used in the period of carrying a child. Therefore, in the absence of complications, many specialists prefer simply to observe erosion and control its development right up to the birth.
If a woman experiences discomfort, a burning sensation, her discharge is disturbed (especially bloody), then the doctor may prescribe the following drugs:
- - methyluracil (vaginal suppositories) - twice a day (in the morning and at night) for 10-14 days,
- - candles with sea buckthorn (sea buckthorn oil) - from one to 2 times a day for 8-15 days,
- - when attaching inflammation - antivirals and antibiotics individually and depending on the results of bacposeva.
Some women prefer to turn to traditional medicine, but the vast majority of specialists in traditional medicine do not welcome such treatment, especially during pregnancy. Traditional methods of therapy usually include the use of phytomasics, tampons, douching. Pumpkin pulp, celandine grass, aloe juice, decoctions of oak bark, calendula, camomile color, as well as propolis, natural honey and mummy are used as the basis. We do not recommend using traditional treatment during pregnancy without first consulting with a specialist!