Is the birth canal soft
Release time : 03/03/2025 10:33:32
The birth canal is the pathway through which a fetus is delivered. It is divided into two parts: the bony part and the soft part.
If abnormal dystocia occurs in the soft birth canal, more attention should be paid to detect the clinical manifestations and causes early.
What are the clinical manifestations of abnormal dystocia in the soft birth canal? What is the cause of abnormal dystocia in the soft birth canal? Is the birth canal soft? What is a soft birth canal? The soft birth canal is a curved canal composed of soft tissue from the lower uterus, vagina, cervix and pelvic floor.
The vaginal delivery is usually referred to as the "os pelvis," and the "soft pelvis" is typically closed. During childbirth, due to uterine contractions and baby compression, the soft pelvic floor will passively expand gradually. Only when it has expanded to about 10cm can the child pass through smoothly. Therefore, the soft pelvic floor easily tears during childbirth.
1. Uterine lower segment formation: the uterine lower segment, which is about 1 cm in length when not pregnant, forms at the cervix of the uterus.
During labor, regular contractions occur, which subsequently stretch the uterine body to a length of 7-10 cm. Due to the contraction force of the myofibrils in the upper segment of the uterus, the myometrium thickens.
The myometrium of the lower segment of the uterus is being stretched thinner and thinner.
Because the myometrium of the upper and lower segments of the uterus is thicker and thinner, a ring-like elevation on the inner surface of the uterine cavity between the upper and lower segments is known as the physiological contraction ring.
2. Changes in Cervical Structure: In the pre-labor period, the cervical canal is approximately 2 cm long; postpartum, due to the upward or outward expansion of the internal os, the cervical canal becomes funnel-shaped, subsequently gradually shortens and eventually disappears, resulting in the formation of the lower segment of the uterus.
Women who have had their first child usually lose the cervix tube and then the cervical opening.
The second production is usually carried out simultaneously.
There are many clinical manifestations of abnormal dystocia caused by abnormal soft birth canal.
This article mainly introduces the following aspects: 1. Vulvar abnormalities: vulvar edema, vulvar stricture, phleangioma, vulvar tumors, vulvar scars, etc. are the causes of dystocia.
2. Vaginal abnormality: Congenital vaginal stricture. Although it can soften after pregnancy, during childbirth, damage can be caused due to poor stretch. Scars from vaginal surgery, such as scars formed by post-operation inflammation and cervical damage, can cause scar bleeding during pregnancy. Cesarean section should be performed, which can easily cause dystocia.
Generally, vaginal tumors are discovered only during childbirth, and the tumor causes the vagina to stretch less, making it prone to bleeding and infection. Suggestions include cesarean delivery.
3. Cervical Pathology: Cervical lacerations followed by infection, cervical canal narrowing, adherence of the cervical orifice, obstruction in the dilation of the cervical orifice, cervical edema, displacement of the external os of the uterus, adhesion between the cervix and the amnion, uterine fibroids, squamous cell carcinoma of the cervix, and cervical sclerosis, may also lead to difficult labor. Therefore, it is recommended to perform a cesarean section during childbirth.
Uterine abnormalities, including uterine prolapse, uterine torsion, fixed operation for anterior uterine displacement and abdominal wall fixation of the uterus, uterine deformity, uterine underdevelopment, and uterine constriction, cause difficult delivery.
5. Pelvic tumors: Ovarian cysts and pelvic masses can also cause difficult labor.
The incidence of difficult labor caused by abnormalities in the soft birth canal is less than that due to bony pelvic obstructions, making it easily overlooked and leading to missed diagnoses.
1. Development abnormalities: If the uterus is dysplastic, vaginal stricture, the perineum is small, or the cervix is long, narrow and hard, lacks elasticity, and is difficult to stretch, it will be very difficult to give birth.
2. High-risk pregnant: Pregnancy in women over 35 years old is called high-risk pregnancy.
35 years old marriage, the risk of difficult labor is different compared to a woman who has had her first child 10 years after marriage and then gives birth at 35.
The former may not necessarily result in difficult labor, while the latter may encounter difficulties during childbirth due to immature genital organs.
Generally, there is an increased chance of uterine prolapse when a vaginal tear occurs.
Due to the poor extension of pelvic floor muscles and fascia in elderly primigravid women, it is likely that the child will cause damage to the pelvic floor muscles and fascia during delivery, leading to uterine prolapse.
3. Check: (1) Laboratory examinations are conducted based on the patient's condition, clinical symptoms and signs, and physical examination findings, including routine blood tests and other related tests.
(2) Other auxiliary examinations, such as ultrasound, X-ray, and other relevant tests, should be selected based on the patient's condition, clinical manifestations, symptoms, and signs.
Diagnosis of abnormal pelvic floor in obstetrics: 1. The thickness, softness, and dilation degree of the cervical canal; whether there is a space between the fetal head and the cervix during the peak contractions of labor; whether there is edema in the cervix, and the location and extent of the edema.
2. Determine the fetal position: For example, determine the orientation of the sagittal suture and the positions of the anterior and posterior fontanelles.
Special attention should be paid to the fact that when the fetal head is severely edema, it may cause the anterior and posterior fontanel to be unclear.
During vaginal examination before midwifery, the method of touching the direction of the ear should be used to help determine whether the fetal orientation examination was wrong.
3. Clarify the position of the presenting part: This is crucial for determining whether the fetus can pass through the bony birth canal and vaginal delivery or requires cesarean section, as it minimizes potential errors.
Therefore, for those with severe fetal head edema, during the examination, it is necessary to measure the lowest point of the skull as a reference standard. Sometimes, another hand needs to be used to check whether the fetal head has passed through the pelvic inlet on the maternal pubic symphysis.
Sometimes the lowest point of the fetal head has been exposed, but the biparietal diameter is still above the entrance to the pelvis.
When diagnosed with soft pelvic floor abnormalities, do not panic. Active treatment and prognosis should be pursued.
1. Soft birth canal abnormalities, aside from genital tract pathology-induced changes, include premature cervical ripening at full term, which prolongs labor and causes great suffering for the parturient, ultimately leading to difficult delivery or neonatal asphyxia.
Therefore, the extent of soft pelvic floor abnormalities varies, and the treatment methods differ accordingly. For instance, a woman with simple scarring can be treated by excision.
If the cervix is not mature, it is necessary to first stimulate the ripening of the cervix and then induce labor.
For patients with a firm cervix who are in labor, if the labor progress is slow, cesarean section should be considered.
If conditions occur that affect the health of the mother and child, delivery should be terminated as soon as possible.
2. People with hard cervix cannot induce labor with small water sacs.
If a coarctation ring occurs, anesthetics can be used to relieve the spasm. If the fetus is alive, cesarean section is performed as soon as possible, otherwise delivery is ended.
3. For patients with adhesions of membranes, if the fetus is alive, perform cesarean section as soon as possible.
The perineum and vulva are abnormally narrow and the pelvic outlet is small, so cesarean section should be performed.
5. When the soft birth canal is abnormal, the labor process is prolonged, causing fetal hypoxia and intrauterine suffocation.
Excessive examinations, including vaginal and anal examinations, can cause intrauterine infections that are detrimental to the fetus.
6. The labor time is prolonged and the surgical labor rate increases. For example, abnormal fetal position and labor stagnation lead to dystocia and birth injuries, premature rupture of membranes, causing intrauterine infection, and obstruction of the expansion of the soft birth canal, which is not conducive to labor.
The above are some introductions about whether the soft birth canal is good or not, hoping to help everyone and improve their awareness of self-protection.
The medical information provided in this text is for reference only.
If you feel unwell, it is recommended to seek medical attention immediately, and the medical diagnosis and treatment will be subject to offline diagnosis.