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The cervix is the lower part of the uterus situated between the external os (external orifice) and internal os (internal orifice). The cervical canal connects the interior of the vagina and the cavity of the body of uterus. The cervix is part of the female reproductive system.
Cervical canal widening can be temporarily achieved by the insertion of dilators into the cervix. If the stenosis is caused by scar tissue, a laser treatment can be used to vaporize the scarring. [5] Finally, the surgical enlargement of the cervical canal can be performed by hysteroscopic shaving of the cervical tissue. [6]
The cervical canal communicates with the uterine cavity via the internal orifice of the uterus (or internal os) and with the vagina via the external orifice of the uterus (ostium of uterus or external os). The internal orifice of the uterus is an interior narrowing of the uterine cavity.
A bimanual examination during early pregnancy will reveal that the uterus is enlarged, softened and globular; the external os may be dilated, but the internal os is typically closed. [24] The structures adjacent to the uterus will be assessed, along with the size and shape of the bony pelvis. [24]
RCOG recommends that the placenta should be at least 2 cm away from internal os for an attempted vaginal delivery. [27] When a vaginal delivery is attempted, consultant obstetrician and anesthetists are present in delivery suite. In cases of fetal distress and major degrees (traditional grade III and IV) a caesarean section is indicated.
Consistency of the cervix refers to the firmness of the cervix; Fetal station is the position of the fetal head relative to the pelvis; Cervical dilation, effacement and station are scored from 0 to 3. Cervical consistency and position are scored from 0 to 2. The total score ranges with a minimum of 0 and maximum of 13.
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Cervical cerclage, also known as a cervical stitch, is a treatment for cervical weakness, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth.