Erosion of the cervix during pregnancy
Content:
- Symptoms of cervical erosion during pregnancy
- Causes of cervical erosion during pregnancy
- What is the danger of cervical erosion during pregnancy?
- Is pregnancy possible with cervical erosion?
- Diagnosis of cervical erosion during pregnancy
- How is cervical erosion treated?
Erosion of the cervix during pregnancy is a violation of the integrity of its mucous membrane, detected during the gestation of a child.
In this case, the normal squamous epithelium of the cervical pharynx is replaced by the columnar 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 gestation period is due to the meager symptoms of the disease, so a woman does not turn to the doctor for lack of complaints.
A thorough physical examination after conception reveals the presence of 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 during a routine examination by a gynecologist or if problems arise in the work of the genitourinary system.
However, as statistics show, the symptoms of erosion begin to manifest themselves with greater force after the conception of 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 contacting a gynecologist about disturbing symptoms of erosion, a woman is found to be pregnant at the initial stages.
The following signs make you wary:
- The appearance of bloody discharge after intercourse;
- Discomfort, expressed in a pulling feeling of pain in the lower abdomen;
- The presence of pathological discharge between periods. 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 genital area and in the vagina.
These signs can be observed both in combination and separately. However, it is they who 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 regimen, as it will make it possible to eradicate the provoking factor.
Among the most common reasons for the development of a pathological process in the cervix during gestation, the following are distinguished:
- Hormonal fluctuations in a woman's body. Moreover, those that do not occur smoothly, but abruptly are especially dangerous;
- Sexually transmitted diseases. Among them are chlamydia, ureplasmosis, gonorrhea, papillomatosis, trichomoniasis and genital herpes. In the event that microorganisms penetrate into the 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 pregnancy;
- Early age of sexual intercourse;
-
Artificial termination of pregnancy. Repeated abortions are especially dangerous;
- Inflammatory diseases of the genital organs that are not infectious;
- Cancer of the reproductive system;
- Decrease in the body's immune forces;
- Sexual violence, or rough sex, leading to injury to the cervix;
- Damage to the mucous membrane of the uterine pharynx as a result of improper douching, or due to the installation of an intrauterine device, etc.;
- Frequent stress loads on the body.
In addition, a combination of two factors, such as the presence of inflammation and hormonal disruption in the body, often leads to the fact that the disease develops in women who have never given birth, and in those who have not had any genital trauma.
What is the danger of cervical erosion during pregnancy?
Pregnancy planning must necessarily include a gynecological examination stage. It is in this way that it is most often possible to find out whether there is an erosive area on the cervix. Inspection must be done because erosion can pose a certain danger during gestation. Mostly the threat comes down 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 lead to during pregnancy are the following:
- The manifestation of inflammatory diseases, the therapy of which is complicated by the position of the woman;
- Spontaneous abortion, especially in the first trimester;
- The onset of preterm labor at a later stage of gestation;
- Transformation of erosion into a malignant cancer process;
- Premature rupture of the fetal bladder, infection and fetal death.
That is why doctors strongly recommend to undergo erosion treatment even before pregnancy, if not surgically, then conservatively. The risk of increased growth of cervical erosion and malignancy of the process during childbearing increases due to the dramatically changing hormonal background. In addition, the increased load and stress on the woman's body negatively affects the disease.
Compulsory treatment during pregnancy is subject to that erosion, the size of which is large and signs of inflammation are already present. However, in medical practice, there are also cases when erosion passes on its own in the process of bearing a child.
Is pregnancy possible with cervical erosion?
A woman with erosion will not experience difficulties in conceiving a child. The disease does not in any way affect the process of maturation or fertilization of the egg. However, if the pathology was detected before the onset of pregnancy, it is first necessary to cure the erosion. It is possible to plan the subsequent conception already after a month, but only on condition that the healing process proceeds normally and without any complications.
When the erosion was impressive in size, and tissue restoration after its removal proceeds slowly, it is necessary to postpone the planning of pregnancy. In this case, the woman should not despair. As a rule, even the most complex regeneration process takes no more than six months.
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Diagnosis of cervical erosion during pregnancy
The treatment process cannot be started without an accurate diagnosis. The research methods are determined by the doctor. One of the most common procedures is to detect erosion during a gynecological examination using mirrors. In this case, a clear epithelial defect is found. As a rule, on the examined surface of the uterine pharynx there is a clearly delineated area that has a red color. The area of erosion can be different.
Another method of examining an eroded area in order to determine the density of the affected tissue in case of suspicion of malignancy is the Chrobak test, which consists in probing the affected area.
In addition, the doctor sends biological material (smear from the erosion surface) to the laboratory for research. 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, the doctor detects visible damage to the epithelial tissue with the stromal area. In this case, the bottom in true erosion is at a low level in the layer of the columnar epithelium (or in the squamous stratified epithelium).
If there is a suspicion that the process is malignant, tissue sampling for biopsy is mandatory. This will detect any abnormal cells present. Only a comprehensive study will make it possible 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 a patient carrying a child should be different from that of a non-pregnant woman. All the most popular techniques, including laser, cryodestruction or diathermocoagulation, can be used only after the baby is born. Pregnancy is the period during which only the most gentle techniques in combination with supportive therapy can be used to eliminate the erosive process.
The primary goal is to stop the progression of the erosive process, to prevent the development of inflammation. However, most experts are of the opinion that erosion should simply be monitored. If it does not threaten the development of complications, then it makes no sense to treat it with medication.
In the case when a pregnant woman complains of a recurring burning sensation and the appearance of bloody discharge, it is possible to use methyluracil in the form of vaginal suppositories. They are administered for two weeks, twice a day. It is recommended to use candles with sea buckthorn oil, 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 observing physician based on the obtained bacteriological culture and taking into account contraindications.
It is during pregnancy that a competent preventive program is important, since in connection with hormonal changes, the risk of developing the disease increases.
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To avoid this, it is important to adhere to the following rules:
- Visits to the gynecologist should be strictly scheduled. You cannot miss the scheduled reception time. This will allow not only to fully monitor the course of pregnancy, but also to detect the development of possible pathological processes in time;
- The rules of intimate hygiene are important. You should take a shower during pregnancy and change your underwear regularly, at least once a day. It is necessary to use only linen made from natural fabrics;
- If possible, you should not change sexual partners during pregnancy, as well as practice unprotected intercourse;
- If any deviations from the norm occur, you should immediately consult a doctor, without waiting for a pre-scheduled visit. We are talking about the occurrence of a burning sensation and discomfort, the appearance of pathological discharge.
Due to the fact that erosion in some cases increases the risks of developing such serious complications as the addition of a purulent or inflammatory process, and also threatens with early termination of pregnancy, doctors strongly recommend getting rid of it before conception. A healthy cervix is one of the components of successful gestation and timely delivery.
If it suddenly happened that the pathological process was discovered after conception, then you should not panic and wait for negative consequences. Constant medical supervision, adequate preventive treatment by conservative methods and the absence of other diseases of the genital area in most cases are the key to a favorable pregnancy outcome without any consequences. It should be remembered that the erosive process is not a reason to terminate a pregnancy. Nevertheless, it is highly advisable to undergo a cytological examination 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 gestation. In this case, only regular medical supervision is sufficient.
As for the behavior of a woman after she has given 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 the erosion. If she has not eliminated herself, then it is necessary to carry out therapeutic measures. It is better to entrust the choice of a specific technique to a doctor.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
