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Chapter: Obstetric and Gynecological Nursing : Congenital Anomalies of the Female Genital Organs

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Cervix Abnormalities

May also affect the course of labour and birth. Three general types of cervical abnormalities have been identified.

Cervix Abnormalities

 

May also affect the course of labour and birth. Three general types of cervical abnormalities have been identified.

The septate cervix consists of a ring of muscular tissue partitioned by a septum that either extends down ward from the uterus or up ward from the vagina or is contained completely with in the cervix itself.

 

A single hemi cervix or half-cervix results from incomplete and asymmetrical development in which only one mullerian duct matures.

A double cervix has two separate cervices in one uterus vaginal abnormalities also occur. The most common abnormality is the presence of vaginal septa and some time there is an absence of vagina.

 

Causes

 

A. Errors of sinus canalization

Imperforated hymen

o       Complete or paritial vaginal atresia 

o       Parital transvers membreane (occurs in the upper vagina)

 

 

B. Failure of re-canalization of the Mullerian ducts. Thiswill head to atresia of the upper vagina or of the cervix.

 

C. Failure of fusion of the mullerian ducts- 

Lead to adouble uterus, a double cervix and two vagina opening in to a common vulva, or into two vulvae.

 

D. Failure of development of one or both mullerian ducts

 

·                 Absence of one duct- unicrnuate uterus with single oviduct

·                 Incomplte development of one duct results in unicrnuate uterus with two ducts

·                 Half or paricial of vagina (fuction normally)

·                 Absence of both -ducts means that neither oviducts nor uterus is present

 

E. Persistence of male (Wolffcan) duct remnants

 

·                 Cysts of the hydatid of morgagni in the mesovarium / leave of broad ligaments in the lateral vaginal wall

 

Effects of abnormality on pregnancy and labour

 

The malformations do not usually reduce fertility, and should the woman become pregnant, they may cause complications which lead to their detection.

 

·        Late abortion

 

·        preterm labour

 

·        malpresentations

 

·        obstructed labour ,retained placenta & PPH

 

Cervical abnormalities affect labour and birth to varying degrees, depending on the ability of the cervix to dilate and efface to permit delivery. It increases risk of cervical rupture and hemorrhage.

 

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