CERVICAL PREGNANCY —
pregnancy, at a cut an attachment and development of fetal egg happens in channel of a neck of uterus, between an internal and outside pharynx. Meets seldom.
Distinguish true cervical pregnancy when the placenta is located in the channel of a neck of uterus, and the cervical and recervical pregnancy which is characterized by an arrangement of a placenta in the channel of a neck of uterus and in the field of an isthmus.
The endometritis, a hypoplasia of a uterus, frequent artificial abortions, repeated diagnostic a scraping of a mucous membrane of a uterus, leading to dystrophic and atrophic changes of an endometria are the reason of an abnormal attachment of fetal egg. Penetration of fetal egg into the channel of a neck of uterus can be promoted by tumors, cicatricial changes in area of an internal pharynx, and also istmiko-cervical insufficiency (see).
Vorsina of chorion are deeply implemented into mucous and muscular layers, quite often sprout all wall of a neck of uterus, getting into perimetric cellulose. In process of growth of fetal egg there is a thinning of walls of a neck of uterus and placental detachment. Well developed network of blood vessels and existence of varicose nodes in a wall of a neck of uterus promote developing of bleeding, life-threatening. Bleeding arises in the I trimester of pregnancy more often and would be the main symptom of Sh. Quite often plentiful bleeding is preceded by periodic scanty bloody allocations (see. Uterine bleedings).
At diagnosis consider lack of periods, existence of other signs of pregnancy and results of vaginal examonation. Apply also ultrasonic investigation (see. Ultrasonic diagnosis).
At survey of a vagina shortening of a vulval part of a neck of uterus is observed, edges has the barrel-shaped form, the expressed cyanosis, considerable thinning of edges of an outside pharynx and its eccentric arrangement is noted. Continuation of the shortened vulval part of a neck of uterus is the fruit bed — soft education, in size corresponding to duration of gestation. The body of the womb is dense, the smaller size, than shall be at estimated duration of gestation, also a little sideways from it is located over a fruit bed, can remind a subserous myomatous node.
ShEYERMANNA - MAU the DISEASE
carry out 391 Differential diagnosis with a hysteromyoma (see) and abortion in the course (see the Misbirth). Distinguishing character of UI. — strengthening of bleeding at a repeated scraping of a neck of uterus.
By the only method of treatment of Sh. an urgent operative measure — a hysterectomy is (see). Attempts of removal of fetal egg through a vagina lead to profuse bleeding. In exceptional cases in the absence of conditions for carrying out operation as a compulsory measure it is possible to use a hard tamponade of a uterus and vagina, imposing of terminals on vessels of a neck of uterus for the period of transportation of the patient in specialized medical institution.
The forecast depends on timeliness of an operative measure.
Prevention consists in timely treatment of gynecologic diseases and the prevention of abortions.
Bibliography: Lekhtman M. N. Kleene -
to - morphological features of cervical and cervical and recervical pregnancy, Frunze, 1970, bibliogr.; About to about e in G. G. Ultrasonic diagnosis of cervical and recervical pregnancy, Owls. medical, No. 8, page 114, 1982; Sketches of obstetric pathology and operational obstetrics, under the editorship of K. N. Zhmakin and JI. G. Stepanova, page 136, M., 1953; Suprutskaya G. G. and Roza of N of t at l E. B. K to a question of cervical and cervical and recervical pregnancy, Akush. and ginek., No. 1, page 49, 1979; In eg-naschek G. u. Kratochwil And. Die Ultraschalldiagnose der Zervikalgravi-ditat, Geburtsh. u. Frauenheilk., S. 509, 1981; Bernstein D. o. Conservative treatment of cervical pregnancy, Obstet. and Gynec., v. 58, p. 741, 1981;
Ratten G. J. Cervical pregnancy treated by ligation of the descending branch of the uterine arteries, Brit. J. Obstet. Gynec., v. 90, p. 367, 1983; S z e j a L. J., R a h a g h i A. Rentz F. P. Ultrasound diagnosis of cervical pregnancy, Amer. J. Obstet. Gynec., v. 136, p. 416, 1980. A. H. Strizhakov.