Causes of cervical obstruction

Some pregnant women find that their cervix is ​​not open when they are about to give birth. This will be very uncomfortable and they will continue to have severe abdominal pain. If this continues for a long time, it will lead to dystocia, which is very dangerous. The reason for this situation is related to the inflammation that occurred during the previous surgery.

1. History of intrauterine operation

(1) Pregnancy factors: pregnancy-related intrauterine surgery such as vacuum aspiration in early pregnancy, forceps curettage in mid-pregnancy, curettage for induction of labor in mid-pregnancy, curettage for postpartum hemorrhage, and curettage for spontaneous abortion. This may be because the basal layer of the endometrium of the pregnant uterus is more easily damaged, causing the uterine walls to adhere to each other and form permanent adhesions.

(2) Non-pregnancy factors: Myomectomy (entering the uterine cavity), transuterine removal of submucosal uterine myomas, hysterectomy, and double uterus surgery destroy the basal layer of the endometrium, exposing the myometrium to the uterine cavity and leading to anterior and posterior adhesions of the uterine wall.

2. Surgical inflammatory factors

Intrauterine infection includes uterine tuberculosis, postmenopausal senile endometritis, secondary infection after uterine operation, puerperal infection, secondary infection after intrauterine contraceptive device placement, etc.

3. Human Factors

Artificially destroy the basal layer of the endometrium to cause intrauterine adhesions. Such as: after endometrial electrosurgical resection, intrauterine microwave, cryotherapy, chemotherapy and local radiotherapy.

4. Endometrial damage during curettage due to various reasons

If the uterus is repeatedly curettaged, it is very easy to damage the basal layer. The intrauterine adhesion caused by this reason is called traumatic adhesion, which is the most common. Therefore, obstetricians and gynecologists should use appropriate depth of curettage. Women of childbearing age should implement contraceptive measures and avoid abortion, especially for the first abortion, which may cause secondary infertility due to intrauterine adhesion.

Under normal physiological conditions, the anterior and posterior walls of the normal uterine cavity are in contact and closed, and adhesions will not occur even when the endometrium is exfoliated during menstruation. This is because the integrity and function of the basal layer of the endometrium are normal. If the endometrium is damaged by physical and chemical factors such as surgery or inflammation, causing the destruction of the basal layer of the endometrium and changing the regular growth and shedding of the endometrium during the normal menstrual cycle, it can lead to the exudation and deposition of fibrinogen in the uterine stroma, causing adhesions between the anterior and posterior walls of the uterine cavity.