Cervicitis diagnosis
Cervicitis is a total infectious process in the cervix, including inflammation of the mucosa of the canal and inflammation of the mucosa of the vaginal segment of the cervix. Cervicitis is rarely an isolated condition, in 75-80% of cases the disease is accompanied by related pathologies - vaginitis and endometritis. Launched cervicitis can lead to cervical erosion, the formation of polyps in the uterine cavity, malignant degeneration of the cellular structures of the uterus, and infertility.
Cervicitis: causes
It develops as a result of invasion of the cervical canal by streptococci, staphylococci, Escherichia coli, less often viruses, Trichomonas. Anaerobic microflora and chlamydia play a certain role in the occurrence of cervicitis. Cervicitis of syphilitic or tuberculous etiology is relatively rare.
At the first stage, the mucous membrane of the cervical canal is affected with further involvement of the stroma in the pathological process. The acute form of cervicitis is characterized by the expansion of the vascular pattern, the accumulation of leukocytes near the glands and blood vessels, periglandular / perivascular abscesses. Patients are concerned about moderate pain in the lower abdomen, burning in the vagina, mucopurulent or purulent discharge from the genital tract, postcoital bleeding, frequent urge to urinate. A gynecological examination reveals swelling, redness of the mucous membrane of the vaginal segment of the cervix, signs of pseudo-erosion or "solid erosion".
The diagnosis of "acute cervicitis" is made on the basis of a visual examination of the cervix using a colposcope and vaginal mirrors, anamnesis, bacteriological examination data of the cervical canal. Transferred viral infection, conjunctivitis, fever - a reason for virological research. Therapy is carried out taking into account the stage of the disease, concomitant pathologies, the nature of the pathogen. Vaginal douching is prescribed with a solution of lactic acid, chamomile infusion, antibiotics or sulfonamides (bacterial C), Tetracycline and Doxycycline (chlamydial C), Metronidazole (anaerobic microflora), leukocyte interferon preparations (viral C).
Cervicitis - possible complications:
- recurrent infectious process in the organs of the genitourinary system;
- "launch" of the pathological mechanism: cervical erosion - dysplasia - oncology;
- polyps on the cervix and in the uterine cavity;
- malignant degeneration (malignancy) of the cellular structures of the uterus;
- miscarriage, infertility.
Chronic cervicitis: symptoms, diagnosis, treatment
The chronic stage of the disease is a consequence of untreated acute cervicitis. It is characterized by scanty mucopurulent or purulent discharge from the vagina, edema and slight hyperemia of the cervix.
Morphological signs of chronic cirvicitis:
- muscle and connective tissue elements are involved in the inflammatory process;
- discharge from the genital tract intensifies 1-2 days after the end of menstruation;
- the cervical canal is re-infected, the rejection of the epithelium is not excluded;
- the cervix is hypertrophied and compacted;
- squamous epithelium partially replaces cylindrical epithelium, metaplasia of the epithelium is likely;
- infiltrates and cysts appear.
Diagnostic measures
Diagnosis of chronic cervicitis is often difficult due to blurred symptoms, which leads to untimely therapy and the transition of the disease into a long process that occurs with exacerbations, which is difficult to respond to drug treatment.
Step-by-step differential diagnosis of cervicitis:
- a thorough analysis of the anamnesis with the obligatory consideration of the postponed childbirth and gynecological surgical interventions;
- assessment of the clinical picture;
- examination of the cervix and cervical canal using mirrors;
- study of the results of cytology, microbiological research.
Required tests:
- macroscopic examination of vaginal discharge, urethra, cervical canal for bacterial flora;
- smear for oncocytology;
- bacteriological culture with the isolation of the pathogen, the identification of its sensitivity to antibacterial drugs;
- general analysis of urine, blood;
- test for HIV and syphilis, seeding for gonococcus;
- colposcopy (detection of deformed segments that differ in vascular structure, color, structure from the rest of the surface);
- diagnosis of ureaplasma, mycoplasma, chlamydia, papillomavirus, herpetic infections.
Treatment of chronic cervicitis
Preparations for the treatment of cervicitis:
- Doxycycline (0.2 g per day throughout the course);
- Acyclovir (200 mg five times a day for 5 days);
- Sumamed (single dose, the dosage is determined by the attending physician, depending on the type of pathogen);
- Valtrex (twice a day, 500 mg for 5 days);
- Terzhinan (one suppository per day, for 10-12 days);
- Tarivid (once 2 tablets);
- Maxakvin (once a day, 400 mg, the duration of admission is determined by the doctor);
- Erythromycin (the duration of the course / dosage is determined by the doctor depending on the type of pathogen).
Candles from cervicitis
Preparations in the form of suppositories (suppositories) are widely used in the complex treatment of chronic cervicitis. Their use allows a targeted effect on the immunopathogenesis of the inflammatory process by regenerating disturbed homeostasis. The optimal ratio of components in suppositories guarantees active absorption of the cervical mucosa and good tolerance.
Terzhinan. Antifungal and antibacterial suppositories of complex action, active against pyogenic bacteria, Trichomonas, anaerobic flora, Candida fungi. They have a local anti-inflammatory effect. Auxiliary components of suppositories preserve the integrity of the vaginal epithelium in infectious and inflammatory diseases, maintain a normal pH balance.
Polygynax. Combined drug, characterized by antifungal, bactericidal, antibacterial effect. The active substances of Polygynax (polymyxin, neomycin) neutralize many gram-positive / gram-negative microorganisms, improve trophic processes in the vaginal mucosa.
Betadine. Broad-spectrum antimicrobial suppositories, effective against viruses, fungi, bacteria, quickly restore the normal microflora of the vagina.
Macmirror complex. Candles are included in the group of antiseptics and antimicrobials. They have a pronounced antifungal, antibacterial, antiprotozoal effect. Do not violate the physiological flora, restore the normocenosis of the vagina.
Cervicitis during pregnancy
The problem of cervicitis is of particular importance during pregnancy. The presence of a history of the diagnosis of "cervicitis" implies a high probability of premature birth, purulent-septic complications, intrauterine infection of the fetus. In Russia, the percentage of intrauterine infections ranges from 6-50%, reaching 75% among premature babies. The frequency of perinatal mortality from this pathology varies from 3% to 65%. There are five routes of penetration of an infectious agent into the body of a pregnant woman: descending, ascending, mixed, transdecidual, hematogenous. The greatest danger is ascending, in which the infection enters the uterus through the cervical canal. The chronic focus of inflammation in the cervical canal serves as a convenient "gateway" for pathogenic viruses and bacteria. If intrauterine infection occurred in the early stages of pregnancy, embryopathies are formed that provoke primary placental insufficiency and congenital malformations - this ends with an undeveloped pregnancy and miscarriages.
Infection in the later stages is accompanied by a delay in fetal development, generalized / local lesions of the fetus, the formation of repeated placental insufficiency. Generalized forms of infection most often develop in the first trimester of pregnancy, when the fetus is not yet able to localize inflammation. In the third semester, inflammatory mutations cause obstruction (blockage) or a significant narrowing of the holes / channels, which leads to anomalies of an already formed organ - hydronephrosis and hydrocephalus. During gestation (the number of complete weeks of gestation), the cervix protects the fetal egg and the uterine cavity from exogenous pathogens, performing a barrier role. Cervicitis provokes premature termination of pregnancy due to infection of the embryo, placenta, amniotic fluid, the fetus itself.
Infection of waters and membranes is also possible with ascending infection. Pathogenic organisms penetrate the fetal fluid, migrate between the membranes and reach the basal plate, where they are opposed by leukocyte infiltration. In parallel, a focus of infection is structured in the amniotic fluid, which causes the death of the fetus.
Cervicitis: treatment during pregnancy
Cervicitis during pregnancy requires an urgent detailed examination and complex therapy. Antiviral, antifungal, antibacterial drugs are used, taking into account the type of infectious agent and its resistance to drugs. The safest and most effective drug for the treatment of cervicitis in pregnant women is Sumamed. He has proven himself in the treatment of mycoplasma, ureaplasma, chlamydial infections. Sumamed (active substance - azistromycin) remains in the focus of inflammation for 5-8 days, which allows doctors to develop the shortest (3 days) and safe treatment courses for pregnant women. Timely and adequate treatment of the disease allows you to neutralize the complications associated with pregnancy, and significantly increases the likelihood of normal delivery.
Treatment of cervicitis with folk remedies
Traditional medicine recipes for the treatment of cervicitis can only be used "in conjunction" with traditional methods and only after consultation with doctors. Self-medication can lead to serious complications.
Prevention of cervicitis:
- regular preventive examinations by a specialized specialist;
- treatment of genitourinary infections, venereal diseases;
- strengthening immunity;
- taking hormonal contraception during menopause.
Cervicitis is a serious pathology that can lead to infertility, so it is impossible to ignore the “first bells” indicating the presence of an infection in the genitals. Adequate and timely treatment of the disease allows you to avoid many health troubles and complications associated with the conception and bearing of a child.