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Where does the cervix GO when it effaces?

post #1 of 14
Thread Starter 
One of my students asked me this question tonight, and I confessed that I have no idea!

She wondered, when the cervix effaces, in going from 1" to the thickness of a piece of paper, where that tissues GOES? Does it literally disappear, or does it get pushed back up into the uterus? Or something else? I'd never considered this issue.

Thanks in advance for the anatomy lesson, someone.
post #2 of 14
One of the groups of muscles in the uterus are round, almost as if they were one inch wide ribbons stacked on top of each other in a spiral from the top down. As the cervix effaces, the uterus is drawing the tissue of the cervix up INTO the rest of the uterus...kind of smooshing those layers into narrower rings, if that makes sense? So the short answer: it gets drawn upward into the body of the uterus.
post #3 of 14
This is generally the way I understand it, too, courtenay_e.
post #4 of 14
With my clients and students I use the illustration of putting on a turtleneck.
post #5 of 14
Yep I agree. I have had SOO many moms ask me that during labor (I worked L&D as an RN) and I explained it to them by the turtleneck diagram.
post #6 of 14
I've heard that the lower part of the uterus sort of pulls the cervix into itself?
post #7 of 14
Thread Starter 
Thanks, ladies!

I use the turtleneck analogy too, but it didn't really explain to me what actually happened to the tissue, geographically speaking. I appreciate the words to share with my student.
post #8 of 14

Cervix structure

It might be interesting to note, that during pregnancy, cervix (lower part of uterus) does not contain too much of muscle cells (around 15%), rather the tough collagen fiber and fibroblast cells keep cervix tight and strong (under the influence of progesterone).On top of that, cervical mucous plug forms, secreted by the large glands of cervical mucosa.

I'll skip the sequence of hormones that play their role during first stage of labor, just to mention that prostagladins cause a reaction and encourage production of enzymes that digest collagen fiber, and fibroblast present goes through a shortening phase, so dilation and effacement occur.
"Thinning" of cervix is usually what happens with collagen structure - digestion and disappearing of it.
Action is upward and to the side, and of course, muscle of fundus work to pull and help with opening of present muscle cells.In certain circumstances, this action can stall and even reverse (so dilation can go from 7-8 cm back to 4 cm, for instance, if Mom is feeling threatened by something or someone), due to vertical and horizontal muscles of the uterus (this is mentioned in Ina May Gaskin's "Guide To Childbirth"). Vertical muscles pull, while horizontal are relaxed, and in case of emergency and stress on Mom's part, that gets reversed, or both types of muscles pull in the same time (that makes progress stop), which usually is painful and cramping.

Here is a nice drawing of myometrial fibers of the uterus:
http://www.moondragon.org/obgyn/grap...rialfibers.jpg

All of the information I mentioned, is gathered from various books & journals, and I need to note that even today, just a fraction of information on cervix,uterus, and mechanism of dilation and early stage of labor are known:
1) Ultrasound and the Uterus (Osmers & Kurjak)
2) Human Reproduction journal
3) Human Reproductive Biology (college textbook)
4) Guide To Childbirth - Ina May Gaskin
post #9 of 14
Quote:
Originally Posted by JessicaE View Post
Where does the cervix GO when it effaces?

Tahiti. Even a lowly cervix needs a vacation from time to time.

post #10 of 14
Quote:
Originally Posted by OHmidwife View Post
Tahiti. Even a lowly cervix needs a vacation from time to time.

post #11 of 14
Quote:
Originally Posted by OHmidwife View Post
Tahiti. Even a lowly cervix needs a vacation from time to time.



Oh I love it!
post #12 of 14
Thread Starter 
Quote:
Originally Posted by OHmidwife View Post
Tahiti. Even a lowly cervix needs a vacation from time to time.

:
post #13 of 14
Tahiti is a good choice! (Love it!)

J.
post #14 of 14
Sorry about that folks, saw the thread title and just couldn't resist. :
But, yeah, what all of them ^ said is right. But if I'm explaining to a lay person, I just say it gets pulled up and kinda squashed into the uterus and that it good enough for most people.
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