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Cervical exam

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Transcript

Hi, everyone. Welcome back to parently Dr. Boyd here. Today we're talking about a very important topic for most women late in pregnancy, and this is your cervical exam. The reason this is important for both a healthcare provider and you as a patient is because it's information. It's objective information that you as a patient, and the healthcare provider can use together to determine if you are a candidate for advancement delivery, if you're a candidate for going into labor early or later. Those are all topics that are helpful in knowing your cervical exam.

So I'm going to be very detailed today explaining what a cervical exam is, and how that relates to labor and delivery. Now, the cervical exam What does this mean and how is it done? The cervical exam is going to start somewhere around your 36 to 38 week depends On if you're a first time mom, or if you've had imagined delivery in the past, now we're just going to use you as a patient as a woman. And look at two different scenarios, we're going to look at the first time mom, she's called a prime app or a Nola and we're going to look a mom that's had a baby in the past she is called a multi male. So we're going to address the Nola or the Private First, and we're going to examine you as a patient and we're going to explain how we do that.

So you're going to come into the office, around 38 weeks, we're going to put you in a late in a laying down position on the exam table. We're going to put your feet in stirrups maybe or we're going to pull your feet up by your bottom and a frog light position. The healthcare provider at that point we'll take one finger or two fingers and place them in your vagina. And we're going to assess both the opening of your cervix and the thinning of your cervix. The opening up your your cervix is called dilation. Now you dilate your cervix from one centimeter to 10 centimeters.

Now, two and a half centimeters equal one inch. So full dilation is 10 centimeters, so it's about four inches. So that's about this big, that's the size of a newborn baby's head that's approximately 10 centimeters, that's fully dilated. Obviously, on the other end of the spectrum when you're one or two centimeters dilated, you're, you're dilated about this much, again, debilitation or dilation synonymous terms, that simply means your cervix is open. The next thing that we assess as a health care provider is your effacement. Very, very confusing term for a lot of patients.

The normal length of your cervix is about four and a half centimeters, four and a half to five centimeters. So it's about two inches in length. As you start the process of getting prepared for vaginal delivery, your cervix will start to thin out. That means the length of your cervix will start to shorten like this. So shortening of your cervix, thinning of your cervix effacement are all synonymous terms and you will hear all of those in a healthcare provider setting. The third issue that we're are attempting to identify when we examine your cervix is the location of your baby's head.

We want your baby's head to be in the head down position. That's called vertex. And we oftentimes can tell because because because we can feel the baby's head in your pelvis if your baby is in the vertex presentation. If we can't tell the position of the baby, or we're feeling a butt or leg, those are issues that we determine oftentimes by ultrasound. So for now Sure of the position of the baby, we will take you in the other room and do an ultrasound or sonogram to determine the position of the baby. Very important as we're doing this exam, that the healthcare provider is communicating with you what these various items mean, cervical dilation or delimitation effacement, thinning or shortening and positioning the baby.

Those will help prepare you of whether labor will occur naturally, vaginally or whether you will be a candidate for a certain section. Now, important also to understand there's not a lot of correlation between cervical dilation effacement and labor. This is very, very confusing to patients because they say, Doctor, you said I was four centimeters 50% thinned out or 50% he faced. Surely that means I'm I'm going to go into labor today or tomorrow the next day. No, that's Not true. Women can stay advanced Li dilated for days and days, weeks and weeks, even months and months.

Now insane that as your cervix is changing, going from one centimeter, two centimeters to five centimeters, obviously there's progression that most women follow. So for now 40 weeks gestation, and you were two centimeters last week, and now you're five to six centimeters, typically that means you will go into labor soon. Now, again, what assume is that today, tomorrow The next day, if your healthcare provider tells you that it's a pure guess, sometimes patients do sometimes they don't. It is interesting statistic that 90% of patients go into labor, within 10 days of their due date. That means 10 days on this side, 10 days on this side. So if you get to your due date and you haven't delivered, that typically doesn't mean that something bad is going on, it simply means that you're not there.

Now the other patient I wanted to address is the patient that had babies before. We call her a multa. Now, multi purpose patients typically if they've delivered badly in the past, have a faster labor than they had before, faster and usually easier than they had before. So I'm going to give an example of a multo that is different from a primary. So oftentimes a multiple baby's head. That position when we examine the cervix typically is higher in the pelvis than a baby that is in a first time mom.

So again, remember we talked about the Nala or the prime minute first time mom, those babies oftentimes get into that into your pelvis as a woman earlier in pregnancy, and when you deliver those babies, oftentimes they have much more of a conehead because they've been in your pelvis much longer in a mall tip the baby's head stays higher until later in labor. Therefore they don't spend as much time in the pelvis. So the long conehead that you see in the Nola press Baby, you typically don't see in the multipurpose baby. These are some items that are very helpful for patients to understand the dynamics of labor. And we'll talk about labor on a separate video. But these are very important topics to understand for you as a woman later in pregnancy.

Have a great day.

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