Cervical edema

　　Postpartum delay, malposition of the pelvis, pelvic contraction, abnormal fetal position, and other factors are common causes of cervical edema. The occurrence of cervical edema is generally related to the composition of the cervical tissue and the anatomical structure of the pelvis:
　　(1) The number of collagen fibers, which play an important role in maintaining the elasticity of the cervix, is greatly reduced, only 30% of that during non-pregnancy, and they are easily degraded under the action of collagenase; the fiber bundles also become thinner and shorter, arranged loosely, and the gaps become wider, which is conducive to water and sodium retention.
　　(2) During the late stage of pregnancy, the blood vessels of the cervix are significantly dilated, and the blood perfusion of the arteries in the cervical tissue increases 1.5 to 2.0 times during uterine contraction compared to the resting period. Cervical edema is often caused by the long-term compression of the anterior lip of the cervix between the fetal head and the pubic symphysis. If the cervix is compressed for a long time or if the pregnant woman uses abdominal pressure prematurely due to obstetric reasons, it can cause an increase in abdominal venous pressure, leading to the obstruction of cervical venous and lymphatic return, which can also cause cervical edema.

　　In addition to its clinical manifestations, cervical edema can also cause other diseases. If this disease is not treated effectively and in a timely manner, it may lead to infertility. Pregnant women may develop cervical canal stenosis, which can cause dystocia.

　　After entering the labor process, the expansion and disappearance of the cervix are not only the result of passive traction but also the result of its active changes, which play a crucial role in delivery. However, due to a series of biochemical and hemorheological changes in the cervix during pregnancy, it is more prone to edema. Cervical edema often manifests as the woman being restless, suffering from severe pain, and panting prematurely, with a slow expansion of the cervix during vaginal examination, the cervix becoming thick and swollen, with poor elasticity, and the affected area can be the whole or part of the cervix, with the anterior lip of the cervix being more common.

　　During the late stage of pregnancy, the number of collagen fibers that play an important role in maintaining the elasticity of the cervix is greatly reduced, only 30% of that in non-pregnant women, and they are easily degraded under the action of collagenase; the fiber bundles also become thinner and shorter, arranged loosely, and the gaps become wider, which is easy to cause water and sodium retention. The blood vessels of the cervix are significantly dilated in the late stage of pregnancy, and the blood perfusion of the arteries in the cervical tissue increases 1.5 to 2.0 times during uterine contraction compared to the resting period. Cervical edema is often caused by the long-term compression of the anterior lip of the cervix between the fetal head and the pubic symphysis. If the cervix is compressed for a long time or if the pregnant woman uses abdominal pressure prematurely due to obstetric reasons, it can cause an increase in abdominal venous pressure, leading to the obstruction of cervical venous and lymphatic return, which can also cause cervical edema.

　　Cervical edema is a common abnormal condition in obstetrics. If not handled properly or in a timely manner, the rate of dystocia or cesarean section will increase, and it will bring physical and mental trauma to pregnant women. At the same time, it will also cause patients to distrust and misunderstand doctors. Prolonged labor, malpresentation, pelvic contraction, and abnormal fetal position are common causes of cervical edema. Therefore, if cervical edema is found, the delivery process needs to be re-evaluated, and the causes of cervical edema should be excluded one by one.

　　1. Color Doppler ultrasound examination showed that the cervical mucosa was congested and edematous, presenting a bright red color.

　　2. The composition of the puncture fluid was examined, and a large amount of recurrent flat epithelium was found.

　　3. Blood routine examination, with a small number of red blood cells, as well as hemoglobin.

　　1. Avoid sweet and greasy foods: Foods that are too sweet and greasy, such as candy, cream cakes, eight-treasure rice, glutinous rice dumplings, lard, and fatty pork, mutton fat, and egg yolks, have the effect of promoting dampness, which can reduce the therapeutic effect and make the disease difficult to treat.

　　2. Avoid alcohol: Alcohol is a warm and stimulating food, and drinking alcohol will exacerbate damp-heat, worsening the condition.

　　4. Avoid spicy, fried, and hot foods: Spicy and fried foods such as chili, fennel, Sichuan pepper, onions, mustard, roasted chicken, fried pork chops, etc.; hot foods such as beef, mutton, and dog meat can all promote heat and inflammation, exacerbating the condition.

　　3. Avoid seafood and river products: Sea fish, crabs, shrimps, clams, scallops, cherrystone clams, oysters, abalones, etc., are all irritants, which are not conducive to the regression of inflammation.

　　Traditional Chinese Medicine for the treatment of cervical edema:

　　1. Downward invasion of damp-heat

　　Symptoms: Excessive leukorrhea, yellowish or purulent, or with blood streaks. Pain during sexual intercourse or vaginal bleeding after sexual intercourse. Lower back pain and distension, abdominal distension and descent, or frequent urination with pain, vulvar itching, bitter taste in the mouth, and dry throat. Red tongue with yellow greasy coating, wiry and slippery pulse.

　　Traditional Chinese Medicine: ①Fuyanping Capsules, 4 to 6 pills each time, 2 times a day, taken with warm water after meals. ②Gongzi Wan, 9 grams each time, 3 times a day, taken with warm water after meals.

　　Food Therapy: ①9 grams of broad bean flower, 12 grams of white bark of toona sinensis, wrapped in gauze and then boiled in 200 milliliters of water to obtain 150 milliliters, taken in divided doses, usually effective after 1 week. ②30 grams of new silkworm chaff (wrapped in cloth), 30 grams of Job's tears, boiled in an earthen pot with an appropriate amount of water, taken once a day, for 5 to 7 days consecutively.

　　2. Deficiency of the spleen and kidney

　　Symptoms: Excessive leukorrhea, thin and continuous, poor appetite, fatigue, soreness in the lower back and knees, pale complexion, or loose stools. Pale tongue with white or greasy coating, soft and slow pulse.

　　Traditional Chinese Medicine: ①Zhidai Wan, 3 to 6 grams each time, 2 to 3 times a day, taken with warm water after meals. ②Rongkun Wan, 6 grams each time, 3 times a day, taken with warm water.

　　Food Therapy: ①6 grams of deer antler, 30 grams of white fungus seeds, 30 grams of Chinese yam, 1 pig bladder. First, clean the pig bladder, crush all the drugs, put them into the pig bladder, tie the bladder mouth tightly, and simmer over low heat until soft, add a little salt for seasoning, and take the medicine, meat, and soup together. ②30 grams of Eucommia ulmoides (wrapped in cloth), 30 to 60 grams of glutinous rice, cook together to make porridge, remove the drug residue, and eat the porridge. Take one dose a day, for 7 to 8 doses consecutively.