Can dilation reverse?

CEG · Sep 19, 2006

If you read some of the crunchier childbirth books, I am thinking Ina May's Guide to Childbirth, they discuss reverse dilation as a stress/fear response. Like arriving at the hospital and feeling intimidated, getting examined by a stranger, pain worsening or some other stressor. It's a pretty common theory among your non-mainstream.

kirsnikity · Sep 19, 2006

Was the woman in labor? Could it just have shrunk due to swelling?

Other than that, perhaps there were subjective differences amongst different examiners?

I don't have any personal stories since I'm still pretty new though.

Nikki

SmilingBluEyes · Sep 19, 2006

yes, it can, in a way.

the cervix can swell up, esp in cases of malpresentation.

also, like said above, it can also be the difference between pracitioners' varying exams. it's all subjective as you know.

allnurses Guide · Sep 19, 2006

yes, it can, in a way.
the cervix can swell up, esp in cases of malpresentation.
also, like said above, it can also be the difference between pracitioners' varying exams. it's all subjective as you know.

Swelling happens - absolutely.

Also, docs I work with fudge a bit on the dilation to placate the moms. Of course that drives me crazy when I check and no way is she 3 cm. :rolleyes:

steph

kastas, BSN, RN · Sep 19, 2006

My thought is that it doesn't necessarily have to be r/t swelling. It could be slightly more dilated b/c pt was up walking and pp was lower and pressing on cervix. I've also seen where the bbow was making cervix seem more dilated. Once water broke or pt layed down and it was less bulgy, cervix did "shrink". By how much? ... I've never noticed more than a cm or so.

bagladyrn, RN · Sep 19, 2006

It can also seem to "shrink" if the previous person checked during a contraction and the next one checks without one. The bulging bow thing can be quite a marked difference.

klone, MSN, RN · Sep 20, 2006

I had a patient recently go from having an anterior lip, to about 7-8 cm. d/t cervical swelling.

Liddle Noodnik · Sep 20, 2006

I had this happen to me in 87, I don't remember the numbers, but I just would not stay dilated. I had some INCREDIBLY strong contractions, they told me that they had seen few contractions register as high as mine. But unfortunately the contractions would not stay consistently regular and frequent. So I would go to (I think) 8 cm and then down to 5 or 6? between contractions. This was after being INDUCED! 42 hrs after my water broke I had a c section. Boy was I ticked, going thru all that agony for nothing.

But at least my son had a BEAUTIFUL round head :)

mitchsmom · Sep 20, 2006

Thanks for all the feedback!

Also, what causes the cervical swelling - I mean, is it just the general pressure and trauma that does it to some people and/or are there certain situations that are going to predispose to swelling?

Mississippi_RN · Sep 20, 2006

I have heard of bulging bag of water making the SVE seem one thing, and then when ROM occurs, SVE seeming to shrink somewhat. Not by much in the case I have had experience with (like 1-2 cm MAYBE)...but then, cervix dilated to complete in fairly short order.

nursejohio, ASN, RN · Sep 20, 2006

Yep, it can. I've heard of it lots, but just had my first pt go backwards. She was 8, huge BBOW, baby was still at -5 (ok, not really. It was still very high though. I made the doc scan her again because I couldn't reach a presenting part) and when she ruptured it went back to 6 because there was nothing applied to the cervix. Her labor curve looked lovely! It can also "shrink" from swelling, usually in CPD if the head is well applied but just not descending or if mom starts pushing before she's complete.