Introduction

Cervicitis is the inflammation of the cervix. It is generally caused by a contagious agent, which is generally sexually transmitted.

Cervicitis is probably the most common infection of all gynaecological disorders affecting half of all people assigned female at birth (AFAB) at some point in their lives. It is important to address the symptoms during gestation to prevent potential complications for both the pregnant parent and the child.

Causes and risk factors

Cervicitis is usually caused by an infectious agent. Moreover, other conditions or factors such as using contraceptives, douching, abortion, injury, and hormone imbalance may lead to cervicitis.

Bacterial infections

Women of reproductive age may be found to have large numbers of facultative bacteria such as Enterobacteriaceae, Streptococci, as well as Lactobacillin which are mostly associated with a healthy state. When antibiotic or some other factors disrupts the Lactobacillus, the acidic PH is no longer maintained and these pathogens may grow, leading to vaginal inflammation that may transfer to the cervix causing cervicitis.

Viral infections

Viral infections acquired during unprotected sex can infect the cervix causing cervicitis.

Sexually transmitted infections (STIs)

Depending on the site of infection, Sexually transmitted infections (STIs) can manifest as urethritis, vaginitis or cervicitis. Most frequently, the bacterial and viral infections that beget cervicitis are transmitted by sexual contact. Cervicitis can be affected by common sexually transmitted infections (STIs), including:

• Chlamydia
• Gonorrhea
• Genital herpes
• Human papillomavirus (HPV)
• Trichomoniasis

Other risk factors

Other conditions/factors that increase the risk of cervicitis include:

• Using contraceptives
• Douching
• Abortion
• Injury
• Hormone imbalances
• Beginning to have sex at an early age

Symptoms

Most people diagnosed with cervicitis are asymptomatic or have nonspecific symptoms such as:

• Intermenstrual bleeding 
• Pain in the lower tummy and during sexual intercourse
• Stinging, burning or irritation in the affected area
• Discomfort when urinating

The symptoms are generally nonspecific, the most significant being an increase in vaginal discharge and or intermenstrual bleeding.

Diagnosis

With early detection and diagnosis, cervicitis can be curbed at the early stage and appropriate treatment provided as the case may be. Methods of diagnosis include:

Physical examination

All people with dubitation of cervicitis should have pelvic and vaginal examinations. The classic signs include mucoid discharge and easy bleeding of the endocervix on touching with a cotton applicator.

After pelvic examination, the person receiving the examination may feel discomfort due to inflammation of the vagina or discharge from the cervix. In addition, the physician will observe an inflamed cervix compared to a woman without cervicitis. Occasionally, the gynaecologist may also consider it necessary to perform cytology to assess whether the cervicitis is due to an infection.

Diagnostic procedures 

Cervicitis can be diagnosed during a full pelvic test. A pap smear may also be performed. These tests allow your healthcare provider to check your cervical and uterine cells for abnormalities. Your provider will also take a sample of any vaginal discharge to test for infections similar to gonorrhoea, chlamydia, trichomoniasis and bacterial vaginosis.

Pelvic exam

During this test, your physician checks your pelvic organs for areas of swelling. They may also place a speculum in your vagina to view the upper, lower and side walls of the vagina and the cervix. In a process similar to a pap smear, your physician uses a small cotton swab to gently remove a sample of cervical and vaginal fluid. Your physician sends the sample to a lab to test for infections. Lab tests may also be performed on a urine sample.

Complications

A pregnant person with untreated cervicitis risks miscarriage, premature delivery, or infections of a newborn baby, which can lead to pneumonia, severe eye infection, or blindness.

Risks to the foetus 

Infection and inflammation of the cervix play a significant role in preterm birth. Early detection and treatment of cervicitis can reduce the threat of preterm birth. Left untreated in pregnancy, cervicitis caused by a sexually transmitted disease can lead to premature labour and miscarriage. It can also cause infection in the eyes and lungs of the newborn.

Treatment

Antibiotic therapy

Cervicitis treatment generally includes antibiotics to exclude any bacterial infections that may be causing the condition. People under age 25 or who engage in high-threat behaviours may be treated with antibiotics indeed if bacteria are not detected because some bacteria can be hard to discover but may still be present. Antibiotics successfully treat cervicitis in most cases.

Antiviral therapy

Your physician may offer antiviral drugs if your cervicitis is caused by conditions like genital herpes, which helps reduce the amount of time you experience cervicitis symptoms.

Importance of partner treatment

Both you and your partner will need treatment, frequently with an antibiotic drug if you have cervicitis caused by a sexually transmitted infection (STI).To avoid passing a bacterial infection along to your partner, refrain from engaging in sexual intercourse until you've finished the treatment recommended by your physician.

Prevention

Safe sexual practices

Though you can’t always avoid cervicitis, you can reduce your risk of contracting it by exercising safe sex practices. Using condoms every time you have intercourse will drastically reduce your threat of sexually transmitted infections.

Regular screening for STIs

The highest incidence of cervicitis is in sexually active AFAB people aged 15 to 24. It is also common in human immunodeficiency virus (HIV) positive AFAB people. This makes regular screening for STIs important in the prevention of cervicitis.

Vaccination against preventable infections

Pre-exposure vaccination is one of the most effective methods for preventing transmission of HPV, and Hepatitis B virus, all of which can be sexually transmitted. Getting vaccinated against these viruses reduces the risk of Sexually Transmitted Infections which in turn reduces the risk of cervicitis.

Management during pregnancy

Monitoring and follow-up care

Early discovery of gynaecological infections is key to achieving better treatment results. For acute cervicitis, the physician will specify a drug as the main treatment. Generally, a combination of oral antibiotics and gynaecological suppositories to increase the effectiveness of treatment. For chronic cervicitis, the physician still prescribes the treatment of cervicitis in combination with special solutions to clean the private area. Because of simplicity during pregnancy, surgical and invasive methods should not be used; if necessary, surgery can be performed after the baby is born. In addition, AFAB people who are pregnant should also take measures to prevent cervicitis during pregnancy to minimise the risk of cervicitis.

Collaborative care with obstetricians and other healthcare providers

Collaborative care between the obstetrician and other health providers is very important during pregnancy. Sharing care plans and disclosing to other healthcare providers involved in care helps to know which procedures can and cannot be performed on the patient.

Summary

Understanding cervicitis and its implications in pregnancy is vital for healthcare providers and expectant parents. By prioritising prevention, early detection, and appropriate treatment, the impact of cervicitis on maternal and foetal health can be minimised, resulting in healthier pregnancies and births.

Importance of proactive management and awareness of cervicitis in pregnancy

Proactive management can help to prevent adverse outcomes and complications arising from cervicitis and help to ensure a healthier pregnancy. It also helps to maintain maternal well-being and foetal health during pregnancy, reduce the likelihood of complications to both the pregnant parent and their child and help individuals experience a smoother pregnancy journey.

Proactive management and awareness of cervicitis in pregnancy play a vital role in safeguarding maternal and foetal health, preventing complications, and enhancing the overall pregnancy experience.

FAQs

Are there home remedies to treat cervicitis?

There are some natural treatment options for cervical inflammation. For example, you can drink infusions of primrose or carrot tea.

Another home remedy for cervicitis would be to use aloe vera for its regenerative power and anti-inflammatory function. However, it is advisable to visit a specialist if symptoms of possible cervicitis appear.

What is the prognosis of cervicitis?

Inflammation of the cervix (cervicitis) generally has a good prognosis, as most AFAB people outgrow the condition after treatment.

However, sometimes cervicitis can last for months or years. Complications can also occur in AFAB people if the infection spreads through the female reproductive tract, although such complications are rare.