Livmorhals

Livmorhals
MeSHCervix+uteri
TA98A09.1.03.010
TA23508
FMA17740

Livmorhals (llatin cervix uteri eller collum uteri) er i anatomi forbindelsen mellom vagina og livmoren.

Livmorhalsen består av samme muskelmasse som, og er den nederste delen av livmoren. Vaginalveggen er festet rundt livmorhalsen. Ved gynekologisk undersøkelse, GU, kan livmorhalsen undersøkes ved at undersøkeren har en eller to fingre i vagina, eller pekefinger i vagina og langfinger i endetarmen. Tidlige graviditeter kan sannsynliggjøres ved at livmorhalsen blir mykere i de første ukene av svangerskapet. På slutten av graviditeten kan livmorhalsens form med utsletting og eventuell åpning av uterinkanalen gi indikasjoner på hvor lenge det er igjen til fødselen. For gravide som må reise langt for å føde er denne undersøkelsen viktig for å bestemme avreisetidspunkt.

Overflatevevet i skjeden er plateepitel, som er en relativt solid overflate. I livmoren er det sylinderepitel som er mykere og er egnet til å ta imot et befruktet egg. I livmorhalsen, ytterst i uterinkanalen er en overgangssone mellom de to epitel/slimhinne -formene. I denne overgangssonen kan det oppstå cervixcancer/ livmorhalskreft. Dette er en av de vanligste kreftformene hos kvinner. Ved å bruke en børste eller/og en trespatel kan det fjernes celler fra overflaten av denne sonen og stryke det ut på en glassplate/objektglass. Glasset behandles med en spray og sendes til et laboratorium hvor utstryket blir farget og gransket av patologer, som er leger med spesialutdannelse blant annet i gransking av slike prøver. Dette er en cytologisk prøve, populært kalt kreftprøve.

Det anbefales at alle kvinner over ca. 22 år tar slik prøve hvert 3. år, eller oftere om de har plager fra underlivet.

Ved lokale kreftforandringer i livmorhalsen gjøres ofte et inngrep som kalles «konisering». Det vil si at det fjernes en kremmerhusformet bit med spissen nesten inne i uterinhulen og den runde grunnflaten av kremmerhuset som en sirkel rundt mormunnen/ åpningen i livmorhalsen. Dette fjerner en del muskelvev i livmorhalsen og øker fare for spontanabort og tidlig fødsel senere.

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