aium communities

Every ultrasound specialty. One professional network.

incompetent cervix

Hi for all,please iwant to ask about acurte of us in diag of i.cervix?

 

Views: 423

Replies to This Discussion

Permalink Reply by Bashir H Samma;MD,PGD&C,SrMAIUM on February 28, 2011 at 3:54pm
send me ur email address at drbashirhs@gmail.com and I shall email details on how to go about it and how to grade the severity oif the cx incompetence. Has had numerous cases of cx incompt. salaam
Permalink Reply by Dr MM Nurus shafi on March 1, 2011 at 7:20am

DR. Bashir,

Why not send in this forum ; we can all learn. Thankss.

Permalink Reply by Dr.Muhammad Bashir Malik on March 9, 2011 at 10:58am

Dear fellow

Incompetent cervix, in routine antenatal scan we ususally dnt look but if ther is any previous history or pt comes with pain before term than it should be look with special care. Bladder should be adequatly filled afetr taht measure cervical length it should be more than 4 cm and approximated both cervical lips mean no funneling sign, if there is opening of internal os and reduced cervical length it is incompetent cervix, below few cases one with incompetent cervix while other two with normal cervical length and close internal os.

Attachments:
Permalink Reply by ZENAB.A.KHAIR on March 9, 2011 at 3:11pm
THANKX FOR REPLY .
Permalink Reply by DR.NANDHINIKUMARI BASKAR on April 1, 2011 at 5:32am

Hi Zenab,

 

Transvaginal USG is the gold standard for the diagnosis of cervical incompetence.

Cervical assessment at the anomaly scan is not recommended routinely in all cases.But in previous h/o preterm birth and in multiple pregnancy and in followup of pts with cervical encerclage it is exteremly useful.We start doing cervical length measurements from 16 weeks up  as before that the lower uterine segment and cevix couldnot be well differentiated.

Cervical length measurements are also helpful in differentiating true and false labour pains and in postdated pregnancies. 

Detailed steps to correctly measure cervical length and applications in obs practise can be found at Fetal medicine foundation website.

I have attached an image each  of normal and incompetent cervix.

Attachments:
Permalink Reply by ZENAB.A.KHAIR on April 1, 2011 at 8:46am

Dear DR .NANDHINKUMARI :

Thanks for this informations &pictures.

Permalink Reply by Syed Amir Gilani on April 10, 2011 at 3:55am
you are great ,sir

Bashir H Samma;MD,PGD&C,SrMAIUM said:
send me ur email address at drbashirhs@gmail.com and I shall email details on how to go about it and how to grade the severity oif the cx incompetence. Has had numerous cases of cx incompt. salaam
Permalink Reply by Syed Amir Gilani on April 10, 2011 at 4:00am
Dear Dr Muhammad Bashir Malik
I just saw your three images--they are not labelled and they look irrelevant---- cervix,its measurement and incompetence is not clear.
Can you please help us by elaborating the latest protocols /classification in this regard.
sincerely;dr syed amir gilani


--

Dr.Muhammad Bashir Malik said:

Dear fellow

Incompetent cervix, in routine antenatal scan we ususally dnt look but if ther is any previous history or pt comes with pain before term than it should be look with special care. Bladder should be adequatly filled afetr taht measure cervical length it should be more than 4 cm and approximated both cervical lips mean no funneling sign, if there is opening of internal os and reduced cervical length it is incompetent cervix, below few cases one with incompetent cervix while other two with normal cervical length and close internal os.

Permalink Reply by Silvia Watman on April 14, 2011 at 9:26pm

Hi all,

The cervix has to be assessed by endovaginal exam with an empty bladder. It should measure at least 3 cm. We have to be careful not to include the posterior vaginal wall in the measurement. If it measures less than 2.5 cm it is considered incompetent. Other signs that help to the diagnosis are funneling  and prolapse of membranes through the open cervical canal. We also have to be careful not to confuse an hypoechoic mucus plug with funneling. There is a dynamic maneuver that could help to demonstrate incompetency. Sometimes the cervix gets shorter after compressing the maternal uterine fundus with one hand while scanning the cervix with EV probe with the other.

I hope this helps

Permalink Reply by Dr.Shagufta Liaqat on June 24, 2011 at 9:33am

Hi Zenab,

             An incompetent cervix is that cervix which starts to dilate prematurely in the absence of labour contractions. The mucus plug that normally fills the cervix can be lost at that time which may result in a brief episode of vaginal bleeding.

When a patient presents with vaginal bleeding in the seocnd or third trimester, we should cautiously examine the cervix with a vaginal probe.There may be a previous history of multiple second trimester abortions so patient may have been referred if going to need a cervical circlage.

 There will be a V shaped indentation of the internal os (funneling) if cervical incompetence is present. Be specially cautious if there is fluid present throughout the cervical canal and ballooning membranes are prolapsing out of ext os into vagina.

Secondly cervical length may be reduced which is normally 3.5 cm or more than this.

   

RSS

© 2012   Created by AIUM.

Badges  |  Report an Issue  |  Terms of Service