Sonographic evaluation of the incompetent cervix

Bernstine, Richard L.; Lee, Sung Ho; Crawford, William L.; Shimek, Maurice P.

doi:10.1002/jcu.1870090804

Cited by 19 publications

(11 citation statements)

References 3 publications

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“…Visualization of the cervix with transabdominal sonography requires a full maternal bladder to provide an acoustic window to visualize the endocervical canal, internal cervical os and external os (100). Despite a full bladder, clear definition of the anatomical landmarks is not always possible (102,103). Therefore, Robinson et al (104) subsequently proposed the placement of a saline solution in the vagina to improve the definition of the ectocervix; however, this approach is not optimal for patients.…”

Section: Discussionmentioning

confidence: 99%

Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix

Hernández‐Andrade¹,

Romero²,

Ahn³

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

102

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Objective To assess the diagnostic performance of transabdominal sonographic measurement of cervical length in identifying patients with a short cervix. Methods Cervical length was measured in 220 pregnant women using transabdominal and transvaginal ultrasound (US). Reproducibility and agreement between and within both methods were assessed. The diagnostic accuracy of transabdominal US for identifying cases with a cervical length <25mm was evaluated. Results Twenty-one out of 220 cases (9.5%) had a cervical length <25mm by transvaginal US. Only 43% (n=9) of patients with a short cervix were correctly identified by transabdominal US. In patients with a cervical length of <25mm by transvaginal US, transabdominal measurement of the cervix overestimated this parameter by an average of 8mm (95% LOAs: −26.4 to 10.5mm). Among women without a short cervix, transabdominal US underestimated cervical length on average (LOA) by 1.1mm (95% LOAs: −11.0 to 13.2mm). Transvaginal US was also more reproducible (intraclass correlation coefficient: (ICC: 0.96; 95% CI: 0.94 to 0.97) based on comparisons between 2D images and immediately acquired 3D volume datasets relative to transabdominal US (ICC: 0.71; 95% CI: 0.57 to 0.84). Transvaginal US detected 13 cases with funneling and 6 cases with sludge whereas only 3 cases of funneling and one of sludge were detected by transabdominal US. Conclusion Transabdominal measurement overestimated cervical LOA by 8mm among women with a short cervix and resulted in the underdiagnosis of 57% of cases.

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Section: Discussionmentioning

confidence: 99%

Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix

Hernández‐Andrade¹,

Romero²,

Ahn³

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

102

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“…In an at-risk group from 10 weeks to 14 weeks, a cervix shorter than 35. 5 mm and a thickness of the anterior wall of the lower uterine segment thinner than 9.8 mm indicate the need for ultrasound examinations at two-week intervals. If progression is seen with ultrasound, even without clinical signs of cervical incompetency, cervical cerclage is recommended.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography in the detection of cervical incompetency

Podobnik¹,

Bulić²,

Smiljanić³

et al. 1988

J of Clinical Ultrasound

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In 80 pregnancies with clinical and ultrasonic signs of cervical incompetency, the length of the cervix and the thickness of the anterior wall of a lower uterine segment have been evaluated ultrasonically. We have also measured the width of the endocervical canal and studied the prolapse of fetal membranes (with fetal parts) into the endocervical canal. We evaluated these same parameters in 80 healthy pregnancies. The length of the cervix, the thickness of the anterior wall of a lower uterine segment, and the width of the endocervical canal were followed longitudinally in the patients from the 10th to the 36th gestation week. No statistically significant differences between age groups were found. In four age groups at risk for cervical incompetency, cervical lengths and wall thickness were significantly different (p less than 0.001) from those in comparable controls. Forty-five percent of the patients in the at-risk group, with cervical cerclage, delivered at 37.3 (range: 32 to 41) weeks and 6.25% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal, with or without some part of the fetus.

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“…vary from 3 c m to a maximum of 6 or 7 c m (Bernstine et al 1981;Zemlyn 1981). Patients at risk for cervical incompetence may demonstrate a progressively shortened cervix and benefit from continued ultrasound follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the literature reveals a few studies of cervical morphology by ultrasound, with some authors documenting active intervention based on clinical and ultrasound assessment (Sarti et al 1979;Bernstine et al 1981;Redford et al 1981;Zemlyn 198 1). Bernstine et al (198 1) prospectively assessed cervices at risk for incompetence during pregnancy with particular attention to the diameter of the internal 0s and cervical length.…”

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confidence: 99%

Diagnostic ultrasound in the assessment of patients with incompetent cervix

Jackson

Pendleton

Nichol

et al. 1984

BJOG

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Twenty-five pregnant women with suspected cervical incompetence were assessed by serial ultrasound. A dilating internal 0s was documented in one patient, incompetence was ruled out in two, and a 'slipping suture' was demonstrated in another; the remaining patients were subjected to cerclage on the basis of their history alone. Patients in whom the diagnosis of cervical incompetence is indefinite should have a diagnostic ultrasound scan to visualize the cervix for length, opening of the canal and integrity of the internal 0s. Selective ultrasonography may be beneficial in both the diagnosis and treatment of cervical incompetence.

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Sonographic evaluation of the incompetent cervix

Cited by 19 publications

References 3 publications

Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix

Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix

Ultrasonography in the detection of cervical incompetency

Diagnostic ultrasound in the assessment of patients with incompetent cervix

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