2 Cervix in Pregnancy

Question 1

3 Methods to Assess the Cervix

Answer 1

1. Transabdominal
2. Tanslabial
3. Transvaginal

Question 2

For a Transabdominal approach what patient prep is required?

Answer 2

Full bladder

Question 3

Why is a over distended bladder not good?

Answer 3

Can falsely elongate the cervix

squish with posterior uterine segment

Question 4

Where doe scanning take place on the patients body?

Answer 4

above public bone, make sure parallel to long axis or may be foreshortening it.

Question 5

As baby grows harder for which approach?

Answer 5

Transabdominal

Question 6

What is another reason the cervix can look elongated?

Answer 6

Uterine Contraction

Question 7

What type of scanning approach is used when ruptured memembranes have occured?

Answer 7

Translabial

Question 8

What is another reason to perform translabia approach?

Answer 8

Placenta previa

No EV due to uterine infection

Question 9

What is the patient prep for translabia exam?

Answer 9

Empty bladder

Question 10

What is a limitation for the translabia exam?

Answer 10

Gas in the rectum obscuring the external os

Question 11

Which probe is used for translabia and how is it performed

Answer 11

Curvilinear with probe cover, placed in SAG plane between labia.

Question 12

What kind of frequency probes are used?

Answer 12

Low frequency probe

As cervix is further away from probe in this approach

Question 13

What is the gold standard exam for assessing the cervix?

Answer 13

EV scanning (transvaginal)

Question 14

Translabial and EV length measurement of CX are often similar or not?

Answer 14

YES

Question 15

Transvaginal method inserts the probe ____ cm into vagina

Answer 15

3-4 cm

Question 16

Transvaginal method is contraindicated with?

Answer 16

ruptured membranes (causing infection)

Question 17

Transvaginal method can cause?

Answer 17

bleeding or contractions or preterm labour

Question 18

what doe the normal Cervix look like in appearance

Answer 18

Echogenic canal (can appear hypo on some occsion)

Question 19

What is the lower limit of normal of cervix length?

Answer 19

30mm (3 cm)

Question 20

<15 mm (1.5cm) cervix length corresponds with

Answer 20

50% effacment (thinning cervix, getting ready for delivery)

Question 21

<10 mm (1.0cm) cervix length corresponds with

Answer 21

75% effacment (thinning cervix, getting ready for delivery)

Question 22

What does the normal Cervix look like in pregnancy?

Answer 22

Echogenic line in cervix canal = the mucus plug
surrounded by hypoechoic area = membrane

(just seeing the hypoechoic area is normal too)

Question 23

The measurement of CX should extend from ?

Answer 23

Internal os to the external os

Question 24

What should the measurement be from the internal to the external os

Answer 24

> 3 cm

Question 25

What is funneling?

Answer 25

Herniation of the fetal membrane into the internal os.

Question 26

What does the external os look like in funneling?

Answer 26

IT REMAINS closed

Question 27

Why is Ultrasound important for funneling?

Answer 27

It can detect early signs of incompetent service

Question 28

What does funneling have an increased risk of?

Answer 28

``` Preterm delivery (note: some carry to term without intervention) ```

Question 29

What size herniation into cervical canal is considered abnormal and seen with EV

Answer 29

AP >5mm before 30 weeks

Question 30

What can be confused with cervical incompetence?

Answer 30

Contraction of the lower uterine segment

Question 31

What is cervical Incompetence

Answer 31

Dynamic process where the CX changes spontaneously and dramatically in a short period of time

Question 32

When does cervical incompetence occur?

Answer 32

When CX unable to retain a pregnancy to full term

Question 33

cervical incompetence can be aquired due to ______ or excessive dilation with a ________-

Answer 33

laceration(deep cut); D & C

Question 34

cervical incompetence can also be the result of a?

Answer 34

congenital anomaly, where UT misshapen

Question 35

What is the classic presentation of cervical incompetence

Answer 35

Painless cervical dilation

Question 36

cervical incompetence has a history of recurrent?

Answer 36

2nd trimester losses

Question 37

What are is the DDX of cervical incompetence

Answer 37

Preterm labour

Question 38

What does preterm labour cause that can dilate the cervix?

Answer 38

Contractions

Question 39

What is the treatment for cervical incompetence ?

Answer 39

Cervical cerclage (string suture)

Question 40

When is a Cervical cerclage inserted? (weeks)

Answer 40

13-16 weeks

Question 41

What are the increased risk of Cervical cerclage (2)

Answer 41

1. Amnionitis | 2. rupture of membranes

Question 42

What does the Cervical cerclage look like sonographically?

Answer 42

ecogenic foci (linear) with shadows, surrounding anterior and posterior portion of the CX

Question 43

When is the Cervical cerclage placed in /Timing?

Answer 43

After bulging membranes occurs

Question 44

what % pregnaancy loss rate does Cervical cerclage have?

Answer 44

30%

Question 45

What is used to assess placement and funneling above and below Cx?

Answer 45

Ultrasound

Question 46

What is preterm labour?

Answer 46

Labour and/or Delivery before 37 weeks

Question 47

How often does preterm labour happen in pregnancy? (%)

Answer 47

5-10% of all pregnancies

Question 48

What are other names for Cervical cerclage (2)

Answer 48

Shirodkar suture | McDonald ""