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Cervical incompetence: the use of transvaginal sonography to provide an objective diagnosis
Author(s) -
Macdonald R.,
Smith P.,
Vyas S.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.00459.x
Subject(s) - medicine , cervical insufficiency , cervical cerclage , cervix , cervical canal , gestation , gestational age , obstetrics , pregnancy , gynecology , ultrasound , radiology , cancer , biology , genetics
Objective To investigate the use of transvaginal sonography in monitoring the cervix in women at high risk of a preterm delivery. Study design One hundred and six women at high risk of preterm labor had regular cervical monitoring by transvaginal ultrasound throughout pregnancy from the second trimester to delivery. The study was designed to be observational, but intervention was considered if the cervical length fell below 10 mm. Results Eleven women demonstrated opening of the cervical canal at rest or with fundal pressure before 24 weeks' gestation. Between 2 and 17 days later all 11 cervices progressively shortened to a cervical length of < 10 mm. Nine women had a cervical cerclage. Seven women had fetal membranes visible within the cervical canal at the time of cerclage. One woman miscarried at 18 weeks, and the other 10 had live births at a median gestational age of 36 (range, 27–38) weeks. Conclusions Cervical length shortening in the second trimester, once started, progressed to a cervical length under 10 mm. Opening of the cervical os at rest or in response to fundal pressure detected by transvaginal ultrasound appears to be the early ultrasound feature of cervical incompetence. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology