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OB GYNE 4 > 2 Cervix in Pregnancy > Flashcards

2 Cervix in Pregnancy Flashcards

1
Q

3 Methods to Assess the Cervix

A
  1. Transabdominal
  2. Tanslabial
  3. Transvaginal
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2
Q

For a Transabdominal approach what patient prep is required?

A

Full bladder

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3
Q

Why is a over distended bladder not good?

A

Can falsely elongate the cervix

squish with posterior uterine segment

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4
Q

Where doe scanning take place on the patients body?

A

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

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5
Q

As baby grows harder for which approach?

A

Transabdominal

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6
Q

What is another reason the cervix can look elongated?

A

Uterine Contraction

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7
Q

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

A

Translabial

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8
Q

What is another reason to perform translabia approach?

A

Placenta previa

No EV due to uterine infection

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9
Q

What is the patient prep for translabia exam?

A

Empty bladder

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10
Q

What is a limitation for the translabia exam?

A

Gas in the rectum obscuring the external os

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11
Q

Which probe is used for translabia and how is it performed

A

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

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12
Q

What kind of frequency probes are used?

A

Low frequency probe

As cervix is further away from probe in this approach

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13
Q

What is the gold standard exam for assessing the cervix?

A

EV scanning (transvaginal)

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14
Q

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

A

YES

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15
Q

Transvaginal method inserts the probe ____ cm into vagina

A

3-4 cm

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16
Q

Transvaginal method is contraindicated with?

A

ruptured membranes (causing infection)

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17
Q

Transvaginal method can cause?

A

bleeding or contractions or preterm labour

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18
Q

what doe the normal Cervix look like in appearance

A

Echogenic canal (can appear hypo on some occsion)

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19
Q

What is the lower limit of normal of cervix length?

A

30mm (3 cm)

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20
Q

<15 mm (1.5cm) cervix length corresponds with

A

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

21
Q

<10 mm (1.0cm) cervix length corresponds with

A

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

22
Q

What does the normal Cervix look like in pregnancy?

A

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

(just seeing the hypoechoic area is normal too)

23
Q

The measurement of CX should extend from ?

A

Internal os to the external os

24
Q

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

A

> 3 cm

25
Q

What is funneling?

A

Herniation of the fetal membrane into the internal os.

26
Q

What does the external os look like in funneling?

A

IT REMAINS closed

27
Q

Why is Ultrasound important for funneling?

A

It can detect early signs of incompetent service

28
Q

What does funneling have an increased risk of?

A 
Preterm delivery 
(note: some carry to term without intervention)
29
Q

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

A

AP >5mm before 30 weeks

30
Q

What can be confused with cervical incompetence?

A

Contraction of the lower uterine segment

31
Q

What is cervical Incompetence

A

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

32
Q

When does cervical incompetence occur?

A

When CX unable to retain a pregnancy to full term

33
Q

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

A

laceration(deep cut); D & C

34
Q

cervical incompetence can also be the result of a?

A

congenital anomaly, where UT misshapen

35
Q

What is the classic presentation of cervical incompetence

A

Painless cervical dilation

36
Q

cervical incompetence has a history of recurrent?

A

2nd trimester losses

37
Q

What are is the DDX of cervical incompetence

A

Preterm labour

38
Q

What does preterm labour cause that can dilate the cervix?

A

Contractions

39
Q

What is the treatment for cervical incompetence ?

A

Cervical cerclage (string suture)

40
Q

When is a Cervical cerclage inserted? (weeks)

A

13-16 weeks

41
Q

What are the increased risk of Cervical cerclage (2)

A
  1. Amnionitis

2. rupture of membranes

42
Q

What does the Cervical cerclage look like sonographically?

A

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

43
Q

When is the Cervical cerclage placed in /Timing?

A

After bulging membranes occurs

44
Q

what % pregnaancy loss rate does Cervical cerclage have?

A

30%

45
Q

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

A

Ultrasound

46
Q

What is preterm labour?

A

Labour and/or Delivery before 37 weeks

47
Q

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

A

5-10% of all pregnancies

48
Q

What are other names for Cervical cerclage (2)

A

Shirodkar suture

McDonald “”

OB GYNE 4 (11 decks)

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