Cervical_Ectropion_Flashcards
Where is the transformation zone located in cervical ectropion?
On the ectocervix where the stratified squamous epithelium meets the columnar epithelium of the cervical canal.
What results in a larger area of columnar epithelium being present on the ectocervix?
Elevated oestrogen levels during the ovulatory phase, pregnancy, or combined oral contraceptive pill use.
What term is used less commonly now for cervical ectropion?
Cervical erosion.
What are the common features of cervical ectropion?
Vaginal discharge and post-coital bleeding.
When is ablative treatment used for cervical ectropion?
Ablative treatment, such as ‘cold coagulation,’ is used only for troublesome symptoms.
summarise cervical ectropion
Cervical ectropion
On the ectocervix there is a transformation zone where the stratified squamous epithelium meets the columnar epithelium of the cervical canal. Elevated oestrogen levels (ovulatory phase, pregnancy, combined oral contraceptive pill use) result in larger area of columnar epithelium being present on the ectocervix
The term cervical erosion is used less commonly now
This may result in the following features
vaginal discharge
post-coital bleeding
Ablative treatment (for example ‘cold coagulation’) is only used for troublesome symptoms
Which one of the following statements regarding cervical ectropion is incorrect?
Describes an increased area of columnar epithelium
May result in post-coital bleeding
Is less common in women who use the combined oral contraceptive pill
May result in excessive vaginal discharge
Is more common during pregnancy
Is less common in women who use the combined oral contraceptive pill
The correct answer is ‘Is less common in women who use the combined oral contraceptive pill’. Cervical ectropion, also known as cervical erosion, is a condition where the columnar epithelium that lines the endocervical canal is found to extend onto the vaginal portion of the cervix. This condition is actually more common in women who use the combined oral contraceptive pill. The hormones present in these pills can cause changes in the cervix and lead to an increase in ectropion.
Now let’s discuss each of the incorrect answers:
‘Describes an increased area of columnar epithelium’ - This statement is true. As mentioned above, cervical ectropion refers to an extension of columnar epithelium onto the vaginal portion of the cervix, effectively increasing its area.
‘May result in post-coital bleeding’ - This statement is also true. The exposed columnar epithelium on the surface of the cervix can bleed after sexual intercourse. Therefore, post-coital bleeding could be a symptom associated with cervical ectropion.
‘May result in excessive vaginal discharge’ - This statement is accurate as well. The glandular cells that make up columnar epithelium produce mucus. When these cells are located on the exterior surface of the cervix due to ectropion, they may produce excessive mucus that results in increased vaginal discharge.
‘Is more common during pregnancy’ - This statement holds true too. Hormonal changes during pregnancy can lead to cervical ectropion. Specifically, increased levels of estrogen may cause this condition to develop or worsen if it pre-existed before pregnancy.
A 26 year-old woman presents to her GP with a 3 month history of inter-menstrual bleeding and occasional post-coital bleeding. She is sexually active and takes Microgynon (a combined oral contraceptive pill). Her last cervical smear was normal.
What is the most likely diagnosis?
Cervical cancer
Endometrial cancer
Ectopic pregnancy
Cervical ectropion
Ovulation
Cervical ectropion
In a young woman taking COCP, cervical ectropions are a common finding in the context of post-coital bleeding. Whilst cervical cancer should be considered, a recent normal smear makes this less likely and ectropion would be more likely regardless.
