Ultrasound of the cervix during pregnancy: doctor's appointment, features and methods of carrying out, indications, contraindications, identified diseases and their treatment

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Ultrasound of the cervix during pregnancy is one of the most important studies. According to his testimony, pathologies and diseases that can be dangerous for a woman and the development of the fetus are determined. Timely diagnosis of deviations will allow prescribing treatment that contributes to the further beneficial course of the entire period of bearing a child.

The essence of sonography for expectant mothers

The cervix is a muscular ring that connects the uterus to the vagina and is the exit channel at the birth of a baby. Reproductive and childbearing function, the general he alth of a woman depends on her condition.

The data obtained during the study are recorded in the medical protocol and are not a diagnosis. The decoding of the data is performed by the attending physician observing the pregnant woman. It is the specialist who confirms the presence of the organ in the norm or its pathological changes.

An important procedure is cervical ultrasoundduring pregnancy. Why and how often should it be done? The study is performed not only in cases of concern and emergency, but also for preventive purposes, as part of the mandatory fetal screening in each trimester. Sonography allows you to diagnose the current condition of the isthmus and uterus.

Scheduled inspection

Ultrasound of the cervix during pregnancy is performed at least two or three times.

1. 10-14 weeks (first trimester). It turns out the uterine / ectopic location, gestational age (age), the presence / absence of deviations in the laying of the organs of the fetus.
2. 20-25 week. In the second trimester, you can see a possible shortening of the cervix.
3. 32-34 weeks. It is carried out in the third trimester only according to indications, for example, if any pathologies or cord entanglement have been previously identified. In a normal pregnancy, this screening is not necessary.

Extraordinary examination

In exceptional cases, when a woman complains of discharge with blood, pain in the lower abdomen, there is a threat of early birth or deviations in the development of the child, an emergency cervical ultrasound during pregnancy is prescribed.

Special attention

Screening should be done more frequently, unscheduled or with special care under certain indicators. This is important when:

• multiple pregnancies;
• suspected isthmic-cervical insufficiency;
• previous conization operations (removal of the siteneck);
• having a history of miscarriage or premature delivery in the second trimester;
• Cervical rupture during previous births.

Two or more fruits

In the second trimester, a woman is actively gaining weight - toxicosis is replaced by a wonderful appetite, and babies begin to grow in size. This puts extra strain on the neck.

Gynecologists pay increased attention to expectant mothers with twins or triplets. To do this, perform an ultrasound of the cervix during pregnancy at 16 weeks. Why such a deadline?

At the first trimester screening, the fetuses are still small and, as a rule, the cervix is normal. The second scheduled ultrasound is performed at week 20. As a result, a significant shortening of the cervix or its partial disclosure may be found, when it is too late to suture or put in an obstetric pessary, it is not possible to keep the pregnancy.

Timely diagnosis will help prevent premature birth, and if a pathology is detected, take the necessary measures and treatment.

How to do an ultrasound of the cervix during pregnancy

Sonography in progress:

1. Transvaginally. The sensor, which was previously put on a condom, is gently inserted into the vagina. The bladder must be completely empty. The technique provides the most accurate data.
2. Transabdominally. Screening through the abdominal wall. Does not require special preparation.

Individual readings

In some cases, transvaginal ultrasound is prohibited, namely:

• anatomical deformation of the vagina;
• surgical interventions on the genitals.

In these cases, ultrasound of the length of the cervix during pregnancy is recommended to be performed by one of the following methods.

Transrectally. Through the rectum. Preparation consists in excluding gas-forming and dairy products from the diet during the day, as well as cleansing the intestines naturally or with the help of microclysters, for example, the Microlax drug, which is allowed for women in position.

Transperineal. Through the epidermis of the perineum. Does not provide as accurate results as the vaginal or rectal method.

Identified pathologies

Often, expectant mothers ask why they do an ultrasound of the cervix during pregnancy. The study is necessary to detect abnormalities during gestation of the fetus. Screening may reveal:

1. ICN or isthmic-cervical insufficiency. One of the reasons for miscarriage. The problem is accompanied by shortening of the isthmus and its premature opening. Potential dangers are miscarriage and premature birth.
2. Immaturity. By week 37, the muscle tissue is not ready for stretching, which threatens with a caesarean section.
3. Cervical pregnancy. Attachment and further development of the fetal egg in the region of the cervical canal. The clinical picture is accompanied by bleeding and septic infection, which, if not detected in time, threatens to be fatal.outcome for a woman.
4. Neoplasms. Ultrasound of the cervix during pregnancy can show the presence of polyps or cysts, which causes complications in natural childbirth. Therapy occurs with medication or, in severe cases, with surgery.
5. Endocervicitis. Inflammation in the cervical canal. Subject to mandatory treatment, as it provokes infection of the membranes.

Based on the results of the examination, the gynecologist decides on the need for therapy and further monitoring of the pregnant woman.

Organ status parameters

During the screening, a detailed description is drawn up, which notes certain indicators of the cervix.

1. Tone. With its increase, the threat of premature birth is possible.
2. Size. Length and shape varies according to gestational age.
3. Echogenicity or density.
4. Disclosure. In the normal course of pregnancy, the isthmus should be tightly closed. In the presence of gaps and extensions, the question of installing a pessary or suturing is considered.
5. Consistency or composition.
6. Erosion. Treatment - vaginal suppositories, plugging and medications. Douching and laser treatment should be postponed until after the baby is born.
7. Scarring. The indicator is relevant for women who have previously had a caesarean section.
8. Internal os and transformation of its state.
9. Cervical canal, its patency, increase in length, expansion.
10. Axial placement according to the uterus (presencebending, twisting, forming an obtuse angle, etc.).

Decryption of parameters

Based on the results of the study, the protocol indicates information about the length of the neck, a gynecologist who monitors the he alth of the expectant mother should familiarize herself with it.

Ultrasound of the cervix during pregnancy is normal with such indicators as indicated in the table:

Thus, at 15-20 weeks, the average size is about 4.0 cm. If the parameters at this time are less than 2.5-3.0 cm, then gynecologists recommend using one of the methods for prolonging pregnancy - installing a ring or suturing.

Pessary

Timely detected isthmic-cervical insufficiency, accompanied by a shortening of the cervix, is not a sentence. For over 30 years, the use of an obstetric device called a pessary has been practiced. Its efficiency is 85%.

The introduction is carried out from 16, according to some indications, sometimes from 13 weeks. This is a completely painless procedure that does not require anesthesia and takes about 20 minutes.

Depending on the physiological characteristics of a woman, the doctor selects the type of ring. They come in three types, the following indicators are taken into account in the configuration:

• has the woman had a childbirth before;
• how many fruits;
• what is the size of the upper third of the vagina.

After installing the ring, a woman needs to take a smear for microflora for a preventive purpose and undergo a course of treatmentantibacterial suppositories. Sex life is prohibited. The pessary is removed at 38 weeks, when the fetus is considered full-term.

Surgical sutures

The operation is performed under short-term and shallow anesthesia. Lasts about a quarter of an hour. The cervix is sutured at 12-16 weeks. If time has been missed, then a ring is introduced.

After the procedure, the woman is recommended to stay in the hospital for a while and not sit down for the first day. As a result of the intervention, small bleeding from the genital tract may occur within two to three days.

In the future, it is important to adhere to a semi-bed rest, wear a bandage and use drugs to relieve uterine tone, such as Papaverine suppositories or Magne B6 tablets. These recommendations are also relevant when installing a pessary.

Ultrasound of the cervix during pregnancy is a safe procedure for both the expectant mother and the fetus. Modern sonography devices provide accurate and objective results. For a woman, such a study is an important and necessary way to detect diseases of the reproductive organs at an early stage, as well as to detect situations that require urgent intervention.