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 fetal development are determined. Timely diagnosis of deviations will allow you to prescribe a 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 muscle ring connecting the uterus to the vagina, and is the outlet channel at the birth of the baby. The reproductive and reproductive function, the general state of a woman’s health depends on her condition.
The data obtained during the study are recorded in the medical protocol and are not a diagnosis. Decryption of data is performed by the attending physician who monitors the pregnant woman. It is the specialist who confirms that the organ is normal or its pathological changes.
An important procedure is the ultrasound of the cervix during pregnancy. Why and how often should it be done? The study is performed not only if there is cause for concern and emergency cases, but also for preventive purposes, as part of the mandatory screening of the fetus in each trimester. Sonography allows you to diagnose the current state of the isthmus and uterus.
Scheduled inspection
An ultrasound of the cervix during pregnancy is performed at least two to three times.
- 10-14 week (in the first trimester). It turns out the uterine / ectopic location, gestational age (age), the presence / absence of deviations in the bookmark of the fetal organs.
- 20-25 week. In the second trimester, you can see a possible shortening of the neck.
- 32-34 week. It is carried out in the third trimester only according to indications, for example, if any pathologies or cord entanglement were previously detected. In the normal course of 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 childbirth or deviations in the development of the child are detected, an emergency ultrasound of the cervix during pregnancy is prescribed.
Special attention
For certain indicators, screening should be carried out more often, unscheduled or with special care. This is important when:
- multiple pregnancy;
- suspected isthmic-cervical insufficiency;
- previous conization operations (removal of the neck);
- a history of miscarriages or premature delivery in the second trimester;
- rupture of the neck during previous childbirth.
Two or more fruits
In the second trimester, a woman is actively gaining weight - toxicosis is replaced by a great appetite, and babies begin to increase in size. This creates an additional burden on the neck.
Gynecologists pay increased attention to expectant mothers with twins or triplets. To do this, an ultrasound of the cervix is performed during pregnancy at 16 weeks. Why such a deadline?
At the screening in the first trimester, the fruits are still small and, as a rule, the neck is normal. The second elective ultrasound is performed at week 20. As a result, a significant shortening of the cervix or its partial opening may appear, when it is too late to stitch or put an obstetric pessary, it is not possible to maintain a pregnancy.
Timely diagnosis will help prevent premature birth, and, if a pathology is detected, take the necessary measures and treatment.
How do ultrasound of the cervix during pregnancy
Sonography is performed:
- Transvaginally. A sensor that has previously been fitted with a condom is carefully inserted into the vagina. The bladder must be completely empty. The technique provides the most accurate data.
- Transabdominally. Screening through the abdominal wall. No special preparation is required.
Individual indications
In some cases, ultrasound is prohibited by a transvaginal method, namely:
- anatomical deformity of the vagina;
- genital surgery.
In these cases, ultrasound of the length of the cervix during pregnancy is recommended to be carried out using one of the methods listed.
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 drug "Microlax", allowed to women in position.
Transperineally. Through the epidermis of the perineum. It does not give such 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 gestational gestation. As a result of screening, the following can be detected:
- ITSN or isthmic-cervical insufficiency. One of the reasons for miscarriage. The problem is accompanied by a shortening of the isthmus and its premature opening. Potential danger - miscarriage and premature birth.
- Immaturity. By the 37th week, muscle tissue is not ready for stretching, which threatens a caesarean section.
- Isthmal pregnancy. Attachment and further development of the fetal egg in the area of the cervical canal. The clinical picture is accompanied by bleeding and septic infection, which if untimely detection is fatal for a woman.
- Neoplasms. Ultrasound of the cervix during pregnancy can show the presence of polyps or cysts, which causes complications during natural birth. Therapy occurs medically or in severe cases, by surgery.
- Endocervicitis. Inflammation in the cervical canal. It is 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.
Body condition parameters
During the screening, a detailed description is made, in which certain indicators of the cervix are noted.
- Tone. With its increase, a threat of premature birth is possible.
- The size. The length and shape varies according to gestational age.
- Echogenicity or density.
- 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.
- Consistency or composition.
- Erosion. Treatment is vaginal suppositories, tamponing and medications. Douching and laser treatment is best postponed until the baby is born.
- Scarring. The indicator is relevant for women who previously had a cesarean section.
- The internal pharynx and the transformation of its state.
- Cervical canal, its patency, increase in length, expansion.
- Axial placement according to the uterus (the presence of bending, twisting, the formation of an obtuse angle, etc.).
Decoding of parameters
According to the results of the study, the protocol indicates information about the length of the neck, a gynecologist who monitors the health of the future mother should familiarize herself with it.
Ultrasound of the cervix during pregnancy is normal at such indicators as indicated in the table:
Thus, at 15-20 weeks, the average size is about 4.0 cm. If the parameters for this period 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 shortening of the cervix, is not a sentence. For 30 years now, they have been practicing the use of an obstetric device called a pessary. Its effectiveness is 85%.
The introduction is carried out from 16, according to some indications sometimes from 13 weeks. This is an absolutely painless procedure, does not require pain relief and takes about 20 minutes.
Depending on the physiological characteristics of the woman, the doctor selects the type of ring. They are of three types, in the configuration the following indicators are taken into account:
- whether the woman has had 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 on the microflora for prophylactic purposes and undergo treatment with antibacterial suppositories. Sex life is prohibited. The pessary is removed at 38 weeks, when the fetus is considered full-term.
Surgical stitches
The operation is performed under short-term and shallow anesthesia. It lasts about a quarter of an hour. The neck is sutured at 12-16 weeks. If time has been missed, then the ring is entered.
After the procedure, the woman is recommended to stay in the hospital for some time and not to sit down for the first day. As a result of the intervention, the appearance of small blood secretions from the genital tract within two to three days is possible.
In the future, it is important to adhere to a half-bed regimen, 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 the pessary.
Ultrasound of the cervix during pregnancy is a safe procedure for both the expectant mother and the fetus. Modern devices for sonography give accurate and objective results. For a woman, such a study is an important and necessary way to identify diseases of the reproductive organs in the early stages, as well as to detect situations requiring urgent intervention.