Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  18 (2024)
Volume  17 (2023)
Volume  16 (2022)
Volume  15 (2021)
Volume  14 (2020)
Volume  13 (2019)
Volume  12 (2018)
Volume  11 (2017)
Volume  10 (2016)
Volume  9 (2015)
Volume  8 (2014)
Volume  7 (2013)
Volume  6 (2012)
Volume  5 (2011)
Volume  4 (2010)
Volume  3 (2009)
Volume  2 (2008)
Volume  1 (2007)
Related articles

VOLUME 17 , ISSUE 4 ( October-December, 2023 ) > List of Articles

REVIEW ARTICLE

Transvaginal Assessment of the Cervix

Zorancho Petanovski, Emilija Petanovska Kostova

Keywords : Cervical length, Color Doppler sonography, Funneling, Preterm labor, Preterm premature rupture of the fetal membranes, Sludge, Transvaginal ultrasonography

Citation Information : Petanovski Z, Kostova EP. Transvaginal Assessment of the Cervix. Donald School J Ultrasound Obstet Gynecol 2023; 17 (4):309-316.

DOI: 10.5005/jp-journals-10009-2003

License: CC BY-NC 4.0

Published Online: 28-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Cervix is an important part of the uterus in obstetrics because that anatomical part withstands the pressure of the pregnant uterus until the moment of childbirth. Many mechanisms play a role in the beginning of labor, and it is fascinating how it is a harmonized mechanism. Unfortunately, under the influence of various factors, it leads to preterm labor (PTL) or preterm premature rupture of the fetal membranes (PPROM). Ultrasound is an ideal tool in detecting the status of the cervix during pregnancy. Vaginal ultrasound has shown better sensitivity and predictability than abdominal ultrasound. Regarding vaginal ultrasonography of the cervix in gynecology, recent studies show the effectiveness of vaginal ultrasound in the detection of cervical pathology. Not only in detection but transvaginal ultrasound (TVU), especially new techniques such as three-dimensional (3D) color Doppler, also helps clinicians in choosing the right therapeutic approach for malignant diseases of the cervix.

HTML PDF Share
  1. WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand 1977;56(3):247–253. PMID: 560099
  2. Caughey AB, 2007. Definition, incidence, significance and demographic characteristics of preterm birth. [online] UpToDate. Available from: http://www.uptodate.com/contents/demographicfactors- inpreterm-birth [Accessed June 2018].
  3. Crane JM, Delaney T, Hutchens D. Transvaginal ultrasonography in the prediction of preterm birth after treatment for cervical intraepithelial neoplasia. Obstet Gynecol 2006;107(1):37–44. DOI: 10.1097/01.aog.0000192169.44775.76
  4. Robinson JN, Norwitz E, 2007. Risk factors for preterm labor and delivery. [online] UpToDate. Available from: https://www.uptodate.com/contents/preterm-birth-risk-factors-and-interventions-for-riskreduction. [Accessed Jun 2018].
  5. Mella MT, Berghella V. Prediction of preterm birth: cervical sonography. Semin Perinatol 2009;33(5):317–324. DOI: 10.1053/j.semperi.2009.06.007
  6. O'Hara S, Zelesco M, Sun Z. Cervical length for predicting preterm birth and a comparison of ultrasonic measurement techniques. Australas J Ultrasound Med 2013;16(3):124–134. DOI: 10.1002/j.2205-0140.2013.tb00100.x
  7. Hernandez-Andrade E, Romero R, Ahn H, et al. Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix. J Matern Fetal Neonatal Med 2012;25(9):1682–1689. DOI: 10.3109/14767058.2012.657278
  8. Hassan SS, Romero R, Berry SM, et al. Patients with an ultrasonographic cervical length < or =15 mM have nearly a 50% risk of early spontaneous preterm delivery. Am J Obstet Gynecol 2000;182(6):1458–1467. DOI: 10.1067/mob.2000.106851
  9. Berghella V, Bega G, Tolosa JE, et al. Ultrasound assessment of the cervix. Clin Obstet Gynecol 2003;46(4):947–962. DOI: 10.1097/00003081-200312000-00026
  10. Belics Z, Papp Z. Ultrasonographic assessment of the cervix for prediction of spontaneous preterm birth in singleton pregnancies. Donald School J Ultrasound Obstet Gynecol 2021;15(1):49–63. DOI: 10.5005/jp-journals-10009-1683
  11. Greco E, Gupta R, Syngelaki A, et al. First-trimester screening for spontaneous preterm delivery with maternal characteristics and cervical length. Fetal Diagn Ther 2012;31(3):154–161. DOI: 10.1159/000335686
  12. Chandiramani M, Shennan AH. Premature cervical change and the use of cervical cerclage. Fetal Matern Med Rev 2007;18(1):25–52. DOI: 10.1017/S0965539507001878
  13. Romero R, Nicolaides K, Conde-Agudelo A, et al. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data. Am J Obstet Gynecol 2012;206(2):124. e1–124.e19. DOI: 10.1016/j.ajog.2011.12.003
  14. Conde-Agudelo A, Romero R. Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol 2015;213(6):789–801. DOI: 10.1016/j.ajog.2015.06.015
  15. Podobnik M, Bulié M, Smiljanicé N, et al. Ultrasonography in the detection of cervical incompetency. J Clin Ultrasound 1988;13(6):383–391. DOI: 10.1002/jcu.1870160604
  16. Michaels WH, Montgomery C, Karo J, et al. Ultrasound differentiation of the competent from the incompetent cervix: prevention of preterm delivery. Am J Obstet Gynecol 1986;154(3):537–546. DOI: 10.1016/0002-9378(86)90598-3
  17. Berghella V, Owen J, MacPherson C, et al. Natural history of cervical funneling in women at high risk for spontaneous preterm birth. Obstet Gynecol 2007;109(4):863–869. DOI: 10.1097/01.AOG.0000258276.64005.ce
  18. Buyuk GN, Oskovi-Kaplan ZA, Kahyaoglu S, et al. Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance? J Obstet Gynaecol 2021;41(7):1048–1052. DOI: 10.1080/01443615.2020.1834520
  19. Ventura W, Nazario C, Ingar J, et al. Risk of impending preterm delivery associated with the presence of amniotic fluid sludge in women in preterm labor with intact membranes. Fetal Diagn Ther 2011;30(2):116–121. DOI: 10.1159/000325461
  20. Romero R, Schaudinn C, Kusanovic JP, et al. Detection of a microbial biofilm in intraamniotic infection. Am J Obstet Gynecol 2008;198(1):135.e1–135.e5. DOI: 10.1016/j.ajog.2007.11.026
  21. Rozenberg P, Gillet A, Ville Y. Transvaginal sonographic examination of the cervix in asymptomatic pregnant women: review of the literature. Ultrasound Obstet Gynecol 2002;19(3):302–311. DOI: 10.1046/j.1469-0705.2002.00645.x
  22. Hartmann K, Thorp JM Jr, McDonald TL, et al. Cervical dimensions and risk of preterm birth: a prospective cohort study. Obstet Gynecol 1999;93(4):504–509. DOI: 10.1016/s0029-7844(98)00497-9
  23. McLaren J, Taylor DJ, Bell SC. Increased concentration of pro-matrix metalloproteinase 9 in term fetal membranes overlying the cervix before labor: implications for membrane remodeling and rupture. Am J Obstet Gynecol 2000;182(2):409–416. DOI: 10.1016/s0002-9378(00)70232-8
  24. Devlieger R, Scherjon SA, Oepkes D, et al. Ultrasound visualization of fetal membrane detachment at the uterine cervix: the ‘moon sign’. Ultrasound Obstet Gynecol 2003;22(4):431–432. DOI: 10.1002/uog.234
  25. Casey PM, Long ME, Marnach ML. Abnormal cervical appearance: what to do, when to worry? Mayo Clin Proc 2011;86(2):147–150; quiz 151. DOI: 10.4065/mcp.2010.0512
  26. Katz VL, Lobo RA, Lentz G, et al. Compresive Gynecology, 5th edition. Philadelphia, PA: Mosby/Elsevier; 2007. pp. 437–438.
  27. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424. DOI: 10.3322/caac.21492
  28. Small W Jr, Bacon MA, Bajaj A, et al. Cervical cancer: a global health crisis. Cancer 2017;123(13):2404–2412. DOI: 10.1002/cncr.30667
  29. Crosbie EJ, Einstein MH, Franceschi S, et al. Human papillomavirus and cervical cancer. Lancet 2013;382(9895):889–899. DOI: 10.1016/S0140-6736(13)60022-7
  30. Cohen PA, Jhingran A, Oaknin A, et al. Cervical cancer. Lancet 2019;393(10167):169–182. DOI: 10.1016/S0140-6736(18)32470-X
  31. Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri. Int J Gynaecol Obstet 2018;143(Suppl 2):22–36. DOI: 10.1002/ijgo.12611
  32. Epstein E, Di Legge A, Måsbäck A, et al. Sonographic characteristics of squamous cell cancer and adenocarcinoma of the uterine cervix. Ultrasound Obstet Gynecol 2010;36(4):512–516. DOI: 10.1002/uog.7638
  33. Belitsos P, Papoutsis D, Rodolakis A, et al. Three-dimensional power Doppler ultrasound for the study of cervical cancer and precancerous lesions. Ultrasound Obstet Gynecol 2012;40(5):576–581. DOI: 10.1002/uog.11134
  34. Wang HR, Lin Y, Zhang XY, et al. Transvaginal color doppler sonography combined with colposcopy for diagnosis of early stage cervical cancer and precancerous lesions. J Biol Regul Homeost Agents 2018;32(1):123–126.
  35. Daskalakis G, Diamantopoulos D, Theodora M, et al. 3D vocal power Doppler sonography for the estimation of tumor volume and vascularization in stage IB1 cervical cancer. Arch Gynecol Obstet 2018;298(3):617–222. DOI: 10.1007/s00404-018-4842-1
  36. Petanovski Z, Medjedovic E, Kurjak A. 2023 Difficult cases in Obstetrics and Gynecology Text book od Jan Donald scool in press.
  37. Pannain GD, Pereira AMG, Rocha MLTLFD, et al. Amniotic sludge and prematurity: systematic review and meta-analysis. Rev Bras Ginecol Obstet 2023;45(8):e489–e498. DOI: 10.1055/s-0043-1772189
  38. Testa AC, Ferrandina G, Moro F. PRospective Imaging of CErvical cancer and neoadjuvant treatment (PRICE) study: role of ultrasound to predict partial response in locally advanced cervical cancer patients undergoing chemoradiation and radical surgery. Ultrasound Obstet Gynecol 2018;51(5):684–695. DOI: 10.1002/uog.17551
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.