Dilation of the Cervix, Pre-term and increased cervical length in Obs Ultrasound scan

1. CERVICAL
INCOMPETENCE
Presenter
Ogbozor Victor Chinedu

2. Outline
1. Structural Anatomy of Uterus
2. Cervical incompetence
Definition
3. Causes
4. diagnosis
5. Pit Falls
6. Remedy

3. Structural Anatomy
-Uterus,Cervix, Vaginal
-Anteriorly Abutted by
Bladder
-
Endometrium,Endocervi
cal canal, Vaginal

8. Cervical incompetence
Definition
-Spontaneous dilatation of cervix , pre-term
dilation
-weakening
-Shortening of Cervical length
-normal length ~3-4.5, 5cm
Increased Cervical length towards delivery can
signify post date labour as it suppose to be
short for delivery

9. Causes
Gynaecological trauma
History of pre-term labour
Uterine Anomalies -
Abnormalities that affects the
Cervical connective tissue etc

10. Diagnosis
(,best with TVS)
-Cervical length measurement
-Endocervical canal- internal os to External Os.
(>25mm at or b4 24weeks)
-Relationship BTW GA and Cervical Length
-Sonographic features
Incompetence mnemonics for Cervical Funneling
(TYVU) Trust Your Vaginal Ultrasound
Normal- T shape
Funneling Y, V, and Worsen at U shape

12. Normal

14. Shortened Cervix due to Funneling

15. Pit Falls in Diagnosis of incompetence
-Excessive pelvic pressure
-Over distended urinary bladder
Compressees the Cervical canal and
apparently diminishes dilatations

18. Remedy
Cervical Cerclage (stitching of the Cervix)
Progesterone supplement...

22. Preparation for Labour and delivery. Towards
labour Cervical dilatation is normal and called
Cervical effacement

24. Thank You

25. https://radiopaedia.org/cases/cervical-incompetence-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513327/
https://radiopaedia.org/articles/funneling-of-the-internal-
cervical-os?lang=us
https://radiopaedia.org/articles/cervical-incompetence-
morphological-changes-on-ultrasound-mnemonic?lang=us
https://en.m.wikipedia.org/wiki/Cervical_cerclage
https://www.mayoclinic.org/diseases-
conditions/incompetent-cervix/diagnosis-treatment/drc-
20373842
References