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31 Cards in this Set
- Front
- Back
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Evaluation of LUS is essential during an OB ultrasound... At what point during the scan is cervical length assessed? What if a problem is suspected? |
- eval length @ beginning of scan - if problem, rescan at end |
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Why does placental edge need to be documented? |
r/o placenta previa |
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We assess the cervix to evaluate risk of ___________ ______________. |
premature delivery - cervical length - funneling / beaking |
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4 Indications for a shortened cervix |
- Hx of premature labor - Multiple gestation - PROM - Uterine anomaly |
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What 2 things can make cervix appear shortened even if it's not? |
1. bladder 'too full' 2. applying too much pressure |
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Most common way to evaluate cervix - requires full bladder - discrepancies due to overfilling |
Transabdominal |
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Used to evaluate cervix when TV is contraindicated - empty bladder |
Translabial |
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In what type of scan will the cervix be oriented horizontally on image? |
Translabial |
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Considered 'gold standard' for imaging cervix? - if too much pressure; can appear shortened |
Transvaginal |
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U/S appearance of cervical canal in nongravid uterus |
echogenic strip continuous w/ uterine endometrium |
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U/S appearance of body of cervix |
hypoechoic cylinder |
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Normal length of cervix |
3-4cm |
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Cervix < 3 cm |
foreshortened |
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Cervix length 2.5cm |
clinical correlation needed to determine treatment |
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When scanning Translabial, what patient orientation would be top of image, bottom of image, left & right sides? |
top - inferior bottom - superior left - anterior right - posterior |
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Incompetent Cervix |
cervix unable to retain IUP |
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Name some of the etiologies of Incompetent Cervix |
- congenital - trauma - hormones |
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S/S of Incompetent Cervix |
Hx of multiple painless 2nd tri abortions |
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Treatment for Incompetent Cervix |
- bed rest - cervical cerclage |
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Cervical Cerclage |
cervix sewn shut for remainder of pregnancy |
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When is it best to do a Cervical Cerclage? When is the stitch usually removed? |
3rd month of pregnancy - removed around 37 weeks |
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At what measurement may the cervix be falsely elongated? |
> 5cm |
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4 criteria with Incompetent Cervix (do not need all of them to be diagnosed) |
1. cervical length < 3cm 2. width of canal > 8mm 3. open internal os 4. protrusion of membranes thru canal |
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Cervical Funneling |
sign of incompetent cervix - dilation of internal os - reduction of cervix length *does not occur in cervix > 3cm |
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When is the cervix considered funneling? |
dilated internal os > .5mm |
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What is the final stage of cervical shortening? |
funneling |
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Minimal funneling |
< 25% *not associated with preterm labor |
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Moderate funneling |
25-50% *associated with >50% chance of preterm labor |
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Severe funneling |
>50% *associated with >50% chance of preterm labor |
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Dynamic Changes *scanning method |
while scanning - applying external pressure while watching internal os with real time imaging *this mimics stress of gravity upon cervix |
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Understand funneling images! *trust your vaginal ultrasound |
T - normal Y - some funneling V - worse funneling U - going to have baby |
