Cervical Incompetence

PowerPoint Presentation

Cervical Incompetence6/3/16

Dr Ahmad TahaFetal Medicine UnitOrient HospitalDamascus Syria

Taha.as@me.com Damascus, Syria

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Definition The inability of the uterine cervix to retain a pregnancy in the absence contractions, labor or both in the second trimester.6/3/16

Taha.as@me.com Damascus, SyriaAnatomy

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Taha.as@me.com Damascus, SyriaAnatomy

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Taha.as@me.com Damascus, SyriaUltrasound Scan TVS

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Taha.as@me.com Damascus, SyriaMeasurementCervical length can be measured by:Transabdominallyor Transperineallybut Transvaginal assessment is the most accurate6/3/16

Taha.as@me.com Damascus, SyriaBasic parameters measurement Standard cervical measurements use the (white stripe) of the internal cervical os as an anatomic land mark for proper caliper placement

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Taha.as@me.com Damascus, SyriaNormal length Varies between457 mm(Anderson et al)And 358 mm(Lams et al)SO The short cervix varies between 15 mm (Hassan et al) and 26 mm (Lams et al)6/3/16

Taha.as@me.com Damascus, SyriaASSESMENTThe very most important for assessment is

Progressive shortening

with or without

FunnelingV shaped lower uterine segment6/3/16

Taha.as@me.com Damascus, SyriaWomen at high riskWomen at risk of developing a weak cervix include:Women with a history of D&C (Dilation and Curettage) for abortion, miss carriage etcWomen who have had surgery on the cervixWomen with a damage to cervix from previous birthsDaughters of women who took DES 6/3/16

Taha.as@me.com Damascus, SyriaDiagnosisThere are no established criteria for diagnosing cervical incompetence6/3/16

Taha.as@me.com Damascus, SyriaDiagnosis6/3/16

Taha.as@me.com Damascus, SyriaHistory6/3/16

Taha.as@me.com Damascus, SyriaUltrasound Scan TVS

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Taha.as@me.com Damascus, SyriaUltrasound Scan TVSUsed when the diagnosis is uncertain but suspected during pregnancy Cervical length < 2.5 cm Funneling of the internal os Is suggestive of cervical incompetenceRepeated TVS is a essential in the border cases 6/3/16

Taha.as@me.com Damascus, SyriaUltrasound Scan TVS Cervical Incompetence

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Taha.as@me.com Damascus, SyriaUltrasound Scan TVS Cervical Incompetence6/3/16

Taha.as@me.com Damascus, SyriaUltrasound Scan TVS Cervical Incompetence6/3/16

Taha.as@me.com Damascus, SyriaUltrasound Scan TVS Cervical Incompetence6/3/16

Taha.as@me.com Damascus, SyriaIncompetent Cervix

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Taha.as@me.com Damascus, SyriaFunneling of >25% cervical length and/or