Ultrasound of the cervix

Ultrasound of the cervix is a method that is one of the most informative methods that allow us to identify the main causes of the pathology development not only of the female genital organs but also of the pelvic organs. Ultrasound is used to diagnose pregnancy and to monitor the fetus. In addition, ultrasound is the "gold standard" for diagnosis of both benign and background diseases, and malignant tumors of female genital organs at an early stage of development. Due to the ability of ultrasonic rays to penetrate through tissues of various densities, today it is possible not only to diagnose the pathology of the cervix, the body of the uterus and appendages, but also to conduct differential diagnosis of various tumors with the establishment of their size and precise localization. The good separate ability of ultrasound waves makes it possible to widely apply this diagnostic method in gynecology.

Indication and technique of ultrasound of the cervix

Ultrasound examination of the cervix is an additional diagnostic method that is used only as directed by the doctor for the purpose of clarifying the diagnosis or conducting differential diagnosis. Therefore, it is important to consider each individual case and decide the question about this method of research, especially since its informativeness is very high, along with low harm. The doctor before appointment should explain the technique and the main points of this survey.

Preparation for ultrasound of the cervix does not have distinctive features, except for the difference in technique. On the eve of the study, it is necessary to conduct basic hygienic procedures that differ nothing from the daily toilet. As a rule, for better visualization, with different techniques of examination, it is necessary to empty the gallbladder - this facilitates the free passage of waves. This must be done immediately before the examination. These are the basic elements of training, which are very simple, if this examination is accompanied by additional manipulation, then there may be other methods of preparation that the doctor will report individually.

Indications for ultrasound of the cervix are conditions that require additional examination to clarify the diagnosis. With regard to ultrasound of the cervix, the testimony is as follows:

• Beli - discharge from the vagina, which can be a consequence of the inflammatory process of both the cervix and uterus with appendages including.
• Bloody discharge from the vagina - can be the result of many processes - ectopic pregnancy, impaired uterine pregnancy, endometriosis, cervical erosion, cervical canal polyp, premature placental abruption, placenta previa, and many other pathological conditions.
• Pain in the lower abdomen with the clinic of the "acute abdomen" can occur when the tube is ruptured with ectopic pregnancy, ovarian apoplexy, torsion of the ovarian cyst leg, with necrosis of the myomatous node.
• Enlargement of the uterus in volume and size with suspicion of uterine fibroids to clarify the size and determine the tactics of treatment.
• Violation of the normal ovario-menstrual cycle to clarify the presence of the follicle, its size, egg, functional endometrial activity.
• If you suspect a malignant neoplasm to clarify the location, size, extent of spread to neighboring organs.
• When pregnancy as a confirmation of the presence of a fetal egg and clarify its location, as well as an obligatory screening method for diagnosing the condition of the fetus and its development.

These are the main indications in which it is necessary to carry out ultrasound of the cervix and uterus, and, depending on the goal, determine the technique of carrying out. There are two main techniques for performing ultrasound - it is transvaginal and transabdominal. Transabdominal ultrasound is performed for pregnant women to assess the condition of the fetus, measure its size, measure the amount of amniotic fluid, as well as for functional diagnosis of its basic systems. This method is convenient for pregnant women in the second half, since good conductivity of ultrasound waves through a dense enlarged uterus.

Transvaginal ultrasound is performed with all other conditions that require examination. At the same time, on a transvaginal transducer, to prevent infection, a condom is inserted and inserted into the vagina, which allows visualization of all uterine structures, as well as ovaries and tubes. With this technique, it is possible to see the extrauterine space.

Such diagnostics makes it possible to reveal all the structural changes, both in the uterus, and in the ovaries, around the uterus and in neighboring organs.

Ultrasound of the cervix in pregnancy

Ultrasound diagnosis in pregnancy is a mandatory method of research and is conducted at least three times in each trimester. The first ultrasound is carried out between 9 and 11 weeks and allows you to determine the number of fetal eggs in the uterus, their location, the level of placentation, as well as the condition of the uterus. At this time, you can see the pathology of fetal development - chromosomal mutations, and in case of suspected development of congenital anomalies, it is possible to refer to invasive examination methods. The technique is transvaginal.

The next ultrasound is carried out in the second trimester and an important element here is a special examination - cervicometry. This method consists in ultrasound examination of the cervix with measurement of its size.

The interpretation of the results of ultrasound of the cervix in pregnancy is that the standard indices of the length of the cervix are 35-45 millimeters, and the size of the uterine throat is not more than 5 millimeters. Until the thirtieth week of pregnancy, the length of the cervix should be at least 35 millimeters. Further, with the next ultrasound in the third trimester at 34-36 weeks, the length of the cervix decreases, as it prepares for childbirth. At the same time its length is about 34-36 millimeters, but it can be 30. This is considered a normative indicator. In the event that the length of the cervix is less than 35 millimeters, then it is diagnosed with ischemic-cervical insufficiency. This condition is characterized by possible complications in the form of premature pregnancy, premature detachment of amniotic fluid, umbilical cord entanglement. In case of timely establishment of this diagnosis, surgical treatment is performed in the form of obstetrics pessaries - a seam on the cervix, which reduces uterine pharynx and extends the cervix. Before birth, this seam is removed. Therefore, it is very important to carry out ultrasound of the cervix during pregnancy, especially in dynamics, since this allows you to control not only the condition of the fetus, but also the readiness of the birth canal and their condition. It should also be noted that in women who had an ischemic-cervical insufficiency earlier in the first pregnancy, the ultrasound cervicometry method is mandatory for the control of the cervix.

Normative indicators of ultrasound of the cervix

The conclusion, which the doctor gives after the ultrasound of the cervix has a lot of incomprehensible things. How do you know if everything is in order with your health? To do this, you need to know the normal indicators that are determined in this study.

The result of the examination is formed not only from the cervical data, but it is complex and the correct interpretation of the results is very important in the diagnosis:

1. The body of the uterus - the location, the presence of deformations, bends.
2. Endometrium - structure, thickness, echogenicity, the presence of additional structures in the form of a fetal egg, polyp and others.
3. The cervix of the uterus is its length, structure, presence of cysts, polyps.
4. The right and left ovary - their size, the presence of follicles and structure.
5. Ectopic space - the presence of fluid or additional structures in the form of a fetal egg, hematoma.

As for the cervix, the normative parameters of ultrasound of the cervix are as follows:

• length is not less than 35 and not more than 45 millimeters;
• the size of the uterine throat is not more than 5 millimeters;
• free patency of the cervical canal - absence of additional echoes, which can be with ectopic cervical pregnancy, localization in the neck of the submucous myomatous node, polyp.
• clear structure of the epithelial cover of the cervix and cervical canal without deformities;
• absence of symptoms of "plus-tissue" and "minus-tissue", which happens with the growth of malignant formations exophytally and endophytically, respectively.

It is also necessary to take into account the location of the cervix relative to neighboring organs. After surgical interventions on the cervix for, for example, dysplasia, there may be scar changes, which must be taken into account by careful collection of anamnesis, since a false diagnosis can be made.

Pathological changes in the cervix by ultrasound

There are many pathologies of the cervix, the diagnosis of which can only be established by ultrasound data. Therefore, ultrasound is the "gold standard" for diagnosing the pathology of the woman's reproductive system. It is important to suspect a planned examination of a pathology, in the future to conduct additional research methods and to exclude or confirm the alleged diagnosis.

1. Erosion of the cervix is a fairly common pathology that occurs in every third woman of any age. This pathology refers to background diseases and is associated with a possible risk in the future development of cancer pathology. Therefore, it is important to establish a diagnosis in a timely manner and conduct treatment. First of all, it is necessary to distinguish between pseudo-erosion and true erosion of the cervix. Pseudo-erosion is a defect in the mucous membrane of the cervix, which is most often found in girls under 25 years of age and is physiological. It arises from the action of hormones and does not require treatment, but only observation. Erosion is a true mucosal defect that can occur as a result of traumatization, the action of microorganisms, and therefore requires treatment. This pathology can be detected by a routine examination of a woman in mirrors or in colposcopy. Then the woman is sent to the ultrasound to exclude the malignant character - then there will be no spreading in the depth of the tissue. When ultrasound of the cervix uterus erosion has a characteristic form - a shallow superficial defect of the cervix of the uterus without propagation into the interior of the tissue. Sometimes, erosion can not be visualized, which depends on the separation ability of the device and the size of the defect.
2. Cervical cancer is a very dangerous pathology and requires an early diagnosis. Ultrasound can accurately determine the localization of the pathological process, the degree of damage to neighboring organs, the state of regional lymph nodes. This allows not only to establish a diagnosis, but also to classify the disease according to the stage, which is important for choosing the tactics of treatment.

Cervical cancer on ultrasound looks like a "plus-tissue" and has a fuzzy structure in the form of a non-uniform echogenic formation with fuzzy contours that performs the cavity of the cervical canal or is located on the neck of the uterus. This pattern is observed with exophytic tumor growth. With endophytic growth of cervical cancer on ultrasound, there is a heterogeneity in the structure of the cervix or cervical canal in the form of a node with fuzzy boundaries and a fuzzy structure.

3. Cervical dysplasia is also a precancerous condition and requires timely diagnosis. This is a pathology in which metaplasia of the epithelium occurs, that is, a multi-layered flat epithelium, which normally is in exocervix, appears in the transition zone or in the cervical canal. This structural disorder is a superficial defect and, unfortunately, ultrasound has no manifestations. This pathology is identified and confirmed by a cytological examination.
4. Polyp of the cervix is a very frequent pathology, which is caused by infection and replication in the cervical cells of the human papillomavirus. This virus multiplies and contributes to the disruption of the normal structure of the epithelial cover, resulting in the formation of benign formations that have the appearance of cauliflower - polyps. These polyps on ultrasound look like a "plus-tissue", but unlike malignant formations, they have clear boundaries and uniform density, do not spread and do not grow deep, and grow only exophytically. Thus, they have the form of an additional elongated formation with distinct boundaries.
5. Cervical cyst is not a frequent phenomenon, but it also happens and requires diagnosis. The cyst is a non-proliferative benign formation that has thin walls and a uniform composition. The ultrasound of the cervix cyst has the appearance of a clear, rounded shape, which has a homogeneous composition inside in the form of a liquid - which is clearly defined on the screen. It is necessary to carry out a careful transvaginal examination if there is a suspicion of the cervix cyst, since there may be a complication in the form of trauma to the cyst.
6. Carcinoma and adenocarcinoma is a malignant formation of the cervix, which develops from the epithelial glandular tissue. Often has an exophytic growth and a heterogeneous structure. On ultrasound has the form of fuzzy formation with a significant depth of penetration into the thickness of the cervix, the sizes are different, the boundaries are not uniform. On ultrasound, it is difficult to distinguish between cancer and adenocarcinoma, because they have similar characteristics, one can only suspect a malignant character, and an accurate diagnosis is established by histological pattern.

Ultrasound of the cervix is an informative diagnostic method that allows to diagnose a normal pregnancy, control the dynamics of the fetus, and also to determine possible pathological processes not only on the cervix, but also on the pelvic organs. Timely diagnosis of benign, background, malignant lesions on the cervix allows you to avoid complications and promptly prescribe treatment.