How to check for cervical insufficiency? Keep these measures in mind!

If women want to know whether their cervical function is healthy, they certainly cannot do it by themselves. They must go to the hospital for a detailed examination. Currently, there are detailed examination methods on the ticket, such as ultrasound examination, which is a relatively common one.

(1) Medical history: The typical medical history is spontaneous rupture of the fetal membranes in the late second trimester, followed by the delivery of a completely normal fetus soon after, with each pregnancy delivering earlier than the previous one.

(2) Cervical examination: During non-pregnancy, palpation of the cervix will reveal that the isthmus of the cervix is ​​short and relatively loose. A No. 8 Hegar dilator can pass through the internal os of the cervix without resistance, which is a simple method for diagnosing cervical insufficiency.

(3) Foley catheter traction test: Place the Foley catheter into the uterine cavity and inject 1 ml of water into the catheter sac to make its diameter reach 6 mm. If the catheter can be easily pulled out of the intrauterine os (traction force is less than 600 mg), it indicates suspected cervical insufficiency and should be further confirmed.

(4) Hysterosalpingography: According to reports, under normal circumstances, the average diameter of the isthmus of the uterus is 2.63 mm. However, in patients with cervical insufficiency, the average diameter of the isthmus increases significantly, and the angle of the cervical canal in the lower segment of the uterus disappears.

(5) Ultrasound examination: Abdominal, perineal or vaginal ultrasound is the most commonly used and effective method for diagnosing cervical insufficiency during pregnancy. A diameter of the internal cervical os ≤19 mm during mid-pregnancy can rule out cervical insufficiency, while a diameter ≥23 mm can confirm the diagnosis. The fetal membrane entering the internal cervical os in a bird-beak or funnel-like shape is also one of the ultrasound images for diagnosing cervical insufficiency. This sign often appears before the cervix shortens. A cervical length of >30mm is normal; a length of <20mm indicates that the cervix is ​​significantly shortened, suggesting miscarriage or premature birth.

(6) Some scholars believe that the internal cervical os acts as a functional sphincter during pregnancy and that the internal cervical os sphincter function is weakened in patients with subclinical uterine contraction or hypotonic internal cervical os. In addition, bromelain and papain can relax the cervix. Cervical incompetence cannot withstand the increase in intrauterine pressure as pregnancy progresses. It often causes spontaneous rupture of the amniotic membrane and miscarriage in the second trimester, and completely normal embryonic tissue can be expelled.