Cervical assessment - the unusual and unexpected

Ellen Dyer, Ultrasound, Rosie Hospital, Cambridge

Cervical assessment is a key part of the screening of high-risk women for preterm birth.  In 2015 NICE recommended that high-risk women with a cervical length of less than 25mm should be offered prophylactic treatment of either progesterone or cervical cerclage to prevent preterm birth.  In May 2017 the Rosie Hospital, Cambridge, established a dedicated Preterm Surveillance Clinic for high-risk women. During the first year we have had some unusual and unexpected ultrasound findings.  Current literature describes well the standardize technique for cervical length assessment of the typical cervix but there is little published literature about more unusual cervical ultrasound appearances.

The aim of this pictorial review is to increase awareness of unusual cervical ultrasound appearances which can make cervical assessment more difficult, these include:

  • Asymmetry of the cervix caused by LLETZ (Large loop excision of the transformation zone)

  • Full dilation Cesarean section scar

  • Uterine didelphis with ‘double cervix’

  • Low uterine contraction

  • Endocervical polyp

  • Vasa previa

  • Placenta previa

Awareness of these more unusual cervical ultrasound appearances along with good technique will enable accurate cervical assessment and appropriate management of women.

View the Poster here