Enlarged cervix

Introduction The cervix is one of the important tissues and organs in the female reproductive system. From embryos and female fetuses to calluses, the cervix involves diseases such as gynaecology, obstetrics, family planning, women's health and reproductive health in women's life. Womens own health, family well-being, economic and social issues are also closely related to sex and reproduction. During cervical pregnancy, the gynecological examination of the cervix becomes larger.

Cause

The cause of cervical pregnancy is unclear and may be related to the following factors:

1. The fertilized egg runs too fast, and has already entered the cervical canal before it has the ability to grow, and grows and grows here.

2, induced abortion, mid-term induction of labor, cesarean section and intrauterine device to damage the endometrium or changes in the intrauterine environment, affecting the normal implantation of pregnant eggs.

3, uterine dysplasia, uterine malformation, uterine fibroids, endocrine disorders, assisted reproductive technology is also a possible related factors.

an examination

Related inspection

Cervical examination of cervical biopsy

In addition to the enlargement of the cervix, the main symptoms of cervical pregnancy are vaginal bleeding or bloody secretions. The amount of bleeding is generally from small to large, and it can also be intermittent vaginal bleeding. The main signs are that the cervix is significantly enlarged, softening and bluening, the outer edge of the cervix is very thin, the inner mouth is tight, and the size and hardness of the palace are normal. Clinical manifestations are as follows:

Menopause, early painless vaginal bleeding, bleeding time in the menopause 5 to 12 weeks, more common in 6 to 8 weeks. Slight lower abdomen pain. Bleeding during the curettage is fierce, uncontrollable, shock or death. There are people, history of cesarean section, history of IVF (in vitro fertilization).

The cervix is larger than the uterine body, the cervical cervix and the external cervix are obviously dilated, and the enlarged cervix is in the shape of a gourd with a normal or slightly larger uterus. Embryonic or placental tissue can be found in the cervical canal. The internal opening of the cervix is closed.

The cervical gland must be found in the placenta attachment site, and the placental tissue is closely attached to the cervix. The placenta is located below the uterine blood vessels into the cervix, or below the uterine anterior and posterior peritoneal reflex levels. There is no gestational sac in the official cavity.

The uterus is normal or slightly enlarged, and there is no gestational sac in the uterus. The gestational sac is located below the internal cervix of the uterine artery. The cervix is inflated, the entire uterus is in the shape of a "cucurbit", the internal cervix is closed, and the gestational sac or disordered echo mass can be seen on the longitudinal or transverse section of the cervix. The bladder position is significantly up.

The image of cervical pregnancy and other ectopic pregnancy, gestational sac and pseudo gestational sac. In ectopic pregnancy, about 20% of cases have an anechoic area of "false gestational sac" in the uterus. One of the differences between it and the normal gestational sac is that the "false gestational sac" is a single ring dark area, while the gestational sac is Double-ringed double deciduous dark area. The second difference is that the pseudopregnancy sac comes from the decidual reaction or decidual tube type with blood, so it is concentrated in the center of the uterine cavity. The sonogram shows the symmetric gestational sac in the middle of the uterus, and the normal early pregnancy implanted in the uterine wall. The capsule is not in the center of the uterine cavity.

Blood pHCG detection of cervical pregnancy blood pHCG levels vary, about 10 ~ 105u / L, and gestational age and embryo survival. In the intrauterine pregnancy 48h blood HCG increased by >60%, doubling time was 1.7 ~ 2.0d. Cervical blood supply is poor, cervical blood ~-HCG titer increased by <50%.

Differential diagnosis

Misdiagnosis of cervical pregnancy:

1, early pregnancy, typical symptoms of cervical pregnancy are menopause and early pregnancy reaction, uterus enlargement and soft, pregnancy test is positive, and the symptoms of early pregnancy are very similar, it is easy to cause misdiagnosis.

2, abortion, cervical pregnancy early clinical symptoms and abortion are very similar, both showed irregular vaginal bleeding after menopause, abdominal pain, etc., so cervical pregnancy is easily misdiagnosed as a variety of miscarriage, such as threatened abortion, inevitable abortion, expired abortion and incomplete Abortion and so on.

3, endometrial cancer, endometrial cancer and this disease can be seen in the clinical vaginal irregular bleeding, uterine blood with lower abdominal pain, it is easy to clinically misdiagnosed cervical pregnancy as endometrial cancer.

4, uterine fibroids, clinical cervix pregnancy and uterine fibroids have vaginal bleeding, uterine enlargement and other similar performance, it is easy to misdiagnosis.

5, embryos stop with uterine blood, intrauterine pregnancy live birth, low placenta, low-position placenta in late pregnancy patients have painless repeated vaginal bleeding, embryos with uterine bleeding and abdominal pain signs, intrauterine Pregnancy live fetus is positive for pregnancy test, which is similar to irregular vaginal bleeding, abdominal pain and pregnancy test in cervical pregnancy, so it is easy to be misdiagnosed clinically.

In addition to the enlargement of the cervix, the main symptoms of cervical pregnancy are vaginal bleeding or bloody secretions. The amount of bleeding is generally from small to large, and it can also be intermittent vaginal bleeding. The main signs are that the cervix is significantly enlarged, softening and bluening, the outer edge of the cervix is very thin, the inner mouth is tight, and the size and hardness of the palace are normal. Clinical manifestations are as follows:

Menopause, early painless vaginal bleeding, bleeding time in the menopause 5 to 12 weeks, more common in 6 to 8 weeks. Slight lower abdomen pain. Bleeding during the curettage is fierce, uncontrollable, shock or death. There are people, history of cesarean section, history of IVF (in vitro fertilization).

The cervix is larger than the uterine body, the cervical cervix and the external cervix are obviously dilated, and the enlarged cervix is in the shape of a gourd with a normal or slightly larger uterus. Embryonic or placental tissue can be found in the cervical canal. The internal opening of the cervix is closed.

The cervical gland must be found in the placenta attachment site, and the placental tissue is closely attached to the cervix. The placenta is located below the uterine blood vessels into the cervix, or below the uterine anterior and posterior peritoneal reflex levels. There is no gestational sac in the official cavity.

The uterus is normal or slightly enlarged, and there is no gestational sac in the uterus. The gestational sac is located below the internal cervix of the uterine artery. The cervix is inflated, the entire uterus is in the shape of a "cucurbit", the internal cervix is closed, and the gestational sac or disordered echo mass can be seen on the longitudinal or transverse section of the cervix. The bladder position is significantly up.

The image of cervical pregnancy and other ectopic pregnancy, gestational sac and pseudo gestational sac. In ectopic pregnancy, about 20% of cases have an anechoic area of "false gestational sac" in the uterus. One of the differences between it and the normal gestational sac is that the "false gestational sac" is a single ring dark area, while the gestational sac is Double-ringed double deciduous dark area. The second difference is that the pseudopregnancy sac comes from the decidual reaction or decidual tube type with blood, so it is concentrated in the center of the uterine cavity. The sonogram shows the symmetric gestational sac in the middle of the uterus, and the normal early pregnancy implanted in the uterine wall. The capsule is not in the center of the uterine cavity.

Blood pHCG detection of cervical pregnancy blood pHCG levels vary, about 10 ~ 105u / L, and gestational age and embryo survival. In the intrauterine pregnancy 48h blood HCG increased by >60%, doubling time was 1.7 ~ 2.0d. Cervical blood supply is poor, cervical blood ~-HCG titer increased by <50%.

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