Early indicators of cervical insufficiency assessed using magnetic resonance imaging of the cervix during pregnancy

Abstract

Objective: To establish the main characteristics of the cervix in pregnant women with cervical insufficiency, by means of magnetic resonance imaging (MRI).

Methods: A prospective observational case-control study was conducted among 59 pregnant women with cervical insufficiency and 10 normal pregnant women, between their 10th and 28th weeks. The parameters analyzed in the MRI examinations were: precise identification of the cervix; presence of hyposignal at the internal orifice of the cervix; loss of definition of the periendocervical stromal zone (PESZ); presence of hyposignal content inside the amniotic sac (sludge sign) and anatomical and functional biometry of the cervix.

Results: Peripheral hyposignal was found in 41 (85.4%) and loss of definition of the PESZ was observed in 36 pregnant women (73.5%) with cervical insufficiency. Sludge was observed in 46 pregnant women with cervical insufficiency, and this was seen on MRI in 27 cases (58.7%). The mean anatomical and functional lengths of the cervix on MRI in the pregnant women with cervical insufficiency were 3.5 ± 0.8 cm (0.8–4.9 cm) and 28.7 ± 6.3 mm (9–41 mm). None of the normal pregnant women presented hyposignal loss of the PESZ and the sludge sign.

Conclusion: MRI may be useful for evaluating the cervix and for early identification of signs of cervical insufficiency during pregnancy.

• Cervical insufficiency
• magnetic resonance imaging
• pregnancy

Declaration of interest

The authors declare no conflicts of interests. The authors alone are responsible for the content and writing of this article.