Cervical Consistency Index: A New Concept in Uterine Cervix Evaluation

Abstract

ABSTRACT Objective To search an ultrasonographic marker to measure cervix consistency throughout pregnancy quantitatively by transvaginal ultrasonography and compare these values with the current pattern–the cervicometry. In a randomly selected population of pregnant and nonpregnant women using a new cervical consistency index (CCI) and compare these changes with the findings using cervicometry. Methods The cervical consistency index (CCI) and cervicometry were measured using transvaginal ultrasonography in a reference population of randomly selected women who were mature enough for reproduction, and women in their first, second and third trimester of pregnancy. Patients with history of cervical conization, two or more dilations and miscarriages, Müllerian abnormalities and history of cervix incompetence were excluded from this study. Furthermore, patients with multiple pregnancies and cervical cerclage were not allowed to participate in this study. Results A total of 162 patients were evaluated for cervicometry and CCI. Eighty of these women were not pregnant and the remaining 82 were pregnant. The database was analyzed using EPI-INFO version 6.0. Statistical values, such as the average, median and standard deviation between two groups, were analyzed. Statistically significant differences were found between nonpregnant and pregnant women in the first, second and third trimester regarding CCI with p < 0.0001. The cervix of pregnant women loses an average of 1.2% of consistency per week of pregnancy. Cervicometry did not show statistically significant difference among the groups (p = 0.4459). Conclusion CCI can quantitatively assess cervix consistency in pregnant and nonpregnant women, also found statistically significant differences between these groups and between the different trimesters of gestation, CCI also shows a remarkably circumscribed linear regression trend from early pregnancy. This ultrasound marker may serve in future for the early identification of patients at risk for preterm delivery. On cervicometry, there was no statistically significant differences between groups mentioned above.