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Intravaginal saline as a contrast agent for cervical sonography in the obstetric patient
J M O'Brien1, A A Allen, J R Barton
1Department of Obstetrics and Gynecology, Central Baptist Hospital, Lexington, Kentucky, USA.
Objective:
To determine whether intravaginal saline alters visualization of the cervix during endovaginal sonographic examinations.
Design:
A prospective trial with comparison of sonographic measurements of cervical length prior to and after administration of an intravaginal contrast agent.
Subjects:
Patients with an indication for endovaginal ultrasonographic assessment of the cervix were considered as candidates for the study.
Methods:
After assessment of cervical dimensions and contour of the internal cervical os, 10 ml of normal saline was placed intravaginally via a needleless syringe. Pre- and post-contrast sonographic examinations of the cervix were compared.
Results:
Twenty-six patients were enrolled. No differences were observed in the identification of funnelling (37% in each group, p = 1.0) or the quantification of cervical length for the entire cohort (p = 0.95). However, in a subset of patients in whom the external os was not satisfactorily visualized (23%), intravaginal contrast resulted in a mean difference in cervical length pre- and post-saline infusion of 6.4 mm compared to 1.4 mm in patients in whom the external os could be easily identified (p < 0.001). No patient expressed undue discomfort related to the administration of contrast.
Conclusion:
Intravaginal saline assists in visualization of the cervix during endovaginal sonography for selected patients in whom precise identification of the external os is difficult.