From the Guidelines
The expected cervical examination finding in a 21-year-old gravida 1, para 0 female at 8 weeks' gestation is a bluish hue, known as cervical cyanosis or Chadwick sign, due to increased vascularity and venous congestion. This physiological change is a normal finding in pregnancy, typically appearing around 6-8 weeks gestation, and is considered one of the presumptive signs of pregnancy 1. The presence of an ectropion, which is a normal developmental finding of the adolescent cervix, may also be noted, but it is not directly related to the pregnancy itself. Other findings, such as friability and hyperemia of the cervix, may indicate infection with an STI, but these are not expected findings in a normal early pregnancy. The bluish discoloration is a result of increased blood flow to the uterus and cervix, which is a normal physiological adaptation to pregnancy. Key points to consider during the speculum examination include:
- Completely visualizing the cervix to note the presence of any lesions
- Inspecting the vaginal walls for discharge and lesions
- Obtaining samples for laboratory and office-based analysis to diagnose potential infections
- Noting the presence or absence of an ectropion on the exocervix.
From the Research
Cervical Examination Findings
- The expected cervical examination finding in a 21-year-old gravida 1, para 0 female at 8 weeks' gestation, with a confirmed intrauterine pregnancy, and a history of multiple sexual partners is not directly addressed by the provided studies.
- However, studies have investigated the use of transvaginal ultrasound in evaluating cervical length and predicting preterm delivery 2, 3.
- A study published in 2003 found that a cervical length < 25 mm on transvaginal ultrasound before 14 weeks of gestation was rare, even in high-risk patients destined to deliver preterm 2.
- Another study published in 2000 found that transvaginal ultrasonographic follow-up examinations of the cervix in women at risk for cervical incompetence, with secondary intervention as indicated, appears to be a safe alternative to the traditional prophylactic cerclage 3.
- The provided studies do not specifically address the expected cervical examination findings at 8 weeks' gestation, but they do suggest that transvaginal ultrasound can be a useful tool in evaluating cervical length and predicting preterm delivery 2, 3, 4, 5.
Transvaginal Ultrasound Findings
- Transvaginal ultrasound has been shown to be effective in identifying viable intrauterine pregnancies and evaluating cervical length 2, 3, 5.
- A study published in 2015 found that transvaginal ultrasound performed in the emergency department revealed a viable intrauterine pregnancy in 49.6% of patients with a nondiagnostic transabdominal ultrasound 5.
- The use of transvaginal ultrasound in evaluating cervical length and predicting preterm delivery has been investigated in several studies 2, 3, 4.