Definition of cervical index( number) - Causes, symptoms and treatment. MF.
The test is based on the characteristic changes in cervical mucus during the menstrual cycle under the influence of estrogens and gestagens. There are several samples: the determination of the amount of mucous secretion, the phenomenon of the pupil, the tension of mucus and the phenomenon of fern.
The amount of mucous secretion depends mainly on the estrogenic activity of the body. The greatest amount is found when ovulating, the smallest - before the beginning of menstruation. The test is assessed qualitatively or in points.
The phenomenon of the pupil is based on the change in the amount of secreted mucus and the tone of the cervix under the influence of steroid hormones. The amount of mucous secretion and the diameter of the external throat of the uterus are maximal during the period of ovulation, so when the ray of light is directed, the outer throat with a protruding droplet of mucus seems dark and resembles a pupil. Evaluation is made in points on a three-point system: a small point or strip - 1 point( +), 0.2-0.25 cm - 2 points( + +), 0.3-0.35 cm - 3 points( + + +).
With old cervical ruptures, erosions, endocervicitis, this test is uncharacteristic.
Tension of the cervical mucus also depends on estrogenic stimulation, which affects the decrease in mucus viscosity and the appearance of fluidity. The tension is determined by careful dilution of the branche of the forceps after removing it from the cervical canal. The length of the mucosa is measured in centimeters;the test is also evaluated on a three-point scale: the filament length is up to 6 cm - 1 point( +), 8-10 cm - 2 points( + +), more than 12 cm - 3 points( + + +).The maximum length of the filament occurs during the period of ovulation.
The fern phenomenon is based on the ability of the cervical mucus to dry undergoing crystallization, the intensity of which varies during the menstrual cycle and depends on the hormonal activity of the ovary.
The evaluation of the crystallization of mucus, dried in air or above the flame of a burner, is produced under a microscope at low magnification in a three-point system: small crystals with indistinct pattern in the form of separate stems - 1 point( +), clearly defined sheet with a clear pattern - 2 points( ++), coarse crystals, folding into "fern leaves", where branches branch at an angle of 90 ° - 3 points( + + +).The maximum pronounced fern phenomenon is associated with the maximum production of estrogens in the ovulation phase. In the lutein phase of the cycle, this phenomenon gradually disappears, before menses the crystallization of mucus is absent - 0 points( -).
Limits the value of research on the phenomenon of fern changes the pH of mucus( inflammatory diseases), since in this case the crystallization pattern may be distorted.
The diagnostic value of studies of the properties of cervical mucus increases when applied in combination. The index of cervical mucus is calculated by the sum of the points when five tests are taken into account: the phenomenon of the pupil, the phenomenon of fern, the amount of cervical mucus, its tension and the number of leukocytes. The maximum score for each test is 3 points, the minimum score is 0 points.
Cervical mucus test standards and cervical index for the 28-day menstrual cycle
| display points | Feature Points | |
| number mucus | 0 1 2 3 | 0,1 ml 0 ml 0,2 ml 0,3 ml |
| Viscosity Thick | 0 1 2 3 | viscous sticky low-viscosity
Watery |
| Crystallization | 0 1 2 3 | No Atypical drawing Primary and secondarybranches of fern Tertiary and quaternary branches of fern |
| Mucus sluggish | 0 1 2 3 | Less than 1 cm 1-4 cm 5-8 cm 9 cm or more |
| Cellularity of mucus( leukocytes) | 0 1 2 3 | More than 11 cells of 6-10 cells of 1-5 cellsok absent |
Cervical indices from 0 to 8 points indicate low saturation, from 9 to 11 points - on moderate, from 12 to 15 points - on high estrogenic saturation.