Insler et al developed a semiquantitative scoring system based on changes seen in the cervix during cervical cycle. This can be used to monitor estrogenic changes about the time of ovulation. The authors are from the Chaim Sheba Medical Center and Tel-Aviv University in Israel.
Parameters:
(1) amount of mucus
(2) spinnbarkeit
(3) ferning
(4) cervix
|
Parameter |
Finding |
Points |
|
amount of mucus |
none |
0 |
|
|
scant; a small amount of mucus can be drawn from the cervical canal |
1 |
|
|
dribble; a glistening drop of mucus seen in the external os; mucus easily drawn |
2 |
|
|
cascade; abundant mucus pouring out of the external os |
3 |
|
spinnbarkeit |
none |
0 |
|
|
slight; uninterrupted mucus thread may be drawn approximately one quarter of the distance between the external os and the vulva |
1 |
|
|
moderate; uninterrupted mucus thread may be drawn about halfway between the external os and the vulva |
2 |
|
|
pronounced; uninterrupted mucus thread may be drawn for the whole distance between the external os and vulva |
3 |
|
ferning |
none; amorphous mucus |
0 |
|
|
linear; fine linear ferning seen in a few spots; no side branching |
1 |
|
|
partial; good ferning with side branches in parts of the slide, linear ferning or amorphous mucus in other parts |
2 |
|
|
complete; full ferning of the whole preparation |
3 |
|
cervix |
closed; mucosa pale pink; external os hardly admits a small applicator |
0 |
|
|
partially open; mucosa pink; the cervical canal easily penetrable by an applicator |
2 |
|
|
gaping; mucosa hyperemic; external os patulous |
3 |
Cervical score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The score starts to rise about 8-9 days before ovulation, with a maximum on the day of ovulation, and then a decline towards 0 on 6-7 days after ovulation.
|
Cervical Score |
Rating |
|
0 to 3 |
Negative |
|
4 to 6 |
Slight |
|
7 to 9 |
Moderate |
|
10 to 12 |
full |
Performance:
• Interobserver variability showed a correlation coefficient that ranged from 0.82 to 0.98.
Specialty: Obstetrics & Gynecology
