📄 SCRS

Casamassima-Morton-Nance
syndrome

Casamassima-Morton-Nance syndrome ultrasound case study

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Reporting Panel

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Fetal Pathology

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Casamassima-Morton-Nance syndrome ultrasound case study

CASE–1

Clinical History

A fetus was referred for a detailed fetal anomaly scan because of severe skeletal abnormalities detected on routine antenatal ultrasound. The examination was performed to evaluate the fetal thoracic cage, vertebral column, ribs, limbs, abdominal wall, and associated anomalies.

Ultrasound Findings

Ultrasound examination demonstrates multiple thoracic and lumbar vertebral segmentation anomalies with severe thoracolumbar scoliosis. The thoracic cage is markedly small with severe thoracic hypoplasia due to multiple absent and malformed ribs. A large anterior abdominal wall defect consistent with gastroschisis is present, with herniation of bowel loops into the amniotic cavity. Unilateral complete absence of the lower limb (amelia) is demonstrated. The combination of severe vertebral and rib anomalies, markedly reduced thoracic volume, anterior abdominal wall defect, and lower limb deficiency is highly suggestive of Casamassima-Morton-Nance syndrome (Spondylocostal dysostosis with anal, urogenital, and limb anomalies).

Fetal ultrasound. Multiple thoracic vertebral segmentation anomalies are present with marked thoracic scoliosis/kyphoscoliosis, a short hypoplastic thorax with absent/fused ribs, and a shortened trunk consistent with short-trunk dwarfism . Complete absence (only soft tissue stump is seen) of both lower limb is also noted Amelia . The constellation of findings is suggestive of Casamassima-Morton-Nance syndrome; however, complete lower-limb absence is not a classic feature of this syndrome and may indicate an expanded phenotypic spectrum or an alternative diagnosis.

Coronal plane. A marked ventral abdominal wall defect (omphalocele) is demonstrated, with herniation of bowel into a membrane-covered sac anterior to the fetal abdomen. The associated omphalocele supports the diagnosis of a complex congenital malformation syndrome.

Report Line

Multiple thoracic vertebral segmentation anomalies are identified with marked thoracic scoliosis/kyphoscoliosis. The thoracic cage is markedly shortened with absent/fused ribs, resulting in severe thoracic hypoplasia and short-trunk dwarfism. Complete bilateral lower-limb amelia (only soft tissue stumps are identified) is demonstrated. A large anterior abdominal wall defect (omphalocele) containing herniated bowel within a membrane-covered sac is also present. The constellation of findings is most suggestive of Casamassima-Morton-Nance syndrome. However, complete bilateral lower-limb amelia is not a classic feature of this syndrome and may represent an expanded phenotypic spectrum or an alternative diagnosis.

Impression

Features are most consistent with Casamassima-Morton-Nance syndrome.
[D/D Jarcho–Levin syndrome, Limb–Body Wall Complex or OEIS complex.]

Recommendation

A detailed fetal anomaly survey is recommended to evaluate for additional skeletal, cardiac, craniofacial, renal, and central nervous system abnormalities. Fetal echocardiography and fetal MRI may be considered for comprehensive assessment of associated anomalies. Genetic counseling is advised, with consideration of chromosomal microarray analysis and molecular genetic testing. Multidisciplinary prenatal counseling should be offered to discuss the guarded prognosis associated with severe thoracic insufficiency and multiple congenital anomalies.

Key Learning Points

• Casamassima-Morton-Nance syndrome is a rare skeletal dysplasia characterized by multiple vertebral segmentation defects, rib anomalies, and short-trunk dwarfism.
• Marked thoracic scoliosis/kyphoscoliosis with a short hypoplastic thorax may result in severe thoracic insufficiency.
• Associated anomalies may include omphalocele and other visceral, cardiac, or genitourinary malformations.
• Complete bilateral lower-limb amelia is not a classic feature and may represent an expanded phenotypic spectrum or an alternative diagnosis.
• Assessment should include the vertebral column, ribs, thoracic circumference, abdominal wall, limbs, heart, kidneys, and central nervous system.
• Fetal MRI and fetal echocardiography can aid in comprehensive evaluation of associated anomalies.
• Genetic counseling and molecular genetic testing are recommended to establish the diagnosis and assist with prenatal counseling.

📄 SCRS

Cervical incompetence/
Cervical insufficiency

Cervical incompetence/Cervical insufficiency ultrasound case study

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Reporting Panel

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Cervical Pathology

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Cervical incompetence/Cervical insufficiency ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Grade i – Mild (funneling T-shaped).	View Report Line
2	Grade II – Moderate (Y-shaped or V-shaped funneling)	View Report Line
3	Grade III – Advanced (Marked funneling U-shaped)	View Report Line
4	Grade IV – Severe (Complete Cervical Insufficiency) -PPROM	View Report Line
5	-	-

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CASE–1
Grade I Cervical Insufficiency (Mild – T-Shaped Cervical Configuration)

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Clinical History

A 26-year-old gravida 2 para 1 female at 21 weeks of gestation presented for routine antenatal ultrasound. She had a previous history of second-trimester pregnancy loss. The examination was performed to evaluate the cervix for suspected cervical insufficiency.

Ultrasound Findings

Transvaginal ultrasound demonstrates mild shortening of the cervix, measuring approximately 22 mm. The internal and external cervical os remain closed. The cervical canal maintains a normal T-shaped configuration without significant funneling. No bulging of the fetal membranes into the cervical canal is identified. Amniotic fluid volume is within normal limits. A single live intrauterine fetus corresponding to the gestational age is visualized.

Transvaginal ultrasound of the cervix. Mild cervical shortening with a preserved T-shaped internal os. No cervical funneling or membrane prolapse is demonstrated.

Report Line

The cervix measures approximately 22 mm in length. Both the internal and external cervical os are closed. The cervical canal demonstrates a preserved T-shaped configuration without evidence of funneling or prolapse of the fetal membranes. These findings are consistent with Grade I (mild) cervical insufficiency.

Impression

Mild cervical shortening with preserved T-shaped internal os and no cervical funneling, consistent with Grade I (mild) cervical insufficiency.

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Recommendation

Clinical correlation is recommended. Serial transvaginal cervical length surveillance should be performed. Obstetric consultation is advised to determine the need for progesterone therapy or cervical cerclage based on obstetric history and risk factors.

Key Learning Points

• Grade I represents the earliest stage of cervical insufficiency.
• The cervix is shortened (<25 mm) but both the internal and external os remain closed.
• The internal os maintains a normal T-shaped appearance.
• No cervical funneling or fetal membrane prolapse is present.
• Transvaginal ultrasound is the gold standard for cervical length assessment.
• Serial cervical length monitoring is important in women at increased risk of preterm birth.
• Early identification allows timely intervention with progesterone therapy and, in selected cases, cervical cerclage.

CASE–2
Grade II Cervical Insufficiency (Moderate – Y/V-Shaped Cervical Funneling)

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Clinical History

A 29-year-old gravida 3 para 1 female at 22 weeks of gestation presented for evaluation because of pelvic pressure and a history of one previous spontaneous second-trimester pregnancy loss. Transvaginal ultrasound was requested to assess cervical competence.

Transvaginal ultrasound of the cervix. Mild to moderate opening of the internal cervical os producing a characteristic Y-shaped funnel. The external os remains closed.

Report Line

The cervix measures approximately 18 mm in length. The internal cervical os is dilated with Y-shaped (early V-shaped) funneling extending into the proximal cervical canal, while the external os remains closed. No prolapse of the fetal membranes beyond the external os is identified. Findings are consistent with Grade II (moderate) cervical insufficiency.

Impression

Shortened cervix with Y-shaped/V-shaped funneling of the internal cervical os and a closed external os, consistent with Grade II (moderate) cervical insufficiency.

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Recommendation

Urgent obstetric consultation is recommended. Serial transvaginal cervical length assessment should be performed. Management may include vaginal progesterone therapy or cervical cerclage in appropriate candidates based on gestational age, obstetric history, and clinical findings. The patient should be monitored closely for symptoms of preterm labor.

Key Learning Points

• Grade II cervical insufficiency is characterized by opening of the internal cervical os with preservation of a closed external os.
• The funnel typically progresses from a Y-shaped to a V-shaped configuration as cervical incompetence advances.
• Cervical length is usually <25 mm.
• No fetal membrane prolapse beyond the external os is present at this stage.
• Transvaginal ultrasound is the preferred modality for assessing cervical length and funneling.
• Early diagnosis allows timely intervention, reducing the risk of spontaneous preterm birth.
• Close follow-up is essential because Grade II disease may rapidly progress to advanced cervical insufficiency.

CASE–3
Grade III Cervical Insufficiency (Advanced – U-Shaped Cervical Funneling)

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Clinical History

A 30-year-old gravida 3 para 1 female at 23 weeks of gestation presented with pelvic pressure and intermittent lower abdominal pain. She had a history of one spontaneous second-trimester miscarriage. Transvaginal ultrasound was requested to assess cervical competence.

Ultrasound Findings

Transvaginal ultrasound demonstrates a markedly shortened cervix measuring approximately 10 mm. There is marked dilatation of the internal cervical os with a characteristic U-shaped cervical funnel extending to more than 50% of the cervical length. The external cervical os remains minimally dilated but not completely open. Bulging fetal membranes are seen extending into the endocervical canal without protrusion beyond the external os. Amniotic fluid volume is within normal limits. A single live intrauterine fetus corresponding to the gestational age is visualized.

Transvaginal ultrasound of the cervix. Marked cervical shortening with a U-shaped funnel and bulging fetal membranes extending into the cervical canal.

Report Line

The cervix measures approximately 10 mm in length. Marked dilatation of the internal cervical os with a U-shaped cervical funnel extending through more than half of the cervical canal is noted. The external cervical os is minimally dilated. Bulging fetal membranes are present within the cervical canal without extrusion beyond the external os. These findings are consistent with Grade III (advanced) cervical insufficiency.

Impression

Advanced cervical insufficiency characterized by marked cervical shortening, U-shaped funneling, and bulging fetal membranes within the cervical canal, consistent with Grade III cervical insufficiency.

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Recommendation

Immediate obstetric consultation is recommended. The patient should be evaluated for emergency (rescue) cerclage if appropriate and in the absence of contraindications such as active labor, infection, or ruptured membranes. Close maternal and fetal surveillance is advised with counseling regarding the increased risk of spontaneous preterm birth.

Key Learning Points

• Grade III cervical insufficiency is characterized by marked U-shaped funneling of the internal cervical os.
• The residual functional cervical length is usually <10–15 mm.
• Bulging fetal membranes commonly extend into the endocervical canal.
• The external cervical os may remain closed or become minimally dilated.
• These findings indicate a high risk of imminent spontaneous preterm birth.
• Transvaginal ultrasound is the imaging modality of choice for diagnosis and follow-up.
• Prompt obstetric assessment is essential to determine eligibility for rescue cerclage and optimize pregnancy outcome.

CASE–4
Grade IV Cervical Insufficiency (Severe – Complete Cervical Dilatation)

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Clinical History

A 31-year-old gravida 4 para 1 female at 24 weeks of gestation presented with pelvic pressure, vaginal fluid leakage, and intermittent lower abdominal pain. She had a history of recurrent second-trimester pregnancy losses. Transvaginal and transabdominal ultrasound examinations were requested to assess fetal well-being and cervical competence.

Ultrasound Findings

Ultrasound demonstrates a markedly shortened and completely effaced cervix. Both the internal and external cervical os are widely open, with complete cervical dilatation. The fetal membranes are prolapsing through the cervical canal and beyond the external os. There is rupture of the amniotic membranes (PPROM) with marked oligohydramnios. A single live intrauterine fetus corresponding to approximately 24 weeks of gestation is identified. No placental abnormality is evident.

Transvaginal ultrasound of the cervix. Complete cervical dilatation with both the internal and external cervical os open, prolapsing fetal membranes, and associated marked oligohydramnios following rupture of membranes.

Report Line

The cervix is completely effaced with both the internal and external cervical os widely open. Prolapse of the fetal membranes through the cervical canal is noted. The amniotic membranes are ruptured with marked oligohydramnios. These findings are consistent with Grade IV (severe) cervical insufficiency, complicated by preterm prelabor rupture of membranes (PPROM).

Impression

Grade IV (severe) cervical insufficiency characterized by complete cervical dilatation with both the internal and external cervical os open, prolapsing fetal membranes, PPROM, and marked oligohydramnios. Findings are highly suggestive of inevitable extremely preterm delivery in the appropriate clinical setting.

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Recommendation

Immediate obstetric consultation and hospital admission are recommended. Clinical evaluation should exclude intra-amniotic infection and active labor. Maternal and fetal monitoring should be instituted. Management should follow current obstetric guidelines for PPROM at 24 weeks' gestation, including consideration of antenatal corticosteroids, latency antibiotics, magnesium sulfate for fetal neuroprotection when indicated, and individualized counseling regarding maternal and neonatal outcomes.

Key Learning Points

• Grade IV represents the most advanced stage of cervical insufficiency with complete cervical dilatation.
• Both the internal and external cervical os are open, with little or no residual functional cervical length.
• Fetal membranes commonly prolapse through the external os and may rupture, resulting in PPROM.
• Marked oligohydramnios is a frequent consequence of membrane rupture.
• The condition carries a very high risk of imminent miscarriage or extremely preterm birth.
• Rescue cerclage is generally contraindicated after membrane rupture, established labor, or suspected intra-amniotic infection.
• Urgent multidisciplinary obstetric and neonatal management is essential to optimize maternal and fetal outcomes.

📄 SCRS

Vanishing Twin Syndrome

Vanishing Twin Syndrome ultrasound case study

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Reporting Panel

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Early pregnancy Pathology

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USG

Vanishing Twin Syndrome ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Vanishing Twin Syndrome (Gestational Sac Only)	View Report Line
2	Vanishing Twin Syndrome (Gestational Sac with Embryo)	View Report Line
3	Vanishing Twin Syndrome with a Viable Co-Twin	View Report Line
4	Vanishing Twin Syndrome (Failure of interval growth)	View Report Line
5	Marked intertwin growth discordance	View Report Line

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CASE–1
Vanishing Twin Syndrome (Gestational Sac Only)

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Clinical History

A 28-year-old gravida 1 para 0 female at 11 weeks of gestation presented for a routine first-trimester obstetric ultrasound. An earlier scan had demonstrated an early twin gestation. The patient reported mild vaginal spotting that had resolved spontaneously and denied significant abdominal pain.

Ultrasound Findings

Ultrasound examination demonstrates a single viable intrauterine pregnancy with fetal biometric parameters appropriate for the gestational age and normal fetal cardiac activity. Adjacent to the viable gestational sac, a second small collapsed gestational sac is identified without a yolk sac or fetal pole. The sac demonstrates irregular margins and features of resorption. No subchorionic hematoma is seen. Both ovaries appear unremarkable, and no free fluid is identified within the pelvis.

Report Line

A live intrauterine fetus with appropriate growth and normal fetal cardiac activity is demonstrated. A second collapsed gestational sac is seen without a yolk sac or embryo, consistent with resorption of a nonviable co-twin. The findings are compatible with vanishing twin syndrome (gestational sac only).

Impression

Vanishing twin syndrome (gestational sac only). A viable singleton intrauterine pregnancy is present with an adjacent collapsed empty gestational sac representing a resorbing nonviable co-twin.

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Recommendation

Routine obstetric follow-up with serial ultrasound examinations is recommended to monitor the ongoing singleton pregnancy. The prognosis for the surviving fetus is generally excellent when vanishing twin syndrome occurs during the first trimester. Clinical review is advised if significant vaginal bleeding, abdominal pain, or other concerning symptoms develop.

Key Learning Points

• Vanishing twin syndrome may present as a residual empty gestational sac without a yolk sac or embryo.
• The gestational sac progressively collapses and is gradually resorbed during pregnancy.
• The surviving singleton fetus usually demonstrates normal growth and cardiac activity.
• Most first-trimester cases have an excellent prognosis for the remaining fetus.
• Serial ultrasound examinations confirm continued fetal growth and gradual disappearance of the residual gestational sac.
• Patient counseling and reassurance are important aspects of management.

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CASE–2
Vanishing Twin Syndrome (Gestational Sac with Embryo)

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Clinical History

A 30-year-old gravida 2 para 1 female at 10 weeks of gestation presented for a routine first-trimester obstetric ultrasound. A previous ultrasound had demonstrated a twin gestation. The patient reported mild intermittent vaginal spotting without significant abdominal pain. Follow-up ultrasound was performed to assess fetal viability.

Report Line

A viable singleton intrauterine pregnancy is identified with appropriate fetal growth and normal cardiac activity. A second gestational sac contains a nonviable embryo without cardiac activity and demonstrates partial collapse, consistent with embryonic demise. These sonographic findings are compatible with vanishing twin syndrome (gestational sac with embryo).

Impression

Vanishing twin syndrome (gestational sac with embryo). A viable singleton intrauterine pregnancy coexists with a second gestational sac containing a nonviable embryo, consistent with spontaneous demise of one twin during early pregnancy.

Go To Table

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CASE–3
Vanishing Twin Syndrome with a Viable Co-Twin

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Clinical History

A 30-year-old gravida 2 para 1 female at 10 weeks of gestation presented for a routine first-trimester obstetric ultrasound. A previous early pregnancy scan had demonstrated a diamniotic twin gestation. The patient reported a brief episode of mild vaginal spotting one week earlier, with no significant abdominal pain or passage of tissue. Follow-up ultrasound was requested to assess fetal viability and pregnancy progression.

Twin B:. Twin B demonstrates a CRL of approximately 34 mm (10w 2D) with absent cardiac activity, compatible with fetal demise. Twin B remains viable, consistent with vanishing twin syndrome.

Twin A: Twin A demonstrates a single live intrauterine fetus with biometric parameters as follows: BPD 31.29 mm, HC 105.9 mm, AC 88.6 mm, and FL 14.4 mm, corresponding to a composite gestational age of 15 weeks 3 days. The estimated date of delivery (EDD) by composite ultrasound age is 21-12-2026. The estimated fetal weight (EFW) is 105.56 ± 15.8 grams. Fetal cardiac activity is present with a fetal heart rate (FHR) of 167 bpm. Amniotic fluid volume is within normal limits. Twin B demonstrates features of fetal demise with a collapsed gestational sac/fetal remnant, consistent with vanishing twin syndrome.

Single live intrauterine fetus: A single loop of the umbilical cord is seen encircling the fetal neck (single-loop nuchal cord). Fetal cardiac activity is present with a normal heart rate. Fetal movements and amniotic fluid volume are within normal limits.

Report Line

A live intrauterine fetus is demonstrated with biometric parameters corresponding to 15 weeks 3 days gestation. Fetal cardiac activity is present (FHR: 167 bpm) with normal amniotic fluid volume. A second gestational sac contains a collapsed fetal remnant without cardiac activity, consistent with fetal demise. These findings are in keeping with vanishing twin syndrome with a viable co-twin.

Impression

Vanishing twin syndrome with a viable co-twin. One live intrauterine fetus of approximately 15 weeks 3 days gestation is identified with normal cardiac activity, while the second twin demonstrates fetal demise with a collapsed gestational sac/fetal remnant, compatible with vanishing twin syndrome.

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CASE–4
Vanishing Twin Syndrome (Failure of Interval Growth)

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Clinical History

A 31-year-old gravida 2 para 1 female presented for a follow-up obstetric ultrasound at 15 weeks of gestation. A previous first-trimester ultrasound had demonstrated a viable twin pregnancy. The current examination was requested to assess interval fetal growth and viability. The patient was asymptomatic except for a history of mild vaginal spotting during early pregnancy.

Report Line

Follow-up ultrasound demonstrates one viable intrauterine fetus with appropriate interval growth and normal fetal cardiac activity. The co-twin demonstrates failure of interval growth compared with the previous examination, with absent fetal cardiac activity and sonographic features of fetal demise. These findings are compatible with vanishing twin syndrome secondary to failure of interval growth of the co-twin.

Impression

Vanishing twin syndrome (Failure of Interval Growth). One viable intrauterine fetus demonstrates appropriate interval growth, while the co-twin shows failure of interval growth with absent cardiac activity, consistent with intrauterine fetal demise and subsequent vanishing twin syndrome.

Go To Table

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CASE–5
Vanishing Twin Syndrome (Marked Intertwin Growth Discordance)

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Clinical History

A 30-year-old gravida 2 para 1 female presented for a follow-up obstetric ultrasound at 16 weeks of gestation. A previous examination had demonstrated a twin pregnancy. The current scan was performed to evaluate fetal growth and well-being after concern regarding discordant fetal development on an earlier study.

Report Line

Follow-up ultrasound demonstrates one viable intrauterine fetus with appropriate interval growth and normal fetal cardiac activity. The co-twin demonstrates marked intertwin growth discordance, measuring significantly smaller than expected for gestational age with absent fetal cardiac activity and sonographic features of fetal demise. These findings are consistent with vanishing twin syndrome associated with marked intertwin growth discordance.

Impression

Vanishing Twin Syndrome (Marked Intertwin Growth Discordance). One viable intrauterine fetus demonstrates appropriate growth and normal cardiac activity, while the co-twin is markedly growth restricted with absent cardiac activity, consistent with fetal demise and subsequent vanishing twin syndrome.

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📄 SCRS

Placenta previa

Placenta previa ultrasound case study

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Reporting Panel

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Placenta previa Pathology

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Placenta previa ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Low-lying placenta	View Report Line
2	Marginal previa (Posterior)	View Report Line
3	Partial previa	View Report Line
4	Complet previa	View Report Line
5	-	-

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CASE–1
Low-Lying Placenta

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Clinical History

A 30-year-old pregnant female at 30 weeks of gestation presented with painless vaginal spotting. Obstetric ultrasound was requested to assess placental location and fetal well-being. There was no history of abdominal trauma or uterine contractions.

Ultrasound Findings

Ultrasound examination demonstrates a single live intrauterine fetus with appropriate cardiac activity. The placenta is located along the lower uterine segment, with the placental edge lying approximately 1.5 cm from the internal cervical os. The placenta does not cover the os. Placental echotexture is homogeneous without evidence of retroplacental hematoma or placental abruption. Amniotic fluid volume is within normal limits. Fetal biometry is appropriate for gestational age. The cervix appears closed and measures within normal limits.

Obstetric ultrasound. The placental edge is seen within 2 cm of the internal cervical os without covering it, consistent with a low-lying placenta.

Report Line

The placenta is implanted in the lower uterine segment with its inferior margin lying approximately 1.5 cm from the internal cervical os. There is no evidence of placenta previa, retroplacental hematoma, or placental abruption. The cervix remains closed. Findings are consistent with a low-lying placenta.

Impression

Features are consistent with a low-lying placenta, with the placental edge located within 2 cm of the internal cervical os but not covering it. No sonographic evidence of placenta previa or placental abruption.

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Recommendation

Follow-up ultrasound examination is recommended during the third trimester (usually at 32–36 weeks) to reassess placental position, as many low-lying placentas migrate upward with advancing pregnancy. Patients should seek immediate medical attention if vaginal bleeding, abdominal pain, or contractions occur. Delivery planning should be based on the final placental location and obstetric assessment.

Key Learning Points

• A low-lying placenta is defined as the placental edge lying within 2 cm of the internal cervical os without covering it.
• Transvaginal ultrasound is the gold standard for accurate assessment of placental location.
• Most low-lying placentas diagnosed during the second trimester migrate upward as pregnancy progresses.
• Placenta previa is diagnosed only when the placenta partially or completely covers the internal cervical os.
• Painless vaginal bleeding during the second or third trimester is the most common clinical presentation.
• Color Doppler evaluation helps assess placental vascularity and identify associated abnormalities when indicated.
• Repeat imaging at 32–36 weeks is recommended before determining the mode of delivery.

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CASE–2
Marginal Placenta Previa

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Clinical History

A 32-year-old gravida 2 para 1 female at 33 weeks of gestation presented with recurrent painless vaginal bleeding. Obstetric ultrasound was requested to evaluate placental location and fetal well-being. There was no history of abdominal trauma or uterine contractions.

Obstetric ultrasound. The placental edge extends up to the internal cervical os without covering it, consistent with marginal placenta previa.

Report Line

The placenta is located along the posterior wall of the lower uterine segment, with its inferior placental margin reaching the internal cervical os without extending beyond it. No evidence of retroplacental hematoma, placental abruption, or abnormal placental vascularity is identified. The cervix remains closed. Findings are consistent with posterior marginal placenta previa.

Impression

Sonographic features are consistent with posterior marginal placenta previa, with the placental edge reaching the internal cervical os without covering it. No sonographic evidence of placental abruption.

Go To Table

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CASE–3
Partial Placenta Previa

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Clinical History

A 29-year-old gravida 3 para 2 female at 34 weeks of gestation presented with recurrent episodes of painless bright-red vaginal bleeding. Obstetric ultrasound was requested to evaluate placental location and fetal well-being. There was no history of abdominal trauma or uterine contractions.

Obstetric ultrasound. The placenta extends over and partially covers the internal cervical os, consistent with partial placenta previa.

Report Line

The placenta is located in the lower uterine segment with placental tissue partially covering the internal cervical os. No retroplacental hematoma, placental abruption, or abnormal placental vascularity is identified. The cervix remains closed. Findings are consistent with partial placenta previa.

Impression

Sonographic features are consistent with partial placenta previa, with partial coverage of the internal cervical os. No evidence of placental abruption or other acute placental abnormality.

Go To Table

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CASE–4
Complete Placenta Previa

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Clinical History

A 35-year-old gravida 4 para 3 female at 35 weeks of gestation presented with recurrent episodes of painless profuse vaginal bleeding. She had a previous history of cesarean section. Obstetric ultrasound was requested to determine placental location and assess fetal well-being.

Obstetric ultrasound. The placenta completely overlies the internal cervical os, consistent with complete placenta previa.

Report Line

The placenta is located in the lower uterine segment and completely covers the internal cervical os. No evidence of retroplacental hematoma, placental abruption, or abnormal placental vascularity is identified. The cervix remains closed. Findings are consistent with complete placenta previa.

Impression

Sonographic features are consistent with complete placenta previa, with complete coverage of the internal cervical os. No sonographic evidence of placental abruption. This represents a high-risk obstetric condition.

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📄 SCRS

Nabothian Cyst

Nabothian Cyst ultrasound case study

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Reporting Panel

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Uterine Pathology

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USG

Nabothian Cyst ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Single Nabothian Cyst	View Report Line
2	Multiple Nabothian Cyst	View Report Line
3	-	-
4	-	-
5	-	-

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CASE–1
Single Nabothian Cyst

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Clinical History

A 36-year-old female presented with chronic pelvic pain and occasional vaginal discharge. Pelvic ultrasound was performed as part of the evaluation. There was no history of abnormal uterine bleeding or cervical malignancy.

Ultrasound Findings

Ultrasound examination demonstrates a well-defined, thin-walled, anechoic cystic lesion measuring approximately 8–15 mm within the cervical stroma. The lesion shows posterior acoustic enhancement without internal septations, mural nodules, or internal vascularity on Color Doppler. The remainder of the cervix appears normal. The uterus and bilateral ovaries are unremarkable. No pelvic free fluid is identified.

Ultrasound of the cervix. A well-defined anechoic cyst is seen within the cervical stroma demonstrating posterior acoustic enhancement and no internal vascularity, consistent with a single Nabothian cyst.

Report Line

A solitary well-defined anechoic thin-walled cyst measuring approximately 8 × 7 mm is identified within the cervical stroma, demonstrating posterior acoustic enhancement without internal echoes, septations, mural nodules, or internal vascularity on Color Doppler. No suspicious cervical mass or associated pelvic abnormality is seen. Findings are consistent with a benign Nabothian cyst.

Impression

Features are consistent with a single benign Nabothian cyst of the cervix. No sonographic evidence of cervical neoplasm or other significant pelvic pathology.

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Recommendation

Nabothian cysts are common benign retention cysts of the cervix and usually require no treatment. Clinical follow-up is recommended only if the lesion is unusually large, symptomatic, atypical in appearance, or associated with abnormal cervical examination findings. Routine gynecological evaluation and cervical screening should continue as clinically indicated.

Key Learning Points

• Nabothian cysts are benign mucus retention cysts resulting from obstruction of endocervical glands.
• Ultrasound typically demonstrates a small, well-circumscribed anechoic cyst within the cervical stroma.
• Posterior acoustic enhancement and absence of internal vascularity are characteristic features.
• Most Nabothian cysts are incidental findings and require no treatment.
• Large or atypical cystic cervical lesions should be differentiated from cervical tunnel clusters, Gartner duct cysts, cervical endometriosis, or cystic cervical neoplasms.
• Correlation with pelvic examination and cervical screening is recommended when clinically indicated.
• Routine follow-up imaging is generally unnecessary for a typical asymptomatic Nabothian cyst.

Report Line

Multiple well-defined anechoic thin-walled cysts are identified within the cervical stroma, the largest measuring approximately 8 × 7 mm. The cysts demonstrate posterior acoustic enhancement without internal echoes, septations, mural nodules, or internal vascularity on Color Doppler. No suspicious cervical mass or associated pelvic abnormality is seen. Findings are consistent with multiple benign Nabothian cysts.

Impression

Features are consistent with multiple benign Nabothian cysts of the cervix. No sonographic evidence of cervical neoplasm or other significant pelvic pathology.

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