|
Name
|
cervical ectropion
|
|
Synonyms
|
cervical eversion, pseudoeversion secondary to DES adenosis
|
General
description
|
presence of endocervical glandular epithelium on the cervix surface (portio)
|
|
Is it common?
|
it is common in teenagers and may be seen in pregnancy, and in women on oral
contraceptives
|
Differentiating
features
|
a transition zone from flat, squamous epithelium to raised, glandular epithelium
can be seen along edges of eversion. There may be an increased, clear
cervical discharge. The presence of the glandular epithelium differentiates eversion
from erosion. A cervical erosion may appear reddened but
the epithelium is denuded and mucous is not clear.
|
|
Other features
|
can be confused with chronic cervicitis (cervical erosion) but in that case the woman usually has
a yellowish, mucous (mucopurulent) discharge
|
|
Cause
|
In teens it is common because the glandular epithelium has not
fully receded under the chronic acidity of the vaginal fluids after
menses start. In women whose mothers were exposed to diethylstilbesterol (DES)
in utero, the glandular tissue stays on the outside of the cervix and even sometimes
over onto the vagina as a developmental birth defect.
|
Unnecessary
studies
|
Cervical biopsy is usually not necessary since it can be recognized
visually without magnification. Occasionally colposcopy visualization
is needed.
|
Natural history
untreated
|
gradually the glandular epithelium is replaced by flat, squamous
epithelium under the acid effect of vaginal secretions. This process
is called metaplasia and can sometimes result in small patchy areas
of glandular epithelium on the face of the cervix or the metaplastic
process can block off endocervical glands and result in mucous pockets
called nabothian cysts.
|
Goals of
therapy (Rx)
|
do no harm, this is not a disease process but rather a common
physical fnding variant
|
|
1st choice therapy
|
explain the finding so that the woman knows about it and so that future
examiners will not try to offer an unneeded treatment
|
|
Other therapies used
|
none
|
Treatments to
avoid
|
any destructive therapy to the cervix such as laser, cryosurgery,
cautery or conization of the cervix
|
Reason for Rx
choices
|
this is a normal anatomical variation
|
|
References
|
Dunnihoo, DR (ed.), Fundamentals of Gynecology and Obstetrics,
J.B. Lippincott, Philadelphia, 1990: 178.
|
|
Other resources
|
|
