Table 1: A sample of fullfilled 3 × 3 grid used for POP-Q clinical documentation at 12 weeks of gestation .
The locations of the six defined points when the prolapse is fully reduced.Anterior vaginal wall:
1. Point Aa: A point located in the midline of the anterior vaginal wall three (3) cm proximal to the external urethral meatus. The potential range of position of Point Aa relative to the hymen is -3, indicating no anterior vaginal POP, to +3 cm which is full prolapse.
2. Point Ba: A point that represents the most distal (ie, most dependent) position of any part of the upper anterior vaginal wall (between the vaginal cuff or anterior vaginal fornix and Point Aa). Point Ba coincides with Point Aa (-3 cm) in a woman who has no anterior POP. In a woman with severe POP, Ba coincides with Point C.
3. Point C: A point on either the most distal (ie, most dependent) edge of the cervix or the leading edge of the vaginal cuff (hysterectomy scar).
4. Point D: The posterior fornix in a woman who still has a cervix.
Posterior vaginal wall:
5. Point Ap: A point located in the midline of the posterior vaginal wall three (3) cm proximal to the hymen. The potential range of position of Point Ap relative to the hymen is -3 to +3 cm.
6. Point Bp: A point that represents the most distal position of any part of the upper posterior vaginal wall (between the vaginal cuff or posterior vaginal fornix and Point Ap).
Three further descriptive landmarks and measurements:
1. The genital hiatus (GH) is measured from the middle of the external urethral meatus to the posterior margin of the hymen.
2. The total vaginal length (TVL) is the length of the vagina (cm) from posterior fornix to hymen when Point C or D is reduced to its full normal position.
3. The perineal body (PB) is measured from the posterior margin of the hymen to the mid-anal opening.