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Cervical Evaluation

From Ancient Medicine to Precision Medicine

Feltovich, Helen MD, MS

doi: 10.1097/AOG.0000000000002106
Contents: Clinical Expert Series
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Since ancient times, cervical assessment for predicting timing of delivery has relied primarily on digital (subjective) assessment of dilatation, softening, and length. To date, transvaginal ultrasound cervical length is the only one of these parameters that meets criteria for a biomarker; no objective, quantitative measure of cervical dilatation or softening has gained clinical acceptance. This review discusses how the cervix has been assessed from ancient times to the present day and how a precision medicine approach could improve understanding of not only the cervix, but also parturition in general.

Cervical evaluation today is primarily subjective and nonquantitative, but precision medicine offers the promise of objective biomarkers for predicting timing of delivery.

Department of Maternal–Fetal Medicine, Intermountain Healthcare, Utah Valley Hospital, Provo, Utah; and the Department of Medical Physics, University of Wisconsin–Madison, Madison, Wisconsin.

Corresponding author: Helen Feltovich, MD, MS, Maternal–Fetal Medicine, Intermountain Healthcare, Utah Valley Hospital, 1034 N 500 W, Provo, UT 84604; email:

Continuing medical education for this article is available at

The author has indicated that she has met the journal's requirements for authorship.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.