Cervical Evaluation: From Ancient Medicine to Precision Medicine

Area of Science:

• Reproductive biology
• Maternal-fetal medicine
• Biomedical engineering

Background:

• Traditional cervical assessment for predicting delivery timing relies on subjective digital evaluation of dilatation, softening, and length.
• Objective, quantitative measures for cervical dilatation and softening lack widespread clinical acceptance.
• Transvaginal ultrasound measurement of cervical length is currently the sole validated objective biomarker.

Observation:

• Historical methods of cervical assessment are reviewed, tracing from ancient practices to modern techniques.
• The limitations of subjective assessments in predicting parturition are highlighted.
• The need for objective, quantitative biomarkers in cervical assessment is emphasized.

Findings:

• No objective, quantitative measure for cervical dilatation or softening has achieved clinical acceptance.
• Transvaginal ultrasound cervical length is the only parameter meeting biomarker criteria.
• A review of historical and current cervical assessment methods is presented.

Implications:

• A precision medicine approach could significantly advance the understanding of cervical physiology during pregnancy.
• Improved objective assessment of the cervix may lead to more accurate prediction of parturition timing.
• Enhanced understanding of the cervix can contribute to a broader comprehension of the physiological processes of childbirth.