Cervical Examination in Labor

Aka: Cervical Examination in Labor, Uterine Cervical Length

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II. Technique: Mnemonic: 5C's

  1. Clean (Sterile technique)
  2. Catheterize or empty Bladder before examination
  3. Cervical evaluation (See Bishop Score)
    1. Cervical Dilation
    2. Cervical Effacement
  4. Caput forming?
  5. Cord
    1. Indicated by pulsations behind membranes

III. Evaluation: (Mnemonic 5P's)

  1. Presentation
    1. See Fetal Presentation
  2. Position
    1. See Fetal Position
  3. Place (Station)
    1. See Bishop Score
  4. Pelvis
    1. See Pelvimetry
  5. Puncture (Assess for Rupture of Membranes)

IV. Interpretation: Cervical Length based on Transvaginal Ultrasound and prediction of preterm delivery before 35 weeks

  1. Cervical Length <2 cm
    1. Week 24: Positive Predictive Value 25%
    2. Week 28: Positive Predictive Value 16.7%
  2. Cervical Length <2.5 cm
    1. Week 24: Positive Predictive Value 17.8%
    2. Week 28: Positive Predictive Value 11.3%
  3. Cervical Length <3 cm
    1. Week 24: Positive Predictive Value 9.3%
    2. Week 28: Positive Predictive Value 7.0%
  4. References
    1. Iams (1996) N Engl J Med 334(9): 567-72 [PubMed]

V. References

  1. Gordon (1995) Obstetrics and Gynecology, Scrub, p. 17

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